Intergenerational comparison of 5-HT3RA in the prevention of chemotherapy-induced nausea and vomiting in gastric cancer patients receiving cisplatin-based chemotherapy: an observational study using a Japanese administrative claims database

• Published in: Supportive care in cancer Vol. 29; no. 7; pp. 3951 - 3959
• Main Authors: Kunitomi, Yuji, Nakashima, Masayuki, Seki, Tomotsugu, Ide, Kazuki, Kawakami, Koji
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2021; Springer Nature B.V
• Subjects: Chemotherapy; Gastric cancer; Medicine; Medicine & Public Health; Nausea; Nursing; Nursing Research; Observational studies; Oncology; Original Article; Pain Medicine; Rehabilitation Medicine; Side effects; Vomiting; Japan; Database; Supportive care; Gastric cancer; 5-Hydroxytryptamine-3 receptor antagonist; Cisplatin; Chemotherapy-induced nausea and vomiting
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-020-05958-0

Purpose In chemotherapy-induced nausea and vomiting (CINV), the superiority of the second-generation 5-hydroxytryptamine-3 receptor antagonist (5-HT 3 RA) over the first-generation 5-HT 3 RA is shown in the delayed emesis in cycle 1. We evaluate the antiemetic efficacy in real-world clinical practice that has not been sufficiently investigated in clinical trials. Methods We included patients who were diagnosed with gastric cancer between April 2012 and June 2017 from the medical claims databases and were treated with cisplatin (≥ 50 mg/m 2 ) and standard antiemetic therapy (5-HT 3 RA + neurokinin-1 receptor antagonist [NK1RA] + dexamethasone). We compared the second-generation 5-HT 3 RA (2nd group) and the first-generation 5-HT 3 RA (1st group) groups to evaluate the additional antiemetic drug as the CINV event. Results In total, 3798 patients were extracted; 1440 and 2358 patients were included in the 1st and 2nd groups, respectively. The clinical and demographic characteristics did not differ between the groups. In the overall (days 1–6) in cycle 1, 51.7% and 44.3% of patients in the 1st and 2nd groups, respectively, had a CINV event. In the acute phase (days 1–2), 38.7% and 30.2% and in the delayed phase (days 3–6), 35.8% and 32.1% of patients in the 1st and 2nd groups, respectively, had a CINV event. Furthermore, the CINV event trend was the same as in cycles 1 to 5. Conclusion The proportion of CINV events in the 2nd group was smaller than that in the 1st group at any cycle. These findings may suggest consistent antiemetic efficacy of second-generation 5-HT 3 RA throughout the cycle.