Meta-Analysis

. 2024 Dec;29(12):1785-1794.

doi: 10.1007/s10147-024-02643-8. Epub 2024 Oct 17.

Efficacy and safety of dexamethasone sparing for the prevention of nausea and vomiting associated with moderately emetogenic chemotherapy: a systematic review and meta-analysis of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clinical Oncology

Kazuhisa Nakashima¹, Ayako Yokomizo², Michiyasu Murakami³, Kenji Okita⁴, Makoto Wada⁵, Keiko Iino⁶, Tatsuo Akechi⁷, Hirotoshi Iihara⁸, Chiyo K Imamura⁹, Ayako Okuyama¹⁰, Keiko Ozawa¹¹, Yong-Il Kim¹², Hidenori Sasaki¹³, Eriko Satomi¹⁴, Masayuki Takeda¹⁵, Ryuhei Tanaka¹⁶, Takako Eguchi Nakajima¹⁷, Naoki Nakamura¹⁸, Junichi Nishimura¹⁹, Mayumi Noda²⁰, Kazumi Hayashi²¹, Takahiro Higashi²², Narikazu Boku²³, Koji Matsumoto²⁴, Yoko Matsumoto²⁵, Nobuyuki Yamamoto²⁶, Kenjiro Aogi²⁷, Masakazu Abe²⁸

Affiliations

¹ Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan.
² Department of Early Clinical Development, Kyoto University Graduate School of Medicine, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan. ayokomizo@kuhp.kyoto-u.ac.jp.
³ Department of Pharmacy, Matsuyama Red Cross Hospital, 1 Bunkyo-Cho, Matsuyama-Shi, Ehime, 790-8524, Japan.
⁴ Department of Surgery, Otaru Ekisaikai Hospital, 1-4‑1, Inaho, Otaru, Hokkaido, 047‑0032, Japan.
⁵ Department of Psycho-Oncology, Osaka International Cancer Institute, 3-1‑69, Chuo-Ku, Osaka, 541‑8567, Japan.
⁶ School of Nursing, National College of Nursing, 1-2‑1, Umezono, Kiyose, Tokyo, 204‑8575, Japan.
⁷ Department of Psychiatry and Cognitive‑Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho‑Cho, Mizuho-Ku, Nagoya, 467-8601, Japan.
⁸ Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu, 501‑1194, Japan.
⁹ Advanced Cancer Translational Research Institute, Showa University, 1‑5‑8 Hatanodai, Shinagawa‑Ku, Tokyo, 142‑8555, Japan.
¹⁰ Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104‑0044, Japan.
¹¹ Division of Survivorship Institute for Cancer Control, National Cancer Center, 5‑1‑1 Tsukiji, Chuo-Ku, Tokyo, 104‑0045, Japan.
¹² Division of Medical Oncology, Yodogawa Christian Hospital, 1‑7‑50 Kunijima, Higasiyodogawa-Ku, Osaka, Osaka, 533‑0024, Japan.
¹³ Division of Medical Oncology, Hematology and Infectious Disease, Fukuoka University Hospital, 7-45‑1, Nanakuma, Jonan‑Ku, Fukuoka, 814‑0180, Japan.
¹⁴ Department of Palliative Medicine, National Cancer Center Hospital, 5‑1‑1 Tsukiji , Chuo-ku, Tokyo, 104‑0045, Japan.
¹⁵ Department of Cancer Genomics and Medical Oncology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634‑8521, Japan.
¹⁶ Department of Pediatric Hematology/Oncology, International Medical Center, Saitama Medical University, 1398-1 Yamane, Hidaka, Saitama, 350‑1298, Japan.
¹⁷ Department of Early Clinical Development, Kyoto University Graduate School of Medicine, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
¹⁸ Department of Radiation Oncology, St. Marianna University, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan.
¹⁹ Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1‑69, Osaka, 541‑8567, Japan.
²⁰ Non-Profit Organization Sasaeau-Kai "Alpha", 518-7 Kawado-Cho, Chuo-Ku, Chiba, Chiba, 260‑0802, Japan.
²¹ Department of Clinical Oncology and Hematology, The Jikei University School of Medicine, 3‑25‑8 Nishi‑Shinnbashi Minatoku, Tokyo, 105‑8461, Japan.
²² Department of Public Health and Health Policy, The University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑Ku, Tokyo, 113‑0033, Japan.
²³ Department of Oncology and General Medicine, IMSUT Hospital, Institute of Medical Science, University of Tokyo, 4‑6‑1 Shiroganedai, Minato-Ku, Tokyo, 108‑8639, Japan.
²⁴ Division of Medical Oncology, Hyogo Cancer Center, 13-70 Kitaoji-Cho, Akashi, Hyogo, 673‑0021, Japan.
²⁵ Non-Profit Organization Ehime Cancer Support Orange-No-Kai, 3‑8‑24 Furukawaminami, Matsuyama, Ehime, 790‑0943, Japan.
²⁶ Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641‑8509, Japan.
²⁷ Department of Breast Surgery, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-Machi, Matsuyama, Ehime, 791‑0280, Japan.
²⁸ Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Chuo-Ku, Hamamatsu, Shizuoka, 431‑3192, Japan.

PMID: 39417943
DOI: 10.1007/s10147-024-02643-8

Meta-Analysis

Efficacy and safety of dexamethasone sparing for the prevention of nausea and vomiting associated with moderately emetogenic chemotherapy: a systematic review and meta-analysis of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clinical Oncology

Kazuhisa Nakashima et al. Int J Clin Oncol. 2024 Dec.

. 2024 Dec;29(12):1785-1794.

doi: 10.1007/s10147-024-02643-8. Epub 2024 Oct 17.

Authors

Affiliations

¹ Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan.
² Department of Early Clinical Development, Kyoto University Graduate School of Medicine, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan. ayokomizo@kuhp.kyoto-u.ac.jp.
³ Department of Pharmacy, Matsuyama Red Cross Hospital, 1 Bunkyo-Cho, Matsuyama-Shi, Ehime, 790-8524, Japan.
⁴ Department of Surgery, Otaru Ekisaikai Hospital, 1-4‑1, Inaho, Otaru, Hokkaido, 047‑0032, Japan.
⁵ Department of Psycho-Oncology, Osaka International Cancer Institute, 3-1‑69, Chuo-Ku, Osaka, 541‑8567, Japan.
⁶ School of Nursing, National College of Nursing, 1-2‑1, Umezono, Kiyose, Tokyo, 204‑8575, Japan.
⁷ Department of Psychiatry and Cognitive‑Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho‑Cho, Mizuho-Ku, Nagoya, 467-8601, Japan.
⁸ Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu, 501‑1194, Japan.
⁹ Advanced Cancer Translational Research Institute, Showa University, 1‑5‑8 Hatanodai, Shinagawa‑Ku, Tokyo, 142‑8555, Japan.
¹⁰ Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104‑0044, Japan.
¹¹ Division of Survivorship Institute for Cancer Control, National Cancer Center, 5‑1‑1 Tsukiji, Chuo-Ku, Tokyo, 104‑0045, Japan.
¹² Division of Medical Oncology, Yodogawa Christian Hospital, 1‑7‑50 Kunijima, Higasiyodogawa-Ku, Osaka, Osaka, 533‑0024, Japan.
¹³ Division of Medical Oncology, Hematology and Infectious Disease, Fukuoka University Hospital, 7-45‑1, Nanakuma, Jonan‑Ku, Fukuoka, 814‑0180, Japan.
¹⁴ Department of Palliative Medicine, National Cancer Center Hospital, 5‑1‑1 Tsukiji , Chuo-ku, Tokyo, 104‑0045, Japan.
¹⁵ Department of Cancer Genomics and Medical Oncology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634‑8521, Japan.
¹⁶ Department of Pediatric Hematology/Oncology, International Medical Center, Saitama Medical University, 1398-1 Yamane, Hidaka, Saitama, 350‑1298, Japan.
¹⁷ Department of Early Clinical Development, Kyoto University Graduate School of Medicine, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
¹⁸ Department of Radiation Oncology, St. Marianna University, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan.
¹⁹ Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1‑69, Osaka, 541‑8567, Japan.
²⁰ Non-Profit Organization Sasaeau-Kai "Alpha", 518-7 Kawado-Cho, Chuo-Ku, Chiba, Chiba, 260‑0802, Japan.
²¹ Department of Clinical Oncology and Hematology, The Jikei University School of Medicine, 3‑25‑8 Nishi‑Shinnbashi Minatoku, Tokyo, 105‑8461, Japan.
²² Department of Public Health and Health Policy, The University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑Ku, Tokyo, 113‑0033, Japan.
²³ Department of Oncology and General Medicine, IMSUT Hospital, Institute of Medical Science, University of Tokyo, 4‑6‑1 Shiroganedai, Minato-Ku, Tokyo, 108‑8639, Japan.
²⁴ Division of Medical Oncology, Hyogo Cancer Center, 13-70 Kitaoji-Cho, Akashi, Hyogo, 673‑0021, Japan.
²⁵ Non-Profit Organization Ehime Cancer Support Orange-No-Kai, 3‑8‑24 Furukawaminami, Matsuyama, Ehime, 790‑0943, Japan.
²⁶ Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641‑8509, Japan.
²⁷ Department of Breast Surgery, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-Machi, Matsuyama, Ehime, 791‑0280, Japan.
²⁸ Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Chuo-Ku, Hamamatsu, Shizuoka, 431‑3192, Japan.

PMID: 39417943
DOI: 10.1007/s10147-024-02643-8

Abstract

Background: Palonosetron, a second-generation 5-HT₃ receptor antagonist (5-HT₃RA), is more effective than first-generation 5-HT₃RA. Several studies have investigated whether dexamethasone (DEX), when combined with palonosetron as a 5-HT₃RA, can be spared in the delayed phase after moderately emetogenic chemotherapy (MEC). In this systematic review, we aimed to determine which between 1- and 3-day DEX administration, when combined with palonosetron, is more useful in patients receiving MEC.

Methods: The PubMed, Cochrane Library, and Ichushi-Web databases were searched for relevant studies published between 1990 and 2020. We included studies that compared the efficacy of 1- and 3-day DEX administration in preventing nausea and vomiting associated with MEC. Outcomes were "prevention of vomiting (complete response rate and no vomiting rate)," "prevention of nausea" (complete control rate, total control rate, no nausea rate, and no clinically significant nausea rate)" in the delayed phase, "prevention of blood glucose level elevation," and "prevention of osteoporosis."

Results: Eight studies were included in this systematic review. The no vomiting rate was significantly higher in the 3-day DEX group than in the 1-day DEX group. However, the other efficacy items did not significantly differ between the two groups. Meanwhile, insufficient evidence was obtained for "prevention of blood glucose level elevation" and "prevention of osteoporosis."

Conclusions: No significant differences in most antiemetic effects were found between 1- and 3-day DEX administration. Thus, DEX administration could be shortened from 3 days to 1 day when used in combination with palonosetron.

Keywords: Chemotherapy-induced nausea and vomiting; Dexamethasone; Meta-analysis; Moderately emetogenic chemotherapy; Palonosetron; Systematic review.

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Conflict of interest statement

Declarations. Conflict of interest: Kazuhisa Nakashima received honoraria from Taiho Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., and Eli Lilly Japan K.K. Michiyasu Murakami received honoraria from Taiho Pharmaceutical Co., Ltd. Eriko Satomi received honoraria from Shionogi & Co., Ltd. Masayuki Takeda received honoraria from Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., Novartis Pharma K.K., Ono Pharmaceutical Co., Ltd., and Bayer. Takako Eguchi Nakajima received research funding from KBBM, Inc. and Takeda Pharmaceutical Co., Ltd. Junichi Nishimura received honoraria from Taiho Pharmaceutical Co., Ltd. Narikazu Boku received honoraria from Ono Pharmaceutical Co., Ltd., Bristol Myers Squibb, Daiichi Sankyo Co., Ltd., Taiho Pharmaceutical Co., Ltd., and Eli Lilly Japan K.K. Koji Matsumoto received honoraria from MSD K.K., Kyowa Kirin Co., Ltd., and Chugai Pharmaceutical Co., Ltd. as well as research funding from Daiichi Sankyo Co., Ltd., MSD K.K., Gilead Sciences, Inc., and Eli Lilly Japan K.K. Nobuyuki Yamamoto received honoraria from MSD K.K., Accuray Japan K.K., AstraZeneca K.K., Abbvie Inc., Amgen Inc., Ono Pharmaceutical Co., Ltd., Guardant Health Japan Corp., Daiichi Sankyo Co., Ltd., Taiho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., Chugai Foundation for Innovative Drug Discovery Science, Lao Tsumura Co., Ltd., Terumo Corporation, Eli Lilly Japan K.K., Nippon Kayaku Co., Ltd., Novartis AG, Pfzer Global Supply Japan Inc., Merck Biopharma Co., Ltd, Pfzer Global Supply Japan Inc., Merck Biopharma Co., Ltd., Janssen Pharmaceutical K.K., and USACO Corporation, as well as legal fees in case of lawsuit from Taiho Pharmaceutical Co., Ltd., Boehringer Ingelheim Japan, Chugai Pharmaceutical Co., Ltd., Kyowa Kirin Co., Ltd., Nippon Kayaku Co., Ltd., Prime Research Institute for Medical RWD, Inc., AstraZeneca K.K., and A2 Healthcare Corporation. Other authors declare that they have no conflict of interest. Ethical approval: Not applicable. Informed consent: Formal consent was not required for this type of study. Consent to participate: Not applicable. Consent for publication: All authors consented to the publication of this study.

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Efficacy and safety of dexamethasone sparing for the prevention of nausea and vomiting associated with moderately emetogenic chemotherapy: a systematic review and meta-analysis of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clinical Oncology

Affiliations

Efficacy and safety of dexamethasone sparing for the prevention of nausea and vomiting associated with moderately emetogenic chemotherapy: a systematic review and meta-analysis of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clinical Oncology

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Conflict of interest statement

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