Adding aprepitant to palonosetron does not decrease carboplatin-induced nausea and vomiting in patients with gynecologic cancer

Abstract Background Recently, aprepitant has been recommended in carboplatin-based regimens, but there are limited reports on the efficacy of administering aprepitant, palonosetron, and dexamethasone (DEX) in carboplatin-containing regimens. Moreover, because aprepitant is an expensive drug, confirming its effectiveness is very important from the medical cost perspective. In this study, we examined the efficacy of prophylactically administered aprepitant, palonosetron and DEX, in paclitaxel and carboplatin (TC) combination chemotherapy. Methods Patients with gynecologic cancer who were treated with paclitaxel (175 mg/m2) and carboplatin (area under the curve, AUC = 5–6) combination chemotherapy were retrospectively evaluated. The complete response (CR) rate, severity of nausea, and incidence of anorexia in the first course were compared between patients who did not receive aprepitant (control group) and those who received (aprepitant group). Results The 106 patients were divided into two groups, consisting of 52 and 54 the control and aprepitant groups, respectively, and the patient background showed no significant difference between both groups. The CR rate of the overall phase between the control and aprepitant groups was 73.1 vs. 74.1%, that in the acute phase was 98.1 vs. 100%, and in the delayed phase was 75.0 vs. 74.1%, respectively, without any significant difference. The severity of nausea and incidence of anorexia were also not significantly different between both groups. Conclusions The results of the study suggest that adding aprepitant to palonosetron and DEX does not prevent carboplatin-induced nausea and vomiting in gynecologic cancer patients. Therefore, adding aprepitant to palonosetron does not decrease carboplatin-induced nausea and vomiting in patients with gynecologic cancer.

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The effect of foot reflexology on chemotherapy-induced nausea and vomiting in digestive or lung cancer patients: a randomized controlled trial (Preprint)

10.2196/preprints.25648 ◽

2020 ◽

Author(s):

Audrey Murat-Ringot ◽

Pierre Jean Souquet ◽

Fabien Subtil ◽

Florent Boutitie ◽

Marie Preau ◽

...

Keyword(s):

Cancer Patients ◽

Controlled Trial ◽

Nausea And Vomiting ◽

Control Group ◽

Digestive Cancer ◽

Complementary Medicines ◽

Antiemetic Drugs ◽

Platinum Based Chemotherapy ◽

Significant Difference ◽

Delayed Nausea

BACKGROUND Cancer is a chronic disease with an incident worldwide had been 24.5 million and 9.6 million deaths in 2017. Lung and colorectal cancer are the most common cancer for both sexes and according to national and international recommendations platinum-based chemotherapy is the reference adjuvant treatment. This chemotherapy can be moderately to highly emetogenic. Despite antiemetic therapy, chemotherapy-induced nausea and vomiting may persist. Moreover, cancer patient are increasingly interested in alternative and complementary medicines and express the desire that non-pharmacological treatments be used in hospitals. Among alternative and complementary medicines, foot reflexology decreases significantly the severity of chemotherapy-induced nausea and vomiting in breast cancer patients. OBJECTIVE The primary objective of the present study was to assess the benefits of foot reflexology as a complement to conventional treatments on severity of acute chemotherapy-induced nausea and vomiting in digestive or lung cancer patients. The secondary objectives assessed were the frequency and severity of delayed chemotherapy-induced nausea and vomiting, quality of life, anxiety, and self-esteem. METHODS The present study was conducted between April 2018 and April 2020 in French University Hospital. This is an open-label randomized controlled trial. Participants are randomized into two groups: 40 to interventional group (conventional care with foot reflexology) and 40 to control group (conventional care without foot reflexology). Foot reflexology sessions (30 minutes) are performed on an outpatient or inpatient. Eligible participants are patients with a lung or digestive cancer with indication for platinum-based chemotherapy. RESULTS The severity of acute nausea and vomiting was assessed with a visual analogue scale during the second cycle of chemotherapy. A significant increase of at least 2 points was observed for control group (20.6%, P = 0.01). Across all cycle, the foot reflexology group showed a trend towards less frequent delayed nausea (P=0.28), a significantly less frequent consumption of antiemetic drugs (P=0.04), and no significant difference for vomiting (P=0.99); there was a trend towards a perception of stronger severity for delayed nausea in the control group (P=0.39). According to quality of life and anxiety, there was no significant difference between the interventional group and the control group (P=0.32 and P=0.53 respectively). CONCLUSIONS In conclusion, the present study results indicated that foot reflexology decreased significantly the severity of acute nausea and consumption of antiemetic drugs in lung and digestive cancer patients. No side effects from foot reflexology have been noted. In order to better respond to a desire of patients for non-pharmacological treatments and CAMs to be used in hospitals to improve their care, the results of this study showed that foot reflexology seems to be a promising complement to conventional antiemetic drugs. To assess the performance of this intervention in routine practice, a larger study with several health care centers would be relevant with a cluster RCT. CLINICALTRIAL The present study registered with clinicaltrials.gov: NCT03508180 (28/06/2018) INTERNATIONAL REGISTERED REPORT RR2-10.2196/17232

