1874P - Time to vomiting after chemotherapy in association with number of emetic risk factors among breast cancer patients receiving highly emetogenic chemotherapy

Background

Despite the efficacy of optimal contemporary antiemetic prophylaxis, chemotherapy-induced nausea and vomiting (CINV) remains to be one of the most disturbing symptoms that cancer patients anticipate when planning for cytotoxic chemotherapy. Previous studies have identified a number of clinical factors associated with CINV. This study aimed to confirm the previously reported risk factors and assess the time to first vomiting in relation to the number of risk factors identified.

Methods

304 patients who received (neo)adjuvant doxorubicin-cyclophosphamide (AC) chemotherapy and who were enrolled into 3 previously reported prospective antiemetic studies were included. Multivariate logistic regression models were used to predict risk factors associated with failure in achieving complete response (CR); CR was defined as no vomiting and no use of rescue medication within 120 hours after the start of AC. Upon identifying the risk factors, time to first vomiting in association with the number of these factors was evaluated using the Kaplan–Meier method.

Results

Multivariate analysis revealed that following factors to be associated with failure in achieving CR: non-obese (OR 1.95, 95% CI [95% confidence interval] 1.07-3.56, p= 0.029), lack of contemporary antiemetic regimens (OR 1.81, 95% CI 1.31-2.51, p= 0.0003), history of motion sickness (OR 2.44, 95% CI 1.35-4.55, p= 0.003) and history of vomiting in pregnancy (OR 1.72, 95% CI 1.04-2.86, p= 0.033). The time to first vomiting was significantly related to the number of identified factors (p < 0.0001). Among patients who had 0, 1, 2, and 3 risk factors, the 24-hour rate of no vomiting was 81.3%, 80.3%, 66.7%, 53.7%, and 17.7%, respectively.

Conclusions

This report confirmed previously reported risk factors for CINV in breast cancer patients receiving AC. Patients with increasing number of risk factors had shorter time to first vomiting. Our findings reflect the need of further optimization of antiemetic prophylaxis for patients undergoing highly emetogenic chemotherapy.

Clinical trial identification

NCT03386617; NCT03079219.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Mundipharma.

Disclosure

W. Yeo: Financial Interests, Personal and Institutional, Funding: Mundipharma. All other authors have declared no conflicts of interest.