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Published in: Supportive Care in Cancer 12/2021

01-12-2021 | Nausea | Original Article

Clinical utility of a prediction tool to differentiate between breast cancer patients at high or low risk of chemotherapy-induced nausea and vomiting

Authors: Mashari Jemaan Alzahrani, George Dranitsaris, Marta Sienkiewicz, Lisa Vandermeer, Mark Clemons

Published in: Supportive Care in Cancer | Issue 12/2021

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Abstract

Background

A personalized risk model (PRM) that can categorize patients into high or low risk of ≥ grade 2 acute and/or delayed chemotherapy-induced nausea and vomiting (CINV) was previously developed. The current study assessed whether the PMR could accurately stratify patients’ risk for other commonly used CINV endpoints.

Methods

Data was pooled from a previously reported trial evaluating CINV in patients with breast cancer (BC) receiving neo/adjuvant anthracycline-cyclophosphamide or carboplatin-based chemotherapy. The predictive ability of the PRM was compared to patient experience of any self-reported significant nausea, any vomiting, complete cycle response, and use of rescue medications, over all cycles of chemotherapy.

Results

Data was available from 242 patients over 819 chemotherapy cycles. Irrespective of the chosen antiemetics, significant nausea was common when evaluated across repeated cycles of treatment with an overall incidence of 24.2% in low-risk patients and 34.6% in high-risk patients. Patients identified as high risk of CINV using the PRM were 4.73 (p = 0.011) times more likely to develop significant nausea than those identified as low risk. The PRM did not show any significant statistical differences between both groups in overall vomiting, complete cycle response, or rescue medications use.