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Effect of ginger tea on chemotherapy-induced nausea and vomiting among cancer patients in selected hospitals, Bhubaneswar, Odisha

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i1.1953 ◽

2020 ◽

Vol 11 (1) ◽

pp. 1165-1171

Author(s):

Sasmita Das ◽

Mary Preety Banra ◽

Neethu Maria Joseph

Keyword(s):

Cancer Patients ◽

Research Design ◽

Demographic Data ◽

Large Population ◽

Nausea And Vomiting ◽

Control Group ◽

Food Component ◽

Significant Difference ◽

Chi Square Analysis ◽

And Control

A quasi-experimental research study (posttest only research design) was conducted to evaluate the effect of ginger tea on chemotherapy-induced nausea and vomiting among cancer patients in selected hospitals of Bhubaneswar and to find out the association of level of chemotherapy-induced nausea and vomiting with selected socio-demographic variables. For this study, a quantitative experimental approach and post-test only research design was adopted. 100 patients were selected by convenience sampling technique and categorized into experimental (n=50) and control group (n=50) for this study. Self- structured socio-demographic proforma and self- structured record analysis proforma was used to collect socio-demographic data and modified nausea and vomiting scale was used to measure the level of chemotherapy-induced nausea and vomiting among cancer patients. The data was analyzed by using SPSS version 20.0 (Statistical Package for the Social Science). The post-testt level of chemotherapy-induced nausea and vomiting among experimental and control groups was compared by unpaired‘t’ test and the result showed (p=<0.0001) significant difference between both groups. The chi-square analysis shows a statistically significance association between chemotherapy-induced nausea and vomiting and the emetogenic potential of the drug in both groups and in control group age was also significance associated. The ANOVA test revealed the statistically significance of the posttest level of chemotherapy-induced nausea and vomiting within groups of the emetogenic potential of a drug. The present study concluded that the food component, like ginger tea, is an effective home remedy for the reduction of chemotherapy-induced nausea and vomiting among cancer patients. Further study can be conducted with a large population, different dose and compositions of ginger and with different adjuvant therapy to manage nausea and vomiting among cancer patients.

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The addition of omeprazole to ondansetron for treating chemotherapy-induced nausea and vomiting in pediatric cancer patients

Paediatrica Indonesiana ◽

10.14238/pi1.1.2018.42-7 ◽

2018 ◽

Vol 1 (1) ◽

pp. 42

Author(s):

Perjuangan Dapot Hamonangan Simbolon ◽

Selvi Nafianti ◽

Pertin Sianturi ◽

Bidasari Lubis ◽

Aznan Lelo

Keyword(s):

Placebo Group ◽

Cancer Patients ◽

Pediatric Cancer ◽

Controlled Trial ◽

Complete Response ◽

Nausea And Vomiting ◽

Chi Square ◽

Double Blind ◽

Significant Difference ◽

Pediatric Cancer Patients

Background Chemotherapy-induced nausea and vomiting are some of the most disturbing side effects in pediatric cancer patients. The standard recommendation is the use of 5-hydroxytryptamine 3 receptor antagonist, such as ondansetron, to treat these symptoms. Despite this treatment, more than 50% of patients still experience nausea and vomiting.Objective To evaluate the effect of the addition of omeprazole to ondansetron in the treatment of chemotherapy-induced nausea and vomiting.Methods A double-blind, randomized, controlled trial was conducted at Haji Adam Malik Hospital, Medan, North Sumatera, from March to May 2016. Subjects were children aged 1 to 18 years, diagnosed with cancer, and who received intravenous chemotherapy. Patients were randomized to receive either a single dose of ondansetron (0.5 mg/kg) plus placebo or ondansetron (0.5 mg/kg) plus omeprazole (0.5 mg/kg). The severity of nausea and vomiting were measured using the Rhodes index of nausea, vomiting, and retching during the 24 hours after initiation of emetogenic chemotherapy. The primary outcome of efficacy was the proportion of patients who achieved complete response (lack of nausea/vomiting). Statistical analysis was performed by Chi-square and Fischer’s exact tests.Results Seventy eligible pediatric patients were randomized into two groups: 32 subjects in the ondansetron + placebo group and 38 others in the ondansetron + omeprazole group. The therapy failed in 50% (16/32) of the ondansetron + placebo group and 18.4% (7/38) of the ondansetron + omeprazole group. There was a significant difference in the clinical response between groups (P=0.01).Conclusion The addition of omeprazole to ondansetron for the treatment of chemotherapy-induced nausea and vomiting is more effective than administration of ondansetron alone.

