The Prospective Multicenter Study of Relation between 5-HIAA / Substance P plasma Concentration Transition and Nausea / Vomiting in Patients with G...

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Supportive Measures
Complications/Toxicities of Treatment
Presenter Kentaro Sawada
Citation Annals of Oncology (2018) 29 (suppl_9): ix129-ix138. 10.1093/annonc/mdy444
Authors K. Sawada1, Y. Komatsu1, T. Muranaka1, S. Nakano2, Y. Kawamoto2, H. Nakatsumi1, S. Yuki2, M. Dazai3, T. Saiki4, A. Ishiguro4, M. Tateyama5, K. Ono6, S. Ohnishi2, N. Sakamoto2
  • 1Cancer Center, Hokkaido University Hospital, 060-8638 - Sapporo/JP
  • 2Gastroenterology And Hepatology, Hokkaido University Hospital, 060-8638 - Sapporo/JP
  • 3Gastroenterology, Sapporo Medical Center NTT EC, 060-0061 - Sapporo/JP
  • 4Medical Oncology, Teine Keijinkai Hospital, 006-8555 - Sapporo/JP
  • 5Internal Medicine, Tomakomai Nisshou Hospital, Tomakomai/JP
  • 6Clinical Research And Medical Innovation Center, Hokkaido University Hospital, Sapporo/JP



Chemotherapy-induced nausea/vomiting (CINV) is one of the important adverse events which must be prevented. We usually use corticosteroid, 5-HT3 receptor blocker and NK-1 receptor blocker to prevent CINV of high emetogenic chemotherapy (HEC). NK-1 receptor blocker is an optional treatment to prevent CINV of MEC. But there are few reports about 5-HIAA/substance P (SP) of patients who received MEC.


We measured the changes in plasma concentration of 5-HIAA/SP by collecting blood samples before and 4, 24, 48, 72, and 96 hours after chemotherapy from patients (pts) with gastrointestinal caner who are planned to receive HEC (for up to 5 pts in cohort 1, for validation of measurement) or MEC (cohort 2). We also collected patients’ reported outcomes to record CINV using Visual Analog Scale (VAS). 5-HIAA was measured by SRL Inc. and SP was measured by KM assay center.


We could measure plasma concentration of both 5-HIAA and SP in all 3 consecutive HEC cases, and 36 pts of MEC were registered. One pts was ineligible and 4 did not write VAS, so 31 pts were fully analyzed. Delayed-phase nausea (DN) was occurred in 15 of 31 pts. The median rates of change (%) of plasma concentration of 5-HIAA in 4, 24, 48, 72, 96 hours after MEC administration compared with the baseline in pts “without” vs “with” DN were 131.04 vs 63.33 (p = 0.0086), -2.17 vs 7.14 (p = 0.46), -10.17 vs 9.30 (p = 0.12), 5.17 vs 0.00 (p = 1.00), 5.26 vs 2.29 (p = 0.56), respectively. Those of SP were 9.46 vs 21.83 (p = 0.61), -0.01 vs -0.30 (p = 0.97), -2.74 vs -2.83 (p = 0.99), 2.83 vs 2.78 (p = 1.00), 4.59 vs -1.30 (p = 0.59), respectively.


Small change between 5-HIAA 4 hours after MEC and before administration might be an early predictive marker of DN. There was no significant difference in plasma SP concentration in the presence or absence of DN after administration of MEC.

Editorial acknowledgement

Clinical trial identification



Legal entity responsible for the study

Non-profit Organization: Hokkaido Gastrointestinal Cancer Study Group.


Non-profit Organization: Hokkaido Gastrointestinal Cancer Study Group.


Y. Komatsu: Honoraria, research fund, donation: Ono Pharmaceutical Co., Ltd. S. Yuki: Honoraria: Ono Pharmaceutical Co., Ltd. All other authors have declared no conflicts of interest.