Conclusion

The PRM was able to identify patients at greater risk of significant nausea but not the other CINV endpoints. As nausea remains a pertinent issue for patients with BC, the PRM could be used to identify these patients a priori for innovative treatment strategies.
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Literature
1.
go back to reference Bliss J, Robertson B, Selby P (1992) The effect of nausea and vomiting on quality of life measures. Br J Cancer 66(19 Suppl):814–823 Bliss J, Robertson B, Selby P (1992) The effect of nausea and vomiting on quality of life measures. Br J Cancer 66(19 Suppl):814–823
2.
go back to reference Schwartzberg LS (2007) Chemotherapy-induced nausea and vomiting: clinician and patient perspectives. J Support Oncol 5(2 Suppl 1):5–12PubMed Schwartzberg LS (2007) Chemotherapy-induced nausea and vomiting: clinician and patient perspectives. J Support Oncol 5(2 Suppl 1):5–12PubMed
3.
go back to reference Roila F, Molassiotis A, Herrstedt J, Aapro M, Gralla R, Bruera E, Clark-Snow R, Dupuis L, Einhorn L, Feyer P (2016) 2016 MASCC and ESMO guideline update for the prevention of chemotherapy-and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients. Ann Oncol 27:v119–v133CrossRef Roila F, Molassiotis A, Herrstedt J, Aapro M, Gralla R, Bruera E, Clark-Snow R, Dupuis L, Einhorn L, Feyer P (2016) 2016 MASCC and ESMO guideline update for the prevention of chemotherapy-and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients. Ann Oncol 27:v119–v133CrossRef
4.
go back to reference National Comprehensive Cancer Network (2016) NCCN clinical practice guidelines in oncology (NCCN Guidelines®). Antiemesis. Version 2.2016 National Comprehensive Cancer Network (2016) NCCN clinical practice guidelines in oncology (NCCN Guidelines®). Antiemesis. Version 2.2016
5.
go back to reference Hesketh PJ, Bohlke K, Lyman GH, Basch E, Chesney M, Clark-Snow RA, Danso MA, Jordan K, Somerfield MR, Kris MG (2016) Antiemetics: American society of clinical oncology focused guideline update. J Clin Oncol 34(4):381–386CrossRef Hesketh PJ, Bohlke K, Lyman GH, Basch E, Chesney M, Clark-Snow RA, Danso MA, Jordan K, Somerfield MR, Kris MG (2016) Antiemetics: American society of clinical oncology focused guideline update. J Clin Oncol 34(4):381–386CrossRef
6.
go back to reference Clemons M, Dranitsaris G, Sienkiewicz M, Sehdev S, Ng T, Robinson A, Mates M, Hsu T, McGee S, Freedman O (2020) A randomized trial of individualized versus standard of care antiemetic therapy for breast cancer patients at high risk for chemotherapy-induced nausea and vomiting. Breast 54:278–285CrossRef Clemons M, Dranitsaris G, Sienkiewicz M, Sehdev S, Ng T, Robinson A, Mates M, Hsu T, McGee S, Freedman O (2020) A randomized trial of individualized versus standard of care antiemetic therapy for breast cancer patients at high risk for chemotherapy-induced nausea and vomiting. Breast 54:278–285CrossRef
7.
go back to reference Dranitsaris G, Molassiotis A, Clemons M, Roeland E, Schwartzberg L, Dielenseger P, Jordan K, Young A, Aapro M (2017) The development of a prediction tool to identify cancer patients at high risk for chemotherapy-induced nausea and vomiting. Ann Oncol 28(6):1260–1267CrossRef Dranitsaris G, Molassiotis A, Clemons M, Roeland E, Schwartzberg L, Dielenseger P, Jordan K, Young A, Aapro M (2017) The development of a prediction tool to identify cancer patients at high risk for chemotherapy-induced nausea and vomiting. Ann Oncol 28(6):1260–1267CrossRef
8.
go back to reference Ng T, Mazzarello S, Wang Z, Hutton B, Dranitsaris G, Vandermeer L, Smith S, Clemons M (2016) Choice of study endpoint significantly impacts the results of breast cancer trials evaluating chemotherapy-induced nausea and vomiting. Breast Cancer Res Treat 155(2):337–344CrossRef Ng T, Mazzarello S, Wang Z, Hutton B, Dranitsaris G, Vandermeer L, Smith S, Clemons M (2016) Choice of study endpoint significantly impacts the results of breast cancer trials evaluating chemotherapy-induced nausea and vomiting. Breast Cancer Res Treat 155(2):337–344CrossRef
9.
go back to reference Torres CH, Mazzarello S, Ng T, Dranitsaris G, Hutton B, Smith S, Munro A, Jacobs C, Clemons M (2015) Defining optimal control of chemotherapy-induced nausea and vomiting—based on patients’ experience. Support Care Cancer 23(11):3341–3359CrossRef Torres CH, Mazzarello S, Ng T, Dranitsaris G, Hutton B, Smith S, Munro A, Jacobs C, Clemons M (2015) Defining optimal control of chemotherapy-induced nausea and vomiting—based on patients’ experience. Support Care Cancer 23(11):3341–3359CrossRef
10.
go back to reference Pirri C, Katris P, Trotter J, Bayliss E, Bennett R, Drummond P (2011) Risk factors at pretreatment predicting treatment-induced nausea and vomiting in Australian cancer patients: a prospective, longitudinal, observational study. Support Care Cancer 19(10):1549–1563CrossRef Pirri C, Katris P, Trotter J, Bayliss E, Bennett R, Drummond P (2011) Risk factors at pretreatment predicting treatment-induced nausea and vomiting in Australian cancer patients: a prospective, longitudinal, observational study. Support Care Cancer 19(10):1549–1563CrossRef
11.
go back to reference Molassiotis A, Stamataki Z, Kontopantelis E (2013) Development and preliminary validation of a risk prediction model for chemotherapy-related nausea and vomiting. Support Care Cancer 21(10):2759–2767CrossRef Molassiotis A, Stamataki Z, Kontopantelis E (2013) Development and preliminary validation of a risk prediction model for chemotherapy-related nausea and vomiting. Support Care Cancer 21(10):2759–2767CrossRef
12.
go back to reference Dranitsaris G, Joy A, Young S, Clemons M, Callaghan W, Petrella T (2009) Identifying patients at high risk for nausesa and vomiting after chemotherapy: the development of a practical prediction tool. I. Acute nausea and vomiting. J Support Oncol 7(4):W1–W8 Dranitsaris G, Joy A, Young S, Clemons M, Callaghan W, Petrella T (2009) Identifying patients at high risk for nausesa and vomiting after chemotherapy: the development of a practical prediction tool. I. Acute nausea and vomiting. J Support Oncol 7(4):W1–W8
13.
go back to reference Petrella T, Clemons M, Joy A, Young S, Callaghan W, Dranitsaris G (2009) Identifying patients at high risk for nausea and vomiting after chemotherapy: the development of a practical validated prediction tool. II. Delayed nausea and vomiting. J Support Oncol 7(4):W9–W16 Petrella T, Clemons M, Joy A, Young S, Callaghan W, Dranitsaris G (2009) Identifying patients at high risk for nausea and vomiting after chemotherapy: the development of a practical validated prediction tool. II. Delayed nausea and vomiting. J Support Oncol 7(4):W9–W16
14.
go back to reference Dranitsaris G, Clemons M (2014) Risk prediction models for chemotherapy-induced nausea and vomiting: almost ready for prime time? Support Care Cancer 22(4):863–864CrossRef Dranitsaris G, Clemons M (2014) Risk prediction models for chemotherapy-induced nausea and vomiting: almost ready for prime time? Support Care Cancer 22(4):863–864CrossRef
15.
go back to reference Dranitsaris G, Mazzarello S, Smith S, Vandermeer L, Bouganim N, Clemons M (2016) Measuring the impact of guideline-based antiemetic therapy on nausea and vomiting control in breast cancer patients with multiple risk factors. Support Care Cancer 24(4):1563–1569CrossRef Dranitsaris G, Mazzarello S, Smith S, Vandermeer L, Bouganim N, Clemons M (2016) Measuring the impact of guideline-based antiemetic therapy on nausea and vomiting control in breast cancer patients with multiple risk factors. Support Care Cancer 24(4):1563–1569CrossRef
16.
go back to reference Dranitsaris G, Bouganim N, Milano C, Vandermeer L, Dent S, Wheatley-Price P, Laporte J, Oxborough K-A, Clemons M (2013) Prospective validation of a prediction tool for identifying patients at high risk for chemotherapy-induced nausea and vomiting. J Support Oncol 11(1):14–21PubMed Dranitsaris G, Bouganim N, Milano C, Vandermeer L, Dent S, Wheatley-Price P, Laporte J, Oxborough K-A, Clemons M (2013) Prospective validation of a prediction tool for identifying patients at high risk for chemotherapy-induced nausea and vomiting. J Support Oncol 11(1):14–21PubMed
17.
go back to reference Clemons M, Bouganim N, Smith S, Dranitsaris G (2016) A randomized trial comparing risk model guided antiemetic prophylaxis to physician’s choice in patients receiving chemotherapy for early stage breast cancer. JAMA Oncol 2:225–231CrossRef Clemons M, Bouganim N, Smith S, Dranitsaris G (2016) A randomized trial comparing risk model guided antiemetic prophylaxis to physician’s choice in patients receiving chemotherapy for early stage breast cancer. JAMA Oncol 2:225–231CrossRef
18.
go back to reference Martin A, Pearson J, Cai B, Elmer M, Horgan K, Lindley C (2000) Validation of a 5-Day Recall Version of the Functional Living Index-Emesis (FLIE) Quality-of-Life Questionnaire for Chemotherapy-Induced Emesis. Quality of Life Research:296–296 Martin A, Pearson J, Cai B, Elmer M, Horgan K, Lindley C (2000) Validation of a 5-Day Recall Version of the Functional Living Index-Emesis (FLIE) Quality-of-Life Questionnaire for Chemotherapy-Induced Emesis. Quality of Life Research:296–296
20.
go back to reference Katz MH (2003) Multivariable analysis: a primer for readers of medical research. Ann Intern Med 138(8):644–650CrossRef Katz MH (2003) Multivariable analysis: a primer for readers of medical research. Ann Intern Med 138(8):644–650CrossRef
21.
go back to reference Bouganim N, Dranitsaris G, Hopkins S, Vandermeer L, Godbout L, Dent S, Wheatley-Price P, Milano C, Clemons M (2012) Prospective validation of risk prediction indexes for acute and delayed chemotherapy-induced nausea and vomiting. Current oncology 19(6):e414CrossRef Bouganim N, Dranitsaris G, Hopkins S, Vandermeer L, Godbout L, Dent S, Wheatley-Price P, Milano C, Clemons M (2012) Prospective validation of risk prediction indexes for acute and delayed chemotherapy-induced nausea and vomiting. Current oncology 19(6):e414CrossRef
22.
go back to reference Molassiotis A, Lee PH, Burke TA, Dicato M, Gascon P, Roila F, Aapro M (2016) Anticipatory nausea, risk factors, and its impact on chemotherapy-induced nausea and vomiting: results from the Pan European Emesis Registry study. J Pain Symptom Manage 51(6):987–993CrossRef Molassiotis A, Lee PH, Burke TA, Dicato M, Gascon P, Roila F, Aapro M (2016) Anticipatory nausea, risk factors, and its impact on chemotherapy-induced nausea and vomiting: results from the Pan European Emesis Registry study. J Pain Symptom Manage 51(6):987–993CrossRef
23.
go back to reference Steyerberg EW, Moons KG, van der Windt DA, Hayden JA, Perel P, Schroter S, Riley RD, Hemingway H, Altman DG, Group P (2013) Prognosis Research Strategy (PROGRESS) 3: prognostic model research. PLoS Med 10(2):e1001381CrossRef Steyerberg EW, Moons KG, van der Windt DA, Hayden JA, Perel P, Schroter S, Riley RD, Hemingway H, Altman DG, Group P (2013) Prognosis Research Strategy (PROGRESS) 3: prognostic model research. PLoS Med 10(2):e1001381CrossRef
Metadata
Title
Clinical utility of a prediction tool to differentiate between breast cancer patients at high or low risk of chemotherapy-induced nausea and vomiting
Authors
Mashari Jemaan Alzahrani
George Dranitsaris
Marta Sienkiewicz
Lisa Vandermeer
Mark Clemons
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 12/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-021-06358-8

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