Despite the considerable progress achieved in the last 30 years vomiting and especially nausea continue to be two of the most distressing side-effects of cancer chemotherapy. The objective of this survey was to assess the compliance of anti-emesis prescriptions with the ESMO 2016 and French AFSOS 2013 guidelines (French speaking association for supportive care in cancer), in primary prophylaxis of moderately emetogenic chemotherapies (MEC) as defined by ESMO guidelines.
Between February and November 2016, 35 pharmacists and 41 nurses from 35 French centers specialized in cancer treatment completed a 13-item questionnaire drawn up by a scientific committee about their anti-emesis practices. Concurrently, the nurses at each center recorded prospectively treatments prescribed to 10 to 20 patients starting the first cycle of MEC.
Data were gathered on 448 patients with gastrointestinal cancers and 166 with lung cancers; 29% and 47% of all patients were treated with carboplatin or oxaliplatin respectively. The most frequent CINV preventive treatments for the acute phase were the combination of 5HT3 antagonist + corticoid (52% of patients) and the combination of 5HT3 antagonist + corticoid + anti-NK1 (33%). For the delayed phase, 5HT3 antagonist only (23%), anti-NK1 only (17%) and the combination of 5HT3 antagonist + anti-NK1 (17%) were the most prescribed treatment. Overall, 49% and 33% of patients in the acute phase and 10% and 17% in the delayed phase were treated in compliance the ESMO and AFSOS guidelines respectively.
The CONVINCE-ME survey shows inadequate use of existing recommendations at specialized centers and highlights the need for improved understanding and guideline application.
Clinical trial identification
Legal entity responsible for the study
F. Scotté: Roche, Vifor, MSD, Teva, Norgine, Prostrakan, Leo pharma, Janssen, Hospira, Boehringer, Sanofi, Amgen, Pierre Fabre Oncologie, Tesaro. H. Bertucat: MSD. All other authors have declared no conflicts of interest.