Anticipatory Nausea, risk factors, and Its impact on chemotherapy-induced nausea and vomiting: results from the Pan European Emesis Registry Study
Anticipatory Nausea, risk factors, and Its impact on chemotherapy-induced nausea and vomiting: results from the Pan European Emesis Registry Study
Context Anticipatory (prechemotherapy) nausea (AN) is a classic conditioned symptom not responding well to current antiemetics. Minimal work has been done to assess its risk factors and impact on chemotherapy-induced nausea and vomiting (CINV). Objectives To evaluate risk factors for AN and assess its impact on CINV development. Methods We analyzed data (n = 991) from a prospective observational multisite study in eight European countries over three cycles of chemotherapy. Patient/treatment characteristics were collected before chemotherapy. History of nausea/vomiting (yes/no), patient expectation of CINV (0-100 mm visual analog scale, [VAS]), and prechemotherapy anxiety (0-100 mm VAS) also were collected before chemotherapy. A patient-completed diary during each chemotherapy cycle obtained information on AN in the 24 hours before chemotherapy administration and nausea and vomiting (episodes of vomiting and severity of nausea) daily for five days after administration of chemotherapy (0-100 mm VAS). Results AN was reported by 8.3%-13.8% of patients, increasing in frequency and intensity over each cycle. Every 1 mm increase in AN on the VAS was significantly associated with 2%-13% of increase in the likelihood of CINV (all P-values <0.05). Key predictors of AN in Cycle 1 included metastatic disease and prechemotherapy anxiety. However, predictors of AN in subsequent cycles included prechemotherapy anxiety and AN and CINV experience in the previous cycle, the latter being the strongest predictor (odds ratio = 3.30-4.09 for CINV outcomes over the cycles). Conclusion AN is a challenging symptom, and its prevention needs to consider better CINV prevention in the previous cycles as well as managing prechemotherapy anxiety.
Anticipatory nausea, antiemetics, cancer, chemotherapy-related nausea and vomiting, prechemotherapy nausea
987-993
Molassiotis, Alexander
ca3892dc-b017-42f5-9e11-b043f406e6c5
Lee, Paul H.
02620eab-ae7f-4a1c-bad1-8a50e7e48951
Burke, Thomas A.
d5a00bde-2b18-44a1-bab1-6d9c7ba91c8f
Dicato, Mario
6c4ddf2e-c209-468c-b4e2-9295db278e3e
Gascon, Pere
565adbad-ee35-4fc6-a952-d780eb8af2f8
Roila, Fausto
be581e8c-1dbf-42ad-b44e-d9501b90be50
Aapro, Matti
d0725643-bf70-473c-afc1-a76ac5a70bf7
1 June 2016
Molassiotis, Alexander
ca3892dc-b017-42f5-9e11-b043f406e6c5
Lee, Paul H.
02620eab-ae7f-4a1c-bad1-8a50e7e48951
Burke, Thomas A.
d5a00bde-2b18-44a1-bab1-6d9c7ba91c8f
Dicato, Mario
6c4ddf2e-c209-468c-b4e2-9295db278e3e
Gascon, Pere
565adbad-ee35-4fc6-a952-d780eb8af2f8
Roila, Fausto
be581e8c-1dbf-42ad-b44e-d9501b90be50
Aapro, Matti
d0725643-bf70-473c-afc1-a76ac5a70bf7
Molassiotis, Alexander, Lee, Paul H. and Burke, Thomas A.
,
et al.
(2016)
Anticipatory Nausea, risk factors, and Its impact on chemotherapy-induced nausea and vomiting: results from the Pan European Emesis Registry Study.
Journal of Pain and Symptom Management, 51 (6), .
(doi:10.1016/j.jpainsymman.2015.12.317).
Abstract
Context Anticipatory (prechemotherapy) nausea (AN) is a classic conditioned symptom not responding well to current antiemetics. Minimal work has been done to assess its risk factors and impact on chemotherapy-induced nausea and vomiting (CINV). Objectives To evaluate risk factors for AN and assess its impact on CINV development. Methods We analyzed data (n = 991) from a prospective observational multisite study in eight European countries over three cycles of chemotherapy. Patient/treatment characteristics were collected before chemotherapy. History of nausea/vomiting (yes/no), patient expectation of CINV (0-100 mm visual analog scale, [VAS]), and prechemotherapy anxiety (0-100 mm VAS) also were collected before chemotherapy. A patient-completed diary during each chemotherapy cycle obtained information on AN in the 24 hours before chemotherapy administration and nausea and vomiting (episodes of vomiting and severity of nausea) daily for five days after administration of chemotherapy (0-100 mm VAS). Results AN was reported by 8.3%-13.8% of patients, increasing in frequency and intensity over each cycle. Every 1 mm increase in AN on the VAS was significantly associated with 2%-13% of increase in the likelihood of CINV (all P-values <0.05). Key predictors of AN in Cycle 1 included metastatic disease and prechemotherapy anxiety. However, predictors of AN in subsequent cycles included prechemotherapy anxiety and AN and CINV experience in the previous cycle, the latter being the strongest predictor (odds ratio = 3.30-4.09 for CINV outcomes over the cycles). Conclusion AN is a challenging symptom, and its prevention needs to consider better CINV prevention in the previous cycles as well as managing prechemotherapy anxiety.
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Published date: 1 June 2016
Additional Information:
Funding Information:
The observational study was funded by Merck Sharpe & Dohme Corp ., but the analysis was performed, and the article written independently without company support. Conflict of interest statements of all authors are listed as follows: 1) Alexander Molassiotis: research funding and consultancies: Merck & Co. Ltd., Helsinn, Tesaro, Acacia Pharma; 2) Paul H. Lee: no conflict of interest declared; 3) Thomas A. Burke: employee of Merck & Co. Ltd.; 4) Mario Dicato: consultancy: Merck & Co. Ltd.; 5) Pere Gascon: Merck & Co. Ltd.; 6) Fausto Roila: consultancies: Merck & Co. Ltd.; 7) Matti Aapro: consultancies and grant support: Helsinn & Eisai and consultancies: Tesaro, Taiho, Mundipharma, and Merck & Co. Ltd.
Publisher Copyright:
© 2016 American Academy of Hospice and Palliative Medicine.
Keywords:
Anticipatory nausea, antiemetics, cancer, chemotherapy-related nausea and vomiting, prechemotherapy nausea
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Local EPrints ID: 475163
URI: http://eprints.soton.ac.uk/id/eprint/475163
ISSN: 0885-3924
PURE UUID: 1fa15732-1f85-40eb-9644-65802de67601
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Date deposited: 10 Mar 2023 17:47
Last modified: 18 Mar 2024 04:09
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Author:
Alexander Molassiotis
Author:
Paul H. Lee
Author:
Thomas A. Burke
Author:
Mario Dicato
Author:
Pere Gascon
Author:
Fausto Roila
Author:
Matti Aapro
Corporate Author: et al.
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