1367P - Evaluation of treatment patterns in acute nausea and vomiting in EU5 countries

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Palliative and Supportive Care
Presenter Nina Schmidt
Citation Annals of Oncology (2014) 25 (suppl_4): iv478-iv480. 10.1093/annonc/mdu351
Authors N. Schmidt1, C. Ricarte2, G. Haas1
  • 1Ims Global Oncology, IMS Health GmbH & Co. OHG, 60598 - Frankfurt/DE
  • 2Oncology, IMS Health GmbH & Co. OHG, 92088 - La Défense Cedex/FR

Abstract

Aim

This analysis aimed at describing the usage of antiemetic treatments (tx) to prevent chemotherapy-induced nausea and vomiting (CINV) in the acute onset across EU5 countries (France, Germany, Italy, Spain, United Kingdom). CINV is known to be one of the most distressful side effects in over 70% of patients (pts) receiving chemotherapy (ct) and can be prevented in up to 70-80% of pts. The emetogenic potential (ep) of the chemotherapeutic agents used is the main risk factor for developing CINV.

Methods

This study is based on IMS Oncology Analyzer™, a quarterly physician panel survey that provides a broad perspective of cancer pts care, across all cancer types and treatment modalities. Pts receiving a ct (defined at ATC L1 EphMRA classification) were analyzed from Jan to Dec 2013 in EU5 countries. Projected estimates for the number of pts currently being treated were provided.

Results

The antiemetic tx (aet) patterns are summarized in the table. 35'874 pts (representing a total treated prevalence of 2'027'394 pts) were identified as currently receiving a ct. Overall, only 52% of those pts received an aet. Among them, 65% of pts received either a setron (setr) or aprepitant (apr) in the first day of ct administration. In that population 2.5% of pts received a combination of both palonosetron (palon) and apr. In 61% of cases this combination was used in breast cancer.

Antiemetic tx patterns - 2'027'394 ct treated pts in EU5

High Moderate Moderate
AC* Non-AC*
ep of ct** (20%) (8%) (32%)
Apr d1 15% 18% 4%
apr mono 20% 22% 24%
+ palon 10% 28% 6%
+ other setr 69% 50% 71%
Setr d1 no apr 39% 35% 44%
palon 7% 18% 7%
other setr 93% 82% 93%
No setr/apr d1 but other aet 3% 3% 4%
aet not d1 13% 9% 18%
No aet 30% 35% 31%

* Only breast cancer, AC: anthracycline (doxorubicin/epirubicin) + cyclophosphamide ** 34% of pts treated with low or minimal emetogenic ct, 6% of pts with unknown emesis risk.

Conclusions

This analysis shows that there is still a significant lack of prophylactic aet. Currently, only about 12% of pts receiving high emetogenic ct, 14% of pts receiving AC and 47% non-AC pts are treated according to antiemetic guidelines (MASCC/ESMO 2013). Further research is necessary to understand the barriers to guideline adherence in clinical practice.

Disclosure

All authors have declared no conflicts of interest.