Practice patterns for prevention of chemotherapy-induced nausea and vomiting and antiemetic guideline adherence based on real-world prescribing data
AffiliationGenolier Cancer Centre, Clinique de Genolier, Genolier, Switzerland.
MetadataShow full item record
AbstractBackground: Guideline-recommended antiemetic prophylaxis improves nausea and vomiting control in most patients undergoing chemotherapy. Multinational Association of Supportive Care in Cancer/European Society for Medical Oncology (MASCC/ESMO) antiemetic guidelines recommend prophylaxis with a neurokinin-1 receptor antagonist (NK1 RA), a 5-hydroxytryptamine-3 (5-HT3 )RA, and dexamethasone for patients receiving highly emetogenic chemotherapy (HEC), including anthracycline-cyclophosphamide (AC)- and carboplatin (considered moderately emetogenic chemotherapy)-based chemotherapy. Here, we analyze the use of NK1 RA-5-HT3 RA-dexamethasone for antiemetic prophylaxis associated with HEC and carboplatin. Methods: The data source was the Global Oncology Monitor (Ipsos Healthcare). Geographically representative physicians from France, Germany, Italy, Spain, and UK were screened for treatment involvement and number of patients treated/month. Patients' data from Jan-Dec 2018 were collected from medical charts and extrapolated on the basis of the total number of physicians who prescribe chemotherapy. The emetic risk of chemotherapy was classified per MASCC/ESMO guidelines. Results: Data from 45,324 chemotherapy-treated patients were collected, representing a total extrapolated prevalence of 1,394,848 chemotherapy treatments included in the analysis. NK1 RAs were used in 45%/42%/19% of patients receiving cisplatin-/AC-/carboplatin-based chemotherapy, respectively; 18%/24%/7% received the guideline-recommended NK1 RA-5-HT3 RA-dexamethasone combination; no antiemetics were prescribed for 12% of the treatments. Often, physicians' perception of the emetic risk of chemotherapy did not follow MASCC/ESMO guideline classification. Conclusion: Low adherence to antiemetic guidelines was revealed in clinical practice in five European countries, with 15% of all HEC-/carboplatin-based treatments receiving guideline-recommended NK1 RA-5-HT3 RA-dexamethasone prophylaxis, and 12% of them receiving no antiemetics. New strategies for improving guideline adherence are urgently needed. Implications for practice: Despite recent advances in antiemetic therapy, a substantial proportion of patients experience nausea and vomiting associated with chemotherapy in daily clinical practice. Antiemetic guidelines aim at prevention of chemotherapy-induced nausea and vomiting (CINV) and guideline-consistent antiemetic therapy can effectively prevent vomiting and, to a lesser extent, nausea in most patients with cancer. This study reports low adherence to antiemetic guidelines in the highly emetogenic chemotherapy setting in daily clinical practice across five European countries. Opportunity exists to increase adherence to antiemetic guideline recommendations. Implementation of strategies to facilitate guideline adherence can potentially improve CINV control.
CitationAapro M, Scotte F, Escobar Y, Celio L, Berman R, Franceschetti A, et al. Practice patterns for prevention of chemotherapy-induced nausea and vomiting and antiemetic guideline adherence based on real-world prescribing data. Oncologist. 2021.
- Antiemetic therapy in Asia Pacific countries for patients receiving moderately and highly emetogenic chemotherapy--a descriptive analysis of practice patterns, antiemetic quality of care, and use of antiemetic guidelines.
- Authors: Yu S, Burke TA, Chan A, Kim HK, Hsieh RK, Hu X, Liang JT, Baños A, Spiteri C, Keefe DM
- Issue date: 2015 Jan
- Avoidable Acute Care Use Associated with Nausea and Vomiting Among Patients Receiving Highly Emetogenic Chemotherapy or Oxaliplatin.
- Authors: Navari RM, Ruddy KJ, LeBlanc TW, Nipp R, Clark-Snow R, Schwartzberg L, Binder G, Bailey WL, Potluri R, Schmerold LM, Papademetriou E, Roeland EJ
- Issue date: 2021 Apr
- Antiemetic prophylaxis in patients undergoing hematopoietic stem cell transplantation: a multicenter survey of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) transplant programs.
- Authors: Pastore D, Bruno B, Carluccio P, De Candia MS, Mammoliti S, Borghero C, Chierichini A, Pavan F, Casini M, Pini M, Nassi L, Greco R, Tambaro FP, Stefanoni P, Console G, Marchesi F, Facchini L, Mussetti A, Cimminiello M, Saglio F, Vincenti D, Falcioni S, Chiusolo P, Olivieri J, Natale A, Faraci M, Cesaro S, Marotta S, Proia A, Donnini I, Caravelli D, Zuffa E, Iori AP, Soncini E, Bozzoli V, Pisapia G, Scalone R, Villani O, Prete A, Ferrari A, Menconi M, Mancini G, Gigli F, Gargiulo G, Bruno B, Patriarca F, Bonifazi F
- Issue date: 2020 Apr
- A Nationwide, Multicenter Registry Study of Antiemesis for Carboplatin-Based Chemotherapy-Induced Nausea and Vomiting in Japan.
- Authors: Iihara H, Shimokawa M, Hayashi T, Kawazoe H, Saeki T, Aiba K, Tamura K
- Issue date: 2020 Feb
- 5-Hydroxytryptamine-3 receptor antagonist and dexamethasone as prophylaxis for chemotherapy-induced nausea and vomiting during moderately emetic chemotherapy for solid tumors: a multicenter, prospective, observational study.
- Authors: Matsui R, Suzuki K, Takiguchi T, Nishio M, Koike T, Hayashi T, Seto T, Kogure Y, Nogami N, Fujiwara K, Kaneda H, Harada T, Shimizu S, Kimura M, Kenmotsu H, Shimokawa M, Goto K
- Issue date: 2020 Oct 6