1881P - Enhancing chemotherapy-induced nausea and vomiting management: Insights into guideline adherence and patient outcomes

Background

Chemotherapy-induced nausea and vomiting (CINV) persist despite the availability of numerous antiemetics, resulting in hospitalizations and increased costs. Initiatives like "Choosing Wisely” advocate for reducing low-value medical practices, with antiemetic drug use representing a potential area of overuse. Therefore, this study aimed to assess the impact of CINV on patients with solid tumors and hematological malignancies, focusing on both acute and delayed phases in cancers with moderate or high emetogenic potential. Additionally, it aimed to evaluate patients' quality of life (QOL) and the effectiveness of various antiemetic drug combinations in managing CINV.

Methods

This longitudinal prospective observational study was conducted between 2020 and 2023 at three tertiary care cancer centers in Hyderabad, India. A total of 128 chemotherapy-treated patients were interviewed, and valid questionnaires were used to assess the impact of CINV on their QOL within the first 24 hours and after 3 to 5 days of chemotherapy treatment. Factors examined included the use of 5-HT3 inhibitors, dexamethasone dosage, substance P/NK-1 RA inhibitors, and the nature of chemotherapy.

Results

The study revealed that delayed CINV significantly affects QOL more than acute CINV (HR=0.83, P=0.05), with nausea (84%) having a greater impact than vomiting (6%). Patients administered higher doses of steroids and any type of substance P/NK-1 RA inhibitors experienced less nausea and better QOL. Adherence to guidelines was observed in 86% of cases, with deviations mainly attributed to patient-reported poor response.

Conclusions

In conclusion, our study highlights the significant impact of delayed CINV on patients' QOL compared to acute CINV. Nausea emerged as the predominant symptom affecting patients, with specific antiemetic combinations showing promise in alleviating symptoms and improving QOL. While guideline adherence was generally high, deviations were primarily due to patient-reported poor response. These findings underscore the importance of personalized approaches to CINV management and the integration of patient feedback in treatment optimization.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.