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Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting in lung cancer patients receiving carboplatin-based therapies.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e21685 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e21685-e21685

Author(s):

Cindy Weinstein ◽

Karin Jordan ◽

Stuart Green ◽

Saleem A. Khanani ◽

Elizabeth Beckford-Brathwaite ◽

...

Keyword(s):

Lung Cancer ◽

Single Dose ◽

Cancer Patients ◽

Nausea And Vomiting ◽

Control Group ◽

Lung Cancer Patients ◽

End Point ◽

Control Regimen ◽

Delayed Phase ◽

Oral Ondansetron

e21685 Background: Chemotherapy-induced nausea and vomiting (CINV) is a distressing symptom of cancer treatment; in lung cancer, carboplatin is commonly used. In a post hoc analysis, we explored prevention of CINV in lung cancer patients with a single-day triple-antiemetic fosaprepitant (FA) regimen compared with a standard 3-day control regimen. Methods: This was a phase 3, global, randomized, double-blind, parallel-group study in adults scheduled to receive an intravenous (IV) dose of ≥1 moderately emetogenic chemotherapy (MEC) on treatment day 1 (NCT01594749). Subjects were randomly assigned 1:1 to a control or FA regimen. The control regimen consisted of 8 mg oral ondansetron, 20 mg dexamethasone, and IV saline as placebo before the first dose of MEC on day 1, and 8 mg oral ondansetron 8 hours after the first dose and every 12 hours on days 2 and 3. The FA regimen consisted of the same dose of oral ondansetron on day 1, along with 12 mg dexamethasone and a single dose of 150 mg IV FA before the first dose of MEC on day 1, with no additional prophylactic antiemetic beyond day 1. The primary end point was complete response (CR; no vomiting or rescue medication) in the delayed phase (25-120 hours). Results: Overall, 1000 subjects were included in the intention-to-treat population (FA: n = 502; control: n = 498). The primary end point was met ( P < 0.001; FA vs control). In a subset of 254 subjects with lung cancer (71% male), 129 in FA regimen and 125 in control regimen, most (98%) received carboplatin-based chemotherapy. CR in the delayed phase was achieved by 80.6% in the FA group and 74.4% in the control group (difference, 6.2%). More subjects had no vomiting episodes in the FA (85.3%) vs control (78.4%) groups within the delayed phase (difference, 6.9%), and overall time-to-first vomiting episode was longer for subjects in the FA group. Adverse events (AEs) were similar between groups: overall AEs occurred in 57.7% and 54.8%, and serious AEs occurred in 12.3% and 12.1% in the FA and control groups, respectively. No serious AEs were considered related to study medication. Conclusions: A single-day IV FA regimen is effective for preventing CINV in patients with lung cancer receiving carboplatin. Clinical trial information: NCT01594749.

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The addition of omeprazole to ondansetron for treating chemotherapy-induced nausea and vomiting in pediatric cancer patients

Paediatrica Indonesiana ◽

10.14238/pi58.1.2018.42-7 ◽

2018 ◽

Vol 58 (1) ◽

pp. 42

Author(s):

Perjuangan Dapot Hamonangan Simbolon ◽

Selvi Nafianti ◽

Pertin Sianturi ◽

Bidasari Lubis ◽

Aznan Lelo

Keyword(s):

Placebo Group ◽

Cancer Patients ◽

Pediatric Cancer ◽

Controlled Trial ◽

Complete Response ◽

Nausea And Vomiting ◽

Chi Square ◽

Double Blind ◽

Significant Difference ◽

Pediatric Cancer Patients

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Efficacy and Safety of 5-Hydroxytryptamine-3 Receptor Antagonists (5-HT3 RAs) for The Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: A Review

Journal of Drug Delivery and Therapeutics ◽

10.22270/jddt.v11i1-s.4554 ◽

2021 ◽

Vol 11 (1-s) ◽

pp. 195-199

Author(s):

Nisaurrahmah Nisaurrahmah ◽

Oktavia Sri ◽

Ifora Ifora

Keyword(s):

Cancer Patients ◽

Heart Rhythm ◽

Complete Response ◽

Nausea And Vomiting ◽

Efficacy And Safety ◽

Receptor Antagonists ◽

Complete Control ◽

Electrocardiogram Ecg ◽

Ecg Abnormalities ◽

Delayed Phase

Objective: This review provides an update review of the efficacy and safety of 5-hydroxytryptamine-3 receptor antagonists in the prevention of chemotherapy-induced nausea and vomiting (CINV) in cancer patients. Methods: The information was collected from electronic scientiﬁc search engines from PubMed, Science Direct, Scopus, and Google Scholar. The publication dates covered were from 2010 to 2020. The primary endpoint was the percentage of patients who achieved a complete response (CR), complete control (CC), no nausea, no emesis, or no rescue medication.The secondary endpoint was the percentage of patients who experience constipation related to 5-HT RA constipation, headache, diarrhea, or dizziness, as well as changes in heart rhythm. Results: Fourteen articles were identified. Palonosetron has the same effectiveness as granisetron as but more effective than ondansetron in the delayed phase and overall. Adverse effects that often occur due to the use of palonosetron, granisetron, and ondansetron are constipation and headache. Some of the articles also mentioned that palonosetron does not cause changes in heart rhythm but granisetron and ondansetron do cause changes in the electrocardiogram (ECG) at certain doses. Conclusion: Palonosetron has the same effectiveness as granisetron, and more effective than ondansetron in delayed, and overall phases. The use of palonosetron, granisetron, and ondansetron cause constipation and headaches at all doses, palonosetron does not cause ECG abnormalities whereas granisetron and ondansetron cause ECG changes. Keywords: palonosetron, ondansetron, granisetron, 5-HT3 RAs, cancer, nausea, vomiting, CINV.

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Exploring The Clinical Significance of Serum Angiopoietin-2 In Breast Cancer Patients

QJM ◽

10.1093/qjmed/hcab091.014 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Abeer I Abd Elmagid ◽

Hala Abdel Al ◽

Wessam El Sayed Saad ◽

Seham Kamal Mohamed

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Serum Levels ◽

Tnm Staging ◽

Control Group ◽

Healthy Controls ◽

Breast Cancer Patients ◽

Female Patients ◽

Significant Difference ◽

Angiopoietin 2

Abstract Background Breast cancer is the most common cancer among women and one of the most important causes of death among them.Angiogenesis is an important step for primary tumor growth, invasiveness, and metastases. Angiopoietins are well-recognized endothelial growth factors that are involved in angiogenesis associated with tumors. Aim To explore the diagnostic significance of serum angiopoietin-2 (Ang-2) in breast cancer and to evaluate its prognostic efficacy through studying the degree of its association with the TNM staging of the disease. Patients and Methods This study was conducted on (35) Egyptian female patients who were diagnosed as breast cancer according to histopathological examination of breast biopsy (Group 1, Breast Cancer Patients) and (25) female patients with benign breast diseases (Group II, Pathological Control Patients), in addition to (20) age - matched apparently healthy, free mammogram, females serving as healthy controls (Group III, Healthy Controls). For all participants, measurement of serum Ang-2 was done using enzyme linked immunosorbent assay (ELISA) technique. Results A highly significant increased levels of Ang-2 was observed in breast cancer patients when compared to healthy control group (Z = 4.95, p < 0.01). However, no significant difference was observed in Ang-2 levels between breast cancer patients group and pathological control group (Z = 3.37, p > 0.05). No significant difference was detected in Ang-2 levels in relation to TNM stage and histological grade. No significant correlation was found between Ang-2 levels and serum levels of CA15-3, hormone receptors, HER2/new receptor status (p > 0.05, respectively). Conclusion This study revealed that Ang-2 serum levels were significantly increased in patient with breast cancer compared with healthy controls, indicating that high Ang-2 level is a promising non invasive biomarker for breast cancer diagnosis. However, no significant difference of Ang-2 levels was detected in relation of breast TNM staging in the population studied.

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The effects of psychological counseling and acupressure based on couple therapy procedure for alