open access

Vol 12, No 4 (2016)
Review paper
Published online: 2016-12-22
Get Citation

Prevention of chemotherapy-induced nausea and vomiting — standards versus clinical practice

Adam Płużański, Ewa Kalinka-Warzocha, Aleksandra Łacko, Maryna Rubach
DOI: 10.5603/OCP.2016.0002
·
Oncol Clin Pract 2016;12(4):153-157.

open access

Vol 12, No 4 (2016)
REVIEW ARTICLES
Published online: 2016-12-22

Abstract

In patients’ perception, chemotherapy-induced nausea and vomiting (CINV) are the main treatment-related adverse events of anti-cancer treatment. The probability of CINV incidence depends on the treatment regimen, dose, administration route, and patient-dependent factors. According to the current guidelines, a combination of setrons, neurokinin-1 receptor antagonists, and glucocorticoids results in control of acute emesis in 80–90% of patients and delayed emesis in 60–80%. Despite the availability of recommendations for prophylaxis CINV, the level of adherence to the guidelines in clinical practice is lower than observed in trials. Only half of the patients with highly and moderately emetogenic chemotherapy receive prophylaxis consistent with recommendations. Overuse of 5-hydroxytryptamine-3 receptor antagonists, incorrect dosing of corticosteroids, and overuse of metoclopramide in prophylaxis of delayed emesis are the main issues of non-adherence. Possible reasons for non-adherence are: insufficient knowledge of the guidelines, inappropriate CINV risk assessment, underestimation of symptoms reported by the patients, and difficulties in communication between a patient, medical personnel, and physician. To improve adequate control of CINV and adherence to the guidelines repetitive educational, administrative, and scientific actions need to be taken.

Abstract

In patients’ perception, chemotherapy-induced nausea and vomiting (CINV) are the main treatment-related adverse events of anti-cancer treatment. The probability of CINV incidence depends on the treatment regimen, dose, administration route, and patient-dependent factors. According to the current guidelines, a combination of setrons, neurokinin-1 receptor antagonists, and glucocorticoids results in control of acute emesis in 80–90% of patients and delayed emesis in 60–80%. Despite the availability of recommendations for prophylaxis CINV, the level of adherence to the guidelines in clinical practice is lower than observed in trials. Only half of the patients with highly and moderately emetogenic chemotherapy receive prophylaxis consistent with recommendations. Overuse of 5-hydroxytryptamine-3 receptor antagonists, incorrect dosing of corticosteroids, and overuse of metoclopramide in prophylaxis of delayed emesis are the main issues of non-adherence. Possible reasons for non-adherence are: insufficient knowledge of the guidelines, inappropriate CINV risk assessment, underestimation of symptoms reported by the patients, and difficulties in communication between a patient, medical personnel, and physician. To improve adequate control of CINV and adherence to the guidelines repetitive educational, administrative, and scientific actions need to be taken.

Get Citation

Keywords

nausea, vomiting, chemotherapy, guidelines

About this article
Title

Prevention of chemotherapy-induced nausea and vomiting — standards versus clinical practice

Journal

Oncology in Clinical Practice

Issue

Vol 12, No 4 (2016)

Article type

Review paper

Pages

153-157

Published online

2016-12-22

DOI

10.5603/OCP.2016.0002

Bibliographic record

Oncol Clin Pract 2016;12(4):153-157.

