e20683 Background: Multi-day chemo regimens have particular advantages in increasing tolerability and maintaining dose intensity of combination cytotoxic therapy. However repeated daily insults of therapy can make control of CINV challenging. Increased knowledge of factors affecting poor control of multi-day chemo, under current CINV prevention conditions, would be beneficial. Methods: A dataset of 621 patients treated in a blinded, randomised non-inferiority study (Grunberg SM, Gabrial NY, Clark G, MASCC 2007, Abstract # 18) of a granisetron transdermal patch (TDS, Sancuso) and oral granisetron, was analysed. As TDS was shown to be non-inferior to oral granisetron, data from both arms were used. All patients had received 3–5 days of moderately or highly emetogenic chemotherapy. Total Control of CINV over Day 1 and Days 1–3 was used as the efficacy endpoint. Stepwise logistic regression analysis was used to assess the predictive performance of patient and chemotherapy factors. Wald chi-squared statistics and Akaike criteria were used to measure significance of predictive factors and model fit, respectively. Results: The simple sum of emetogenicity scores of each cytotoxic (Grunberg SM,(2005) Evaluation of new antiemetic agents_an update. Support Care Cancer (2005) 13: 80–84) provided best overall prediction of emetogenicity of the multiday regimen. Cisplatin was more emetogenic and doxorubicin less so compared to established scoring (Grunberg SM,(2005) Evaluation of new antiemetic agents_an update. Support Care Cancer (2005) 13: 80–84). Age and gender were significant in predicting control: females <60 and males <40years being at risk. A genitourinary site of cancer was also an independent risk factor. Smoking, alcohol use, previous chemotherapy and performance score had no significant effect on risk of CINV. Conclusions: Established emetogenicity scores, derived from historical data on untreated patients, are relevant to multi-day chemo but could be revised to improve prediction of CINV. Cisplatin has a stronger impact on poor control in multi-day than single-agent scoring predicts. Age and gender factors remain important; but with different age breaks for male and female. These and tumour site factors should be taken into account when designing clinical trials or analysing data relating to antiemetics and CINV. [Table: see text]