Abstract 558P
Background
NEPA has demonstrated superiority in preventing chemotherapy induced nausea and vomiting (CINV) compared to palonosetron and non-inferiority compared to Aprepitant/Granisetron. However, despite the application of NEPA in previous studies, grade (Gr) 2 or higher CINV was reported in 30-50% of cases. The aim of this study was to investigate the efficacy of NEPA for CINV prevention in Korean cancer patients treated with HEC, and to evaluate the usefulness of adding olanzapine in cases experiencing Gr 2 or higher CINV in previous cycles.
Methods
A retrospective cohort study was conducted on cancer patients treated with HEC and CINV prophylaxis using NEPA. If Gr 2 or higher CINV occurred, olanzapine 5mg/day was administered for 5 days. The primary endpoint was the incidence of Gr 2 or higher CINV during cycle 1. Secondary endpoints included the efficacy of adding olanzapine and identification of risk factors for Gr2 or higher CINV.
Results
Of 164 patients, 142 patients were analyzed. The median age was 66.0 years, and males were 54.9%. Tumor sites included biliary tract (45%), genitourinary (27%), and breast (9%). The HEC regimens included cisplatin <50 mg/m2 (49%), cisplatin ≥50 mg/m2 (20%), Carboplatin > AUC 4.0 (18%), and doxorubicin (12%). The incidence of Gr 2 or higher CINV was 23% (33/142), and the incidence of all-grade CINV was 58% (82/142). Among those with Gr 2 or higher CINV, 82% (27/33) were treated with olanzapine combination without dose modification of HEC, and 74% (20/27) improved to Gr 1 CINV.
Conclusions
This study demonstrated that NEPA was comparably effective in Korean patients treated with HEC, and also showed efficacy of olanzapine combination therapy. Further studies needed to confirm CINV prophylaxis strategies, either through initial combination with olanzapine in high-risk CINV cases or by adding olanzapine in patients with prior Gr2 or higher CINV.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Institutional Review Board of Pusan National University Yangsan Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.