Identifying cancer patients at high risk for chemotherapy-induced nausea and vomiting (CINV): the development of a prediction tool

Background

Nausea and vomiting (N&V) remain among the most feared side effects of chemotherapy (CT). In addition to type of CT, several patient risk factors for CINV have been consistently reported in the literature. A large dataset was assembled to develop a repeated measures cycle based model that would accurately predict the risk of ≥ grade 2 CINV (≥3 vomiting episodes) over 5 days post CT.

Methods

CINV outcomes and risk factor data were obtained from 1198 patients enrolled in 1 of 5 non-interventional prospective cohort studies. For the cycle-based risk model, disease and treatment factors that were potential predictors of CINV were identified at baseline and after each cycle of CT. Factors with a p-value 

Results

Over 4197 cycles of CT, 42.2% of patients experienced ≥ grade 2 CINV. Ten risk factors were retained in the final model (eg, age

Conclusions

Risk of CINV varies according to number of cycles administered, type of CT, N&V in the prior cycle, and patient factors. The application and continued refinement of this prediction tool will be an important source of patient-specific risk information that will allow the personalization of antiemetic therapy.

Clinical trial identification

Legal entity responsible for the study

Augmentium Pharma Consulting

Funding

Helsinn Healthcare

Disclosure

G. Dranitsaris: Consultant/Advisory Board: Helsinn Healthcare. A. Molasiotis: Honoraria: Helsinn, Tesaro, Merck, Acacia. Pharma Consulting/Advisory Role: Helsinn, Tesaro, Merck Speaker's Bureau: Helsinn, Merck. Research Funding: Helsinn, Merck, Acacia Pharma. E. Roeland: Consultant/Advisory Role: Cellceutix, Helsinn, Eisai, Teva. Speaker's Bureau: Helsinn, Teva Expert Testimony: Scripps Health. L. Schwartzberg: Consulting/Advisory Role: Eisai, Helsinn, Merck, Tesaro. Research Funding: Helsinn. D. Warr: Consulting/Advisory Role: Helsinn Speaker's Bureau: Merck. Research Funding: Merck. K. Jordan: Honoraria: MSD, Merck, Helsinn. Consulting/Advisory Role: MSD, Merck, Helsinn. P. Dielenseger: Consulting/Advisory Role: Helsinn, Roche, Pfizer, Bayer, Boehringer Ingelheim. Travel/Accomodations/Expenses: Helsinn, Bayer, Pfizer, Roche. M.S. Aapro: Honoraria/Consulting/Advisory: Sandoz, Amgen, Helsinn, Novartis, Teva, Hospira. Research Funding: Novartis, Sandoz Expert Testimony: Amgen. All other authors have declared no conflicts of interest.