Prophylactic Antiemetics for Haematological Malignancies: Prospective Nationwide Survey Subset Analysis in Japan

In Vivo. 2019 Jul-Aug;33(4):1355-1362. doi: 10.21873/invivo.11611.

Abstract

Background/aim: Although neurokinin-1 receptor antagonists are approved chemotherapy drugs in Japan, no nationwide surveys have been performed to validate chemotherapy-induced nausea and vomiting (CINV) guidelines in clinical practice. This study evaluated CINV in patients with haematological malignancies starting first-time chemotherapy.

Patients and methods: A nationwide CINV survey on patients with haematological malignancies was conducted at 118 institutions. Patients undergoing moderately emetic chemotherapy (n=17) and highly emetic chemotherapy (HEC; n=180) were compared.

Results: Forty-one patients undergoing HEC received triple antiemetics. Female gender and young age were risk factors for early-phase nausea, while female gender remained a risk factor for late-phase nausea and vomiting. Among 125 patients receiving CHOP (doxorubicin, cyclophosphamide, vincristine, prednisone)-like regimens, complete response and complete control were increased in patients receiving triple antiemetics, compared to those with double antiemetics.

Conclusion: Guideline compliance was very low. Although not statistically significant, there was a trend for reduced CINV and improved disease control for triple versus double antiemetics, suggesting that triple antiemetics should be considered for HEC, especially in young female patients with non-Hodgkin lymphoma receiving CHOP-like regimens.

Keywords: Antiemetic; CHOP therapy; chemotherapy-induced nausea and vomiting; haematological malignancies.

MeSH terms

  • Adult
  • Aged
  • Antiemetics / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Female
  • Health Care Surveys
  • Hematologic Neoplasms / complications*
  • Hematologic Neoplasms / drug therapy
  • Hematologic Neoplasms / epidemiology
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Nausea / diagnosis
  • Nausea / epidemiology
  • Nausea / etiology*
  • Nausea / prevention & control*
  • Premedication
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vomiting / diagnosis
  • Vomiting / epidemiology
  • Vomiting / etiology*
  • Vomiting / prevention & control*

Substances

  • Antiemetics