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Yokomizo A, Nakashima K, Iba A, Okita K, Wada M, Iino K, Akechi T, Iihara H, Imamura CK, Okuyama A, Ozawa K, Kim YI, Sasaki H, Satomi E, Takeda M, Tanaka R, Nakajima TE, Nakamura N, Nishimura J, Noda M, Hayashi K, Higashi T, Boku N, Matsumoto K, Matsumoto Y, Yamamoto N, Aogi K, Abe M. Efficacy and safety of dexamethasone sparing for the prevention of nausea and vomiting associated with highly emetogenic risk antineoplastic agents: a systematic review and meta-analysis of the Clinical Practice Guidelines for Antiemesis 2023 from the Japan Society of Clinical Oncology. Int J Clin Oncol 2024:10.1007/s10147-024-02624-x. [PMID: 39340704 DOI: 10.1007/s10147-024-02624-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 09/01/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND Chemotherapy-induced nausea and vomiting (CINV) are common side effects, classified according to timing and severity. Conventional agents such as dexamethasone are effective but have various side effects. For moderately emetogenic chemotherapy, dexamethasone-sparing antiemetic therapies have been developed to minimize these side effects. This systematic review evaluated the efficacy and safety of dexamethasone-sparing antiemetic therapy for highly emetogenic chemotherapy (HEC). METHODS We performed a thorough literature search for studies related to dexamethasone-sparing antiemetic therapy with neurokinin-1 antagonists (NK1RA) for HEC using the PubMed, Cochrane Library, and Ichushi-Web databases. A qualitative analysis of the combined data was performed and risk differences with confidence intervals were calculated. RESULTS Two reviewers independently assessed the 425 records and 12 full-text articles were evaluated for eligibility. Two studies were included in the qualitative and meta-analyses. These studies included anthracycline-cyclophosphamide (AC) regimens and cisplatin-based regimens, with palonosetron as the serotonin receptor antagonist. In the two studies, no difference was found in the prevention of vomiting (delayed complete response). However, non-inferiority was not demonstrated in the subgroup that received cisplatin-containing regimens. Delayed complete control showed different results for nausea prevention; however, there was no significant difference in the meta-analysis. Only one report has shown non-inferiority for delayed total control. Although the strength of evidence for individual outcomes varied, there was no difference in the duration of dexamethasone administration. CONCLUSIONS This systematic review and meta-analysis revealed that dexamethasone-sparing antiemetic therapy with NK1RA and palonosetron can be used to prevent CINV in HEC, limited to AC combination therapy.
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Affiliation(s)
- Ayako Yokomizo
- Department of Early Clinical Development, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kazuhisa Nakashima
- Faculty of Medicine, Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan.
| | - Arisa Iba
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Kenji Okita
- Department of Surgery, Otaru Ekisaikai Hospital, 1-4-1, Inaho, Otaru, Hokkaido, 047-0032, Japan
| | - Makoto Wada
- Department of Psycho-Oncology and Palliative Medicine, Osaka International Cancer Institute, Otemae 3-1-69, Chuo-ku, Osaka, 541-8567, Japan
| | - Keiko Iino
- School of Nursing, National College of Nursing School of Nursing, National College of Nursing, Japan, 1-2-1, Umezono, Kiyose, Tokyo, 204-8575, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan
| | - Chiyo K Imamura
- Advanced Cancer Translational Research Institute, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Ayako Okuyama
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan
| | - Keiko Ozawa
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yong-Il Kim
- Division of Medical Oncology, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higasiyodogawa-ku, Osaka, 533-0024, Japan
| | - Hidenori Sasaki
- Division of Medical Oncology, Hematology and Infectious Disease, Fukuoka University Hospital, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Fukuoka, 814-0180, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masayuki Takeda
- Department of Cancer Genomics and Medical Oncology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Ryuhei Tanaka
- Department of Pediatric Hematology/Oncology, International Medical Center, Saitama Medical University, 1398-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Takako Eguchi Nakajima
- Department of Early Clinical Development, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Naoki Nakamura
- Department of Radiation Oncology, St. Marianna University, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan
| | - Junichi Nishimura
- Department of Gastroenterological Surgery, Oisana International Cancer Institute, 3-1-69, Otemae, Chuoku, Osaka, 541-8567, Japan
| | - Mayumi Noda
- Non-Profit Organization Sasaeau-Kai "Alpha", 518-7 Kawado-cho, Chuo-ku, Chiba-shi, Chiba, 260-0802, Japan
| | - Kazumi Hayashi
- Department of Clinical Oncology and Hematology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi Minato-ku, Tokyo, 105-8461, Japan
| | - Takahiro Higashi
- Department of Public Health and Health Policy, The University of Tokyo, 7-3-1 Hongo, Bunkyoku, Tokyo, 113-0033, Japan