Keywords

nausea
vomiting
chemotherapy
guidelines

Authors

Adam Płużański
Ewa Kalinka-Warzocha
Aleksandra Łacko
Maryna Rubach

References (28)
  1. Bloechl-Daum B, Deuson RR, Mavros P, et al. Delayed nausea and vomiting continue to reduce patients' quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol. 2006; 24(27): 4472–4478.
  2. Aapro M, Molassiotis A, Dicato M, et al. PEER investigators. The effect of guideline-consistent antiemetic therapy on chemotherapy-induced nausea and vomiting (CINV): the Pan European Emesis Registry (PEER). Ann Oncol. 2012; 23(8): 1986–1992.
  3. Gralla RJ, de Wit R, Herrstedt J, et al. Antiemetic efficacy of the neurokinin-1 antagonist, aprepitant, plus a 5HT3 antagonist and a corticosteroid in patients receiving anthracyclines or cyclophosphamide in addition to high-dose cisplatin: analysis of combined data from two Phase III randomized clinical trials. Cancer. 2005; 104(4): 864–868.
  4. Roila F, Herrstedt J, Aapro M, et al. ESMO/MASCC Guidelines Working Group. Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol. 2010; 21 Suppl 5: v232–v243.
  5. Warr DG, Grunberg SM, Gralla RJ, et al. The oral NK(1) antagonist aprepitant for the prevention of acute and delayed chemotherapy-induced nausea and vomiting: Pooled data from 2 randomised, double-blind, placebo controlled trials. Eur J Cancer. 2005; 41(9): 1278–1285.
  6. Gilmore JW, Peacock NW, Gu A, et al. Antiemetic guideline consistency and incidence of chemotherapy-induced nausea and vomiting in US community oncology practice: INSPIRE Study. J Oncol Pract. 2014; 10(1): 68–74.
  7. Hsieh RK, Chan A, Kim HK, et al. Baseline patient characteristics, incidence of CINV, and physician perception of CINV incidence following moderately and highly emetogenic chemotherapy in Asia Pacific countries. Support Care Cancer. 2015; 23(1): 263–272.
  8. Grunberg SM, Deuson RR, Mavros P, et al. Incidence of chemotherapy-induced nausea and emesis after modern antiemetics. Cancer. 2004; 100(10): 2261–2268.
  9. Navari RM, Qin R, Ruddy KJ, et al. Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting. N Engl J Med. 2016; 375(2): 134–142.
  10. De Tursi M, Carella C, Tomao S, et al. Consorzio Interuniversitario Nazionale per la Bio-Oncologia. Chemotherapy-induced nausea and vomiting in Italian cancer centers: results of CINVDAY, a prospective, multicenter study. Tumori. 2014; 100(6): e309–e313.
  11. Hori K, Kobayashi N, Atsumi H, et al. Changes in compliance with Japanese antiemetic guideline for chemotherapy-induced nausea and vomiting: a nationwide survey using a distributed research network. Support Care Cancer. 2014; 22(4): 969–977.
  12. Krzakowski M. Nudności i wymioty związane z chemioterapią — obecne postępowanie. Onkol Prakt Klin. 2013; 9: 16–21.
  13. Płużański A. Nudności i wymioty towarzyszące wysokoemetogennej chemioterapii — analiza klinicznej praktyki. Nowotwory. Journal of Oncology. 2015; 65(2): 122–127.
  14. Basch E, Hesketh PJ, Kris MG, et al. American Society of Clinical Oncology. Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2011; 29(31): 4189–4198.
  15. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Antiemesis v2.2015. In. 2015.
  16. Kawecki A, Krzakowski M. Nudności i wymioty związane z chemioterapią i radioterapią. In: Krzakowski M, Warzocha K. ed. Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych 2013. Via Medica, Gdańsk 2013: 586–597.
  17. Schmidt N, Ricarte C, Haas G. Evaluation of treatment patterns in acute nausea and vomiting in EU5 countries. Ann Oncol. 2014: iv480.
  18. França MS, Usón Junior PL, Antunes YP, et al. Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy. Einstein (Sao Paulo). 2015; 13(2): 221–225.
  19. Sun CC, Bodurka DC, Weaver CB, et al. Rankings and symptom assessments of side effects from chemotherapy: insights from experienced patients with ovarian cancer. Support Care Cancer. 2005; 13(4): 219–227.
  20. Di Maio M, Gallo C, Leighl NB, et al. Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials. J Clin Oncol. 2015; 33(8): 910–915.
  21. Kenefick H, Lee J, Fleishman V. Barriers to guidelines adherence. Improving physician adherence to clinical practice guidelines: barriers and strategies for change. Cambridge: New England Healthcare Institute. 2008.
  22. Celio L, Bonizzoni E, Bajetta E, et al. Palonosetron plus single-dose dexamethasone for the prevention of nausea and vomiting in women receiving anthracycline/cyclophosphamide-containing chemotherapy: meta-analysis of individual patient data examining the effect of age on outcome in two phase III trials. Support Care Cancer. 2013; 21(2): 565–573.
  23. Aapro M, Rugo H, Rossi G, et al. A randomized phase III study evaluating the efficacy and safety of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy. Ann Oncol. 2014; 25(7): 1328–1333.
  24. Hesketh PJ. Chemotherapy-induced nausea and vomiting. N Engl J Med. 2008; 358(23): 2482–2494.
  25. Turini M, Piovesana V, Ruffo P, et al. An assessment of chemotherapy-induced nausea and vomiting direct costs in three EU countries. Drugs Context. 2015; 4: 212–285.
  26. Molassiotis A, Coventry PA, Stricker CT, et al. Validation and psychometric assessment of a short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC antiemesis tool. J Pain Symptom Manage. 2007; 34(2): 148–159.
  27. Grunberg SM. Obstacles to the implementation of antiemetic guidelines. J Natl Compr Canc Netw. 2009; 7(5): 601–605.
  28. Kaiser R. Antiemetic guidelines: are they being used? Lancet Oncol. 2005; 6(8): 622–625.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl