1504P - Incidence of chemotherapy-induced nausea and vomiting with moderately emetogenic chemotherapy: ADVICE study

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Complications/Toxicities of Treatment
Supportive Measures
Presenter Yolanda Escobar
Citation Annals of Oncology (2014) 25 (suppl_4): iv517-iv541. 10.1093/annonc/mdu356
Authors Y. Escobar1, G. Cajaraville2, J. Virizuela3, R. Alvarez Alvarez1, A.J. Muñoz Martín4, O. Olariaga2, B. Muros5, M.J. Lecumberri Biurrun6, J. Feliu7, P. Martinez Del Prado8, J.J. Cruz Hernandez9, M.J. Martínez Bautista10, R. Lopez11, A. Blasco12, P. Gascon13, V. Calvo14, P. Luna Fra15, J. Montalar16, P. Del Barrio17, M.V. Tornamira17
  • 1Servicio De Oncología Médica, Hospital General Gregorio Marañon, 28007 - Madrid/ES
  • 2Servicio De Farmacia, Onkologikoa, San Sebastian/ES
  • 3Medical Oncology, Hospital Universitario Virgen Macarena, 41007 - Sevilla/ES
  • 4Medical Oncology Service, Hospital General Universitario Gregorio Marañón, 28007 - Madrid/ES
  • 5Servicio De Farmacia, Hospital Clínico Virgen de la Victoria de Málaga, Malaga/ES
  • 7Medical Oncology, Hospital Universitario La Paz, 28046 - Madrid/ES
  • 8Medical Oncology, Universitary Hospital of Basurto, 48013 - Bilbao/ES
  • 9Oncología Médica, Hospital Universitario de Salamanca, ES-37007 - Salamanca/ES
  • 10Servicio De Farmacia, Hospital Universitario Puerta del Mar, Cádiz/ES
  • 11Oncología Médica, Complejo Hospitalario Universitario de Santiago de Compostela SERGAS, 15706 - Santiago de Compostela/ES
  • 12Medical Oncology, Hospital General Universitario de Valencia, 46014 - Valencia/ES
  • 13Medical Oncology, Hospital Clinic y Provincial de Barcelona, 08036 - Barcelona/ES
  • 14Clinical Oncology, Hospital Universitario Puerta de Hierro Majadahond, 28222 - Majadahonda/ES
  • 15Servicio Oncologia, Hospital Universitario Sons Espases, Mallorca/ES
  • 16Medical Oncology, Hospital Universitari i Polit, ES-46026 - Valencia/ES
  • 17Medical Department, MSD, 28027 - Madrid/ES



Background: Limited information regarding incidence of chemotherapy induced nausea and vomiting (CINV) is available in patients receiving moderately emetogenic chemotherapy (MEC).


Chemotherapy-naive patients receiving MEC, between April-2012 and May-2013 were included in an observational and prospective trial evaluating incidence of CINV during 120 hours post-chemotherapy as primary endpoint. Patients completed a diary to capture intensity of nausea and number of vomiting episodes. Complete response (no vomiting or rescue medication use) and complete protection (no vomiting and no severe nausea or use of rescue medication) were assessed as secondary endpoints.


Of 261 patients included, 240 were evaluated. The median age was 64.36 years (36.15-87.3), 44.17% were female and 11.25% were aged less than 50 years. The majority, 95.3% of patients received a combination of a 5-HT3 antagonist+corticosteroid as antiemetic treatment. Episodes of vomiting within 5 days of chemotherapy administration occurred in 20.78% of patients, nausea of any intensity in 42% (≥5 mm to 100mm VAS (visual analog scale)), and significant nausea in 23.8% of patients (≥25 mm to 100 mm VAS). An increase in the percentage of patients with severe nausea and vomiting was observed from the acute to the delayed phase, from 9.44% to 21.65% and from 9.24% to 15.45% respectively. Complete response in the acute phase was 85%, 77% in the late phase and 68.9% in the overall study period. Complete protection was 79.5% in the acute phase, 69.7% in the late phase and 62.4% throughout the study period. Physicians estimated prophylaxis would be effective (no vomiting or nausea and no use of rescue medication) for 75% of patients receiving MEC, compared with 54.1% obtained from patient's diary.


Despite receiving prophylactic treatment, 31% of patients did not achieve a complete response and 38% patients did not achieve complete protection. In general nausea was worse controlled than vomiting. The results also showed the late phase was worse controlled than the acute phase in all variables. Healthcare providers overestimated the effectiveness of antiemetic prophylaxis.


P. Del Barrio: Employee of Merck Sharp & Dohme; M.V. Tornamira: Employee of Merck Sharp & Dohme. All other authors have declared no conflicts of interest.