Emetogenicity and Risk Factors of Nausea and Vomiting in Patients With Metastatic Colorectal Cancer Receiving Trifluridine/Tipiracil and Bevacizumab Chemotherapy

Anticancer Res. 2023 May;43(5):2351-2357. doi: 10.21873/anticanres.16400.

Abstract

Background/aim: Although combination chemotherapy with trifluridine/tipiracil (TAS-102) and bevacizumab (BEV) is highly effective for metastatic unresectable colorectal cancer (mCRC), this combination chemotherapy often induces nausea and vomiting. To identify risk factors for nausea and vomiting, we investigated the occurrence of nausea and vomiting in mCRC patients treated with TAS-102 and BEV.

Patients and methods: Study patients with mCRC received TAS-102 and BEV between March 2016 and December 2021. The status of nausea, vomiting, and antiemetic measures in each course were investigated, and factors involved in the occurrence of nausea and vomiting were analysed by logistic regression analysis.

Results: Data from 57 patients were analysed. The incidence rates of nausea and vomiting during the overall period were 57.9% and 17.5%, respectively. Nausea and vomiting were frequent not only in the early courses but also after the sixth course. Multivariate logistic regression analysis showed that the experience of nausea and vomiting in previous treatment with other agents was significantly associated with nausea and vomiting with TAS-102 and BEV.

Conclusion: The experience of nausea and vomiting in previous treatment was associated with increased risk for nausea and vomiting in mCRC patients treated with TAS-102 and BEV.

Keywords: Unresectable colorectal cancer; bevacizumab; chemotherapy-induced nausea and vomiting; trifluridine/tipiracil.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bevacizumab / adverse effects
  • Colonic Neoplasms* / drug therapy
  • Colorectal Neoplasms* / pathology
  • Drug Combinations
  • Humans
  • Nausea / chemically induced
  • Rectal Neoplasms* / drug therapy
  • Risk Factors
  • Trifluridine / adverse effects
  • Uracil / adverse effects
  • Vomiting / chemically induced
  • Vomiting / drug therapy
  • Vomiting / epidemiology

Substances

  • tipiracil
  • trifluridine tipiracil drug combination
  • Bevacizumab
  • Trifluridine
  • Uracil
  • Drug Combinations