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Duration of Chemotherapy-Induced Nausea and Vomiting (CINV) as a Predictor of Recurrent CINV in Later Cycles.

Publication ,  Journal Article
Navari, R; Binder, G; Molasiotis, A; Herrstedt, J; Roeland, EJ; Ruddy, KJ; LeBlanc, TW; Kloth, DD; Klute, KA; Papademetriou, E; Schmerold, L ...
Published in: Oncologist
March 17, 2023

BACKGROUND: The relationship between CINV duration and recurrence in subsequent cycles is largely unstudied. Our objective was to determine if patients experiencing CINV in their first cycle of chemotherapy (C1) would face increased risk of CINV in later cycles and whether the duration of the CINV would predict increased risk of recurrence. PATIENTS AND METHODS: Using data from a previously reported phase III trial, we assessed patients' recurrence of breakthrough CINV after antiemetic prophylaxis for anthracycline+cyclophosphamide (AC) for breast cancer, comparing C1 short CINV vs. extended CINV as a secondary analysis. Complete response (CR) and CINV duration were primary and secondary endpoints, respectively. CR was considered prophylaxis success; lack of CR was considered treatment failure (TF). RESULTS: Among 402 female patients, 99 (24.6%) had TF in C1 (TF1). The remaining 303 patients (CR1) had ≥93% CR rates in each subsequent cycle, while the 99 patients with TF1 had TF rates of 49.8% for cycles 2-4 (P < .001). The 51 patients with extended TF (≥3 days) in C1 had recurrent TF in 73/105 later cycles (69.5%, P < .001), while the 48 patients with short TF (1-2 days) in C1 had recurrent TF in 33/108 later cycles (30.6%). The relative risk of recurrence after C1 extended TF was 2.28 (CI 1.67-3.11; P < .001) compared to short TF. CONCLUSIONS: Prophylaxis success in C1 led to >90% repeat success across cycles of AC-based chemotherapy. For patients with breakthrough CINV, extended duration strongly predicted recurrent CINV. The duration of CINV should be closely monitored, and augmenting antiemetic prophylaxis considered for future cycles when extended CINV occurs.

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Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

March 17, 2023

Volume

28

Issue

3

Start / End Page

208 / 213

Location

England

Related Subject Headings

  • Vomiting
  • Oncology & Carcinogenesis
  • Nausea
  • Humans
  • Female
  • Cyclophosphamide
  • Antineoplastic Agents
  • Antiemetics
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

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Navari, R., Binder, G., Molasiotis, A., Herrstedt, J., Roeland, E. J., Ruddy, K. J., … Schwartzberg, L. (2023). Duration of Chemotherapy-Induced Nausea and Vomiting (CINV) as a Predictor of Recurrent CINV in Later Cycles. Oncologist, 28(3), 208–213. https://doi.org/10.1093/oncolo/oyac240
Navari, Rudolph, Gary Binder, Alex Molasiotis, Jørn Herrstedt, Eric J. Roeland, Kathryn J. Ruddy, Thomas W. LeBlanc, et al. “Duration of Chemotherapy-Induced Nausea and Vomiting (CINV) as a Predictor of Recurrent CINV in Later Cycles.Oncologist 28, no. 3 (March 17, 2023): 208–13. https://doi.org/10.1093/oncolo/oyac240.
Navari R, Binder G, Molasiotis A, Herrstedt J, Roeland EJ, Ruddy KJ, et al. Duration of Chemotherapy-Induced Nausea and Vomiting (CINV) as a Predictor of Recurrent CINV in Later Cycles. Oncologist. 2023 Mar 17;28(3):208–13.
Navari, Rudolph, et al. “Duration of Chemotherapy-Induced Nausea and Vomiting (CINV) as a Predictor of Recurrent CINV in Later Cycles.Oncologist, vol. 28, no. 3, Mar. 2023, pp. 208–13. Pubmed, doi:10.1093/oncolo/oyac240.
Navari R, Binder G, Molasiotis A, Herrstedt J, Roeland EJ, Ruddy KJ, LeBlanc TW, Kloth DD, Klute KA, Papademetriou E, Schmerold L, Schwartzberg L. Duration of Chemotherapy-Induced Nausea and Vomiting (CINV) as a Predictor of Recurrent CINV in Later Cycles. Oncologist. 2023 Mar 17;28(3):208–213.

Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

March 17, 2023

Volume

28

Issue

3

Start / End Page

208 / 213

Location

England

Related Subject Headings

  • Vomiting
  • Oncology & Carcinogenesis
  • Nausea
  • Humans
  • Female
  • Cyclophosphamide
  • Antineoplastic Agents
  • Antiemetics
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis