Top

Supportive Care in Cancer

Published in:

01-12-2011 | Short Communication

Incidence of delayed nausea and vomiting in patients with colorectal cancer receiving irinotecan-based chemotherapy

Authors: Paul J. Hesketh, Snezana M. Bosnjak, Vlada Nikolic, Bernardo Rapoport

Published in: Supportive Care in Cancer | Issue 12/2011

Abstract

Purpose

This study sought to prospectively determine the frequency of delayed nausea and vomiting with irinotecan-based chemotherapy following day 1 prophylaxis with a 5-HT₃ receptor antagonist and dexamethasone.

Methods

Patients with colorectal cancer aged ≥ 18 years with ECOG performance status ≤ 2 receiving irinotecan alone, combined with cetuximab or as part of a standard folinic acid, 5-flourouracil, irinotecan (FOLFIRI) regimen for the first time were eligible. All patients received a 5-HT₃ receptor antagonist and dexamethasone 8 mg on day 1 prior to irinotecan. No routine prophylaxis for delayed emesis was given. Antiemetic outcome was recorded in patient-completed diaries for the 120-h study period after irinotecan administration. Primary endpoint was frequency of delayed (24–120 h) emesis.

Results

Forty-four patients were enrolled, and all are evaluable. The median age was 61 (39–79) years; the male–female ratio was 37:7. Four patients (9%) experienced vomiting or retching during the delayed period. Three patients (7%) vomited during the first 24 h after irinotecan. The overall no emesis rate was 89% (39/44). Fifteen patients (34%) experienced delayed nausea (mild in 11 patients, moderate in four patients). Six patients (14%) took rescue antiemetics during the delayed period. Delayed and overall complete response (no emesis or use of rescue antiemetics) rates were 82% and 77% respectively.

Conclusions

The use of a 5-HT₃ antagonist and dexamethasone prior to irinotecan results in excellent control of nausea and vomiting (CR 86%) during the 24 h after chemotherapy. Without further antiemetic treatment, most patients (82%) will not experience delayed emesis or require rescue antiemetics. Routine prophylaxis for delayed emesis following irinotecan does not appear to be warranted.

Hesketh PJ (2008) Chemotherapy-induced nausea and vomiting. N Engl J Med 358(23):2482–2494PubMedCrossRef

Hesketh PJ, Kris MG, Grunberg SM et al (1997) Proposal for classifying the acute emetogenicity of cancer chemotherapy. J Clin Oncol 15:103–9PubMed

Kris MG, Hesketh PJ, Somerfield MR et al (2006) American Society of Clinical Oncology. American Society of Clinical Oncology guideline for antiemetics in oncology: update 2006. J Clin Oncol 24(18):2932–2947PubMedCrossRef

Roila F, Herrstedt J, Aapro M et al (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol 21(Suppl 5):v232–43PubMedCrossRef

Tavorath R, Hesketh PJ (1996) Drug treatment of chemotherapy-induced delayed emesis. Drugs 52(5):639–648PubMedCrossRef

Kris MG, Gralla RJ, Clark RA et al (1985) Incidence, course and severity of delayed nausea and vomiting following the administration of high-dose cisplatin. J Clin Oncol 3:1379–84PubMed

Martin M, Diaz-Rubio E, Sanchez A et al (1990) The natural course of emesis after carboplatin treatment. Acta Oncologica 29:593–595PubMedCrossRef

Hesketh PJ, Sanz-Altamira P, Bushey J, Hesketh AM (2011) Prospective evaluation of the incidence of delayed nausea and vomiting in patients with colorectal cancer receiving oxaliplatin-based chemotherapy. Support Care Cancer (Epub ahead of print) May 9, 2011

Fukuoka M, Niitani H, Suzuki A et al (1992) A phase II study of CPT-11, a new derivative of camptothecin, for previously untreated non-small-cell lung cancer. J Clin Oncol 10:16–20PubMed

10.

Shimada Y, Yoshino M, Wakui A et al (1993) Phase II study of CPT-11, a new camptothecin derivative in metastatic colorectal cancer. J Clin Oncol 11:909–13PubMed

Title: Incidence of delayed nausea and vomiting in patients with colorectal cancer receiving irinotecan-based chemotherapy
Authors: Paul J. Hesketh
Snezana M. Bosnjak
Vlada Nikolic
Bernardo Rapoport
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 12/2011
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-011-1286-6

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 12/2011

Loss of lifestyle: health behaviour and weight changes after becoming a caregiver of a family member diagnosed with ovarian cancer

Dyspnoea associated with anxiety—symptomatic therapy with opioids in combination with lorazepam and its effect on ventilation in palliative care patients

Informational and decisional empowerment in online health support communities: initial psychometric validation of the Cyber Info-Decisional Empowerment Scale (CIDES) and preliminary data from administration of the scale

Emerging drugs for cancer-related pain

Perception of healthcare providers versus patient reported incidence of chemotherapy-induced nausea and vomiting after the addition of NK-1 receptor antagonists

Breakthrough pain: a qualitative study involving patients with advanced cancer

Keynote webinar | Spotlight on antibody–drug conjugates in cancer