| | - Narikazu Boku
- Department of Oncology and General Medicine, IMSUT Hospital, Institute of Medical Science, University of Tokyo, 4-6-1, Shiroganedai, Minatoku, Tokyo, 108-8639, Japan
| | - Koji Matsumoto
- Division of Medical Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-0021, Japan
| | - Yoko Matsumoto
- Non-Profit Organization Ehime Cancer Support "Orange-no-kai", 3-8-24 FurukawaMinami, Matsuyama, Ehime, 790-0943, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, Kimiidera 811-1, Wakayama, Wakayama, 541-8509, Japan
| | - Kenjiro Aogi
- Department of Breast Surgery, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-matchi, Matsuyama, Ehime, 791-0280, Japan
| | - Masakazu Abe
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu, Shizuoka, 431-3192, Japan
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Belluomini L, Avancini A, Sposito M, Pontolillo L, Tregnago D, Trestini I, Insolda J, Carbognin L, Milella M, Bria E, Pilotto S. Integrating nutrition, physical exercise, psychosocial support and antiemetic drugs into CINV management: The road to success. Crit Rev Oncol Hematol 2024; 201:104444. [PMID: 39002789 DOI: 10.1016/j.critrevonc.2024.104444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/26/2024] [Accepted: 07/06/2024] [Indexed: 07/15/2024] Open
Abstract
Over the years, advancements in antiemetic drugs have improved chemotherapy-induced nausea and vomiting (CINV) control. However, despite the antiemetics therapies, in a relevant number of adult patients (∼30 %), CINV is still persistent, leading to several complications, such as electrolyte imbalances, anorexia, and treatment discontinuation. Supportive care interventions have gained credibility in cancer care, helping to improve patients' psycho-physical condition, quality of life, and managing symptoms, including CINV. Physical exercise and tailored nutritional counseling have demonstrated benefits in reducing the severity of nausea and vomiting. Psychological intervention has been postulated as a key approach in controlling anticipatory nausea/vomiting, as well as acupuncture/acupressure has been shown to decrease nausea and vomiting after chemotherapy treatments. In the current review, we aim to provide a clinical update on current prophylactic and delayed antiemetic guidelines for CINV and an overview of the non-pharmacological interventions tested for alleviating CINV in patients with cancer.
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Affiliation(s)
- Lorenzo Belluomini
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Alice Avancini
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Marco Sposito
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Letizia Pontolillo
- UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Medical Oncology, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Daniela Tregnago
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Ilaria Trestini
- Dietetic Service, Hospital Medical Direction, University and Hospital Trust (AOUI) of Verona, Italy.
| | - Jessica Insolda
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Luisa Carbognin
- UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Medical Oncology, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Michele Milella
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
| | - Emilio Bria
- UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Medical Oncology, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Sara Pilotto
- Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.
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Walsh DJ, O'Driscoll M, Sahm LJ, Meagher AM, Doblas P, McGowan E, Smith-Lehane G, Hannan M, Goggin C, Buckley C, Horgan AM. Ageing-related considerations for medication used in supportive care in cancer. J Geriatr Oncol 2024; 15:101760. [PMID: 38556399 DOI: 10.1016/j.jgo.2024.101760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/23/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
Both randomized controlled trials (RCTs) and retrospective studies have shown that a comprehensive geriatric assessment (CGA) prior to a patient commencing systemic anti-cancer therapy (SACT) results in improved quality of life outcomes and is associated with a decreased risk of grade 3-5 toxicity; however, data are lacking in relation to adverse drug events (ADE) associated with supportive care medications. Supportive care medications are prescribed as prophylactic agents in a SACT regimen, for management of treatment related toxicity and for symptoms caused by the disease itself. While necessary, the commencement of SACT and supportive medications may cause, or exacerbate, a significant drug burden in older patients, some of whom may have existing comorbidities. For many medications, older adults are underrepresented in pharmacokinetic and pharmacodynamic modelling studies. In this article we will review ageing-related changes in pharmacokinetics and pharmacodynamics, as well as how these changes may impact supportive care medications. Additional considerations for prescribing these medications in older adults with cancer, such as polypharmacy, potentially inappropriate medications, drug-drug interactions, and anticholinergic burden, as well as ageing-related considerations and recommendations for supportive care medications commonly used in older adults with cancer are also reviewed.
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Affiliation(s)
- Darren J Walsh
- Pharmacy Department, University Hospital Waterford, Waterford, Ireland; Oncology Department, University Hospital Waterford, Waterford, Ireland; Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
| | - Michelle O'Driscoll
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Laura J Sahm
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland; Department of Pharmacy, Mercy University Hospital, Grenville Place, Cork. Ireland
| | - Anne Marie Meagher
- Pharmacy Department, University Hospital Waterford, Waterford, Ireland; Oncology Department, University Hospital Waterford, Waterford, Ireland
| | - Pedro Doblas
- Pharmacy Department, University Hospital Waterford, Waterford, Ireland; Oncology Department, University Hospital Waterford, Waterford, Ireland
| | - Eimear McGowan
- Pharmacy Department, University Hospital Waterford, Waterford, Ireland; Oncology Department, University Hospital Waterford, Waterford, Ireland
| | - Gráinne Smith-Lehane
- Pharmacy Department, University Hospital Waterford, Waterford, Ireland; Oncology Department, University Hospital Waterford, Waterford, Ireland
| | - Michelle Hannan
- Oncology Department, University Hospital Waterford, Waterford, Ireland
| | - Caitríona Goggin
- Oncology Department, University Hospital Waterford, Waterford, Ireland
| | - Carol Buckley
- Oncology Department, University Hospital Waterford, Waterford, Ireland
| | - Anne M Horgan
- Oncology Department, University Hospital Waterford, Waterford, Ireland
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Herrstedt J, Celio L, Hesketh PJ, Zhang L, Navari R, Chan A, Saito M, Chow R, Aapro M. 2023 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following high-emetic-risk antineoplastic agents. Support Care Cancer 2023; 32:47. [PMID: 38127246 PMCID: PMC10739516 DOI: 10.1007/s00520-023-08221-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE This systematic review updates the MASCC/ESMO recommendations for high-emetic-risk chemotherapy (HEC) published in 2016-2017. HEC still includes cisplatin, carmustine, dacarbazine, mechlorethamine, streptozocin, and cyclophosphamide in doses of > 1500 mg/m2 and the combination of cyclophosphamide and an anthracycline (AC) in women with breast cancer. METHODS A systematic review report following the PRISMA guidelines of the literature from January 1, 2015, until February 1, 2023, was performed. PubMed (Ovid), Scopus (Google), and the Cochrane Database of Systematic Reviews were searched. The literature search was limited to randomized controlled trials, systematic reviews, and meta-analyses. RESULTS Forty-six new references were determined to be relevant. The main topics identified were (1) steroid-sparing regimens, (2) olanzapine-containing regimens, and (3) other issues such as comparisons of antiemetics of the same drug class, intravenous NK1 receptor antagonists, and potentially new antiemetics. Five updated recommendations are presented. CONCLUSION There is no need to prescribe steroids (dexamethasone) beyond day 1 after AC HEC, whereas a 4-day regimen is recommended in non-AC HEC. Olanzapine is now recommended as a fixed part of a four-drug prophylactic antiemetic regimen in both non-AC and AC HEC. No major differences between 5-HT3 receptor antagonists or between NK1 receptor antagonists were identified. No new antiemetic agents qualified for inclusion in the updated recommendations.
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Affiliation(s)
- Jørn Herrstedt
- Department of Clinical Oncology, Zealand University Hospital, Sygehusvej 10, DK-4000, Roskilde, Denmark.
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | | | - P J Hesketh
- Division of Hematology Oncology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - L Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - R Navari
- World Health Organization, Birmingham, Alabama, USA
| | - A Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, CA, USA
| | - M Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - R Chow
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - M Aapro
- Genolier Cancer Center, Genolier, Switzerland
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