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Observational Study
. 2021 Sep;29(9):5029-5035.
doi: 10.1007/s00520-021-06061-8. Epub 2021 Feb 16.

Efficacy of one-day versus multiple-day dexamethasone for chemotherapy-induced nausea and vomiting in lung cancer patients receiving carboplatin-based chemotherapy: a propensity score-matched analysis

Toshinobu Hayashi  1 , Mototsugu Shimokawa  2 , Fumitaka Mizuki  3 , Koichi Matsuo  4   5 , Kei Kawada  6 , Takafumi Nakano  4 , Takashi Egawa  4
Affiliations
Observational Study

Efficacy of one-day versus multiple-day dexamethasone for chemotherapy-induced nausea and vomiting in lung cancer patients receiving carboplatin-based chemotherapy: a propensity score-matched analysis

Toshinobu Hayashi et al. Support Care Cancer. 2021 Sep.

Abstract

Purpose: Dexamethasone (DEX)-sparing strategies (one-day DEX) with palonosetron as doublet antiemetic prophylaxis have previously been studied. However, DEX-sparing regimens with 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) and aprepitant (APR), as triplet antiemetic prophylaxis, have not been evaluated. This study aimed to evaluate the efficacy of a combination of 5-HT3RA, APR, and DEX on day 1 of carboplatin (CBDCA)-based chemotherapy in patients with lung cancer.

Methods: Data were pooled from a nationwide, multicenter, prospective observational study using propensity score-matched analysis to compare the incidence of chemotherapy-induced nausea and vomiting (CINV) between one- and multiple-day DEX regimens in combination with 5-HT3RA plus APR.

Results: Incidence of delayed nausea was significantly higher in the one-day than in the multiple-day DEX group. Incidence of nausea was also significantly higher in the one-day than in the multiple-day DEX group on days 3-5. Kaplan-Meier curves for nausea showed a significant difference between the two groups; however, there was no significant difference in the occurrence of vomiting or the Kaplan-Meier curves of time to vomiting.

Conclusion: To the best of our knowledge, this study is the first to evaluate the efficacy of a DEX-sparing regimen by comparing one- and multiple-day DEX combined with 5-HT3RA and APR concerning CINV incidence in lung cancer patients receiving CBDCA-based chemotherapy. Antiemetic regimens of one-day DEX result in poor control of delayed nausea; therefore, we recommend the application of the DEX-sparing strategy only after careful patient selection while considering the development of nausea.

Keywords: Antiemetics; Carboplatin; Chemotherapy-induced nausea and vomiting; Dexamethasone; Lung cancer; Steroid-sparing.

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References

    1. Roila F, Warr D, Hesketh PJ, Gralla R, Herrstedt J, Jordan K, Aapro M, Ballatori E, Rapoport B (2017) 2016 Updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following moderately emetogenic chemotherapy. Support Care Cancer 25:289–294. https://doi.org/10.1007/s00520-016-3365-1 - DOI
    1. Hesketh PJ, Kris MG, Basch E, Bohlke K, Barbour SY, Clark-Snow RA, Danso MA, Dennis K, Dupuis LL, Dusetzina SB, Eng C, Feyer PC, Jordan K, Noonan K, Sparacio D, Lyman GH (2020) Antiemetics: ASCO Guideline update. J Clin Oncol 38:2782–2797. https://doi.org/10.1200/JCO.20.01296 - DOI
    1. NCCN clinical practice guidelines in oncology (2020) Antiemetics. version 2, vol. 2020. https://www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf . Accessed 20 Oct 2020
    1. Aogi K, Takeuchi H, Saeki T, Aiba K, Tamura K, Iino K, Imamura CK, Okita K, Kagami Y, Tanaka R, Nakagawa K, Fujii H, Boku N, Wada M, Akechi T, Iihara H, Ohtani S, Okuyama A, Ozawa K, Kim YI, Sasaki H, Shima Y, Takeda M, Nagasaki E, Nishidate T, Higashi T, Hirata K (2020) Optimizing antiemetic treatment for chemotherapy-induced nausea and vomiting in Japan: update summary of the 2015 Japan Society of Clinical Oncology Clinical Practice Guidelines for Antiemesis. Int J Clin Oncol published online 08 November 2020. https://doi.org/10.1007/s10147-020-01818-3
    1. Iihara H, Shimokawa M, Hayashi T, Kawazoe H, Saeki T, Aiba K, Tamura K (2020) A nationwide, multicenter registry study of antiemesis for carboplatin-based chemotherapy-induced nausea and vomiting in Japan. Oncologist 25:e373–e380. https://doi.org/10.1634/theoncologist.2019-0292 - DOI

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