Shogo Takei1, Atsushi Ishibe2, Jun Watanabe3, Kazuteru Watanabe1, Yusuke Suwa3, Shinsuke Suzuki1, Kazuya Nakagawa1, Hirokazu Suwa4, Mitsuyoshi Ota5, Yasushi Ichikawa6, Chikara Kunisaki3, Takeharu Yamanaka7, Itaru Endo1. 1. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. 2. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. a.ishibe1225@gmail.com. 3. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan. 4. Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan. 5. Department of Surgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan. 6. Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 7. Department of Biostatistics and Epidemiology, Yokohama City University, Yokohama, Japan.
Abstract
PURPOSE: Although the effectiveness of antiemetic therapy for colorectal cancer chemotherapy has improved with further drug development, some patients still suffer from chemotherapy-induced nausea and vomiting (CINV) even with only 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. The present study investigated the risk factors of CINV in patients who received chemotherapy for colorectal cancer and clarified which patients need additional neurokinin 1 receptor antagonist. METHODS: Patients with colorectal cancer receiving moderate-emetic-risk chemotherapy (MEC) were enrolled in this prospective single-arm study with intravenous palonosetron 0.75 mg and dexamethasone 9.9 mg before chemotherapy and with paroral dexamethasone 8 mg on days 2 and 3. The primary endpoint was the complete response (CR) rate for delayed-phase CINV. RESULTS: A total of 179 patients were eligible for this study. The delayed CR rate was 84.9% (152/179). There were no significant differences in any risk factors, but women with a low body mass index (BMI) (a combination of "female sex" and "BMI < 20") showed a significantly lower rate of CC (complete control) (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.17-1.13; p = 0.039), and young patients with a low BMI (combination of "age < 65" and "BMI < 20") showed a significantly lower rate of CR (OR = 0.34, 95% CI = 0.13-0.88; p = 0.022) than the other patients. CONCLUSIONS: This study failed to identify any single risk factors associated with delayed CINV in patients who received chemotherapy for advanced colorectal cancer. However, combinations of "thin and women" or "young and thin patients" might be possible predictive conditions, thus, candidates for NK1 receptor antagonist administration in MEC. Further investigations are required to develop criteria for the supplementation of NK1 receptor antagonist.
PURPOSE: Although the effectiveness of antiemetic therapy for colorectal cancer chemotherapy has improved with further drug development, some patients still suffer from chemotherapy-induced nausea and vomiting (CINV) even with only 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. The present study investigated the risk factors of CINV in patients who received chemotherapy for colorectal cancer and clarified which patients need additional neurokinin 1 receptor antagonist. METHODS:Patients with colorectal cancer receiving moderate-emetic-risk chemotherapy (MEC) were enrolled in this prospective single-arm study with intravenous palonosetron 0.75 mg and dexamethasone 9.9 mg before chemotherapy and with paroral dexamethasone 8 mg on days 2 and 3. The primary endpoint was the complete response (CR) rate for delayed-phase CINV. RESULTS: A total of 179 patients were eligible for this study. The delayed CR rate was 84.9% (152/179). There were no significant differences in any risk factors, but women with a low body mass index (BMI) (a combination of "female sex" and "BMI < 20") showed a significantly lower rate of CC (complete control) (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.17-1.13; p = 0.039), and young patients with a low BMI (combination of "age < 65" and "BMI < 20") showed a significantly lower rate of CR (OR = 0.34, 95% CI = 0.13-0.88; p = 0.022) than the other patients. CONCLUSIONS: This study failed to identify any single risk factors associated with delayed CINV in patients who received chemotherapy for advanced colorectal cancer. However, combinations of "thin and women" or "young and thin patients" might be possible predictive conditions, thus, candidates for NK1 receptor antagonist administration in MEC. Further investigations are required to develop criteria for the supplementation of NK1 receptor antagonist.
Authors: Paul J Hesketh; Mark G Kris; Ethan Basch; Kari Bohlke; Sally Y Barbour; Rebecca Anne Clark-Snow; Michael A Danso; Kristopher Dennis; L Lee Dupuis; Stacie B Dusetzina; Cathy Eng; Petra C Feyer; Karin Jordan; Kimberly Noonan; Dee Sparacio; Mark R Somerfield; Gary H Lyman Journal: J Clin Oncol Date: 2017-07-31 Impact factor: 44.544
Authors: F Roila; A Molassiotis; J Herrstedt; M Aapro; R J Gralla; E Bruera; R A Clark-Snow; L L Dupuis; L H Einhorn; P Feyer; P J Hesketh; K Jordan; I Olver; B L Rapoport; J Roscoe; C H Ruhlmann; D Walsh; D Warr; M van der Wetering Journal: Ann Oncol Date: 2016-09 Impact factor: 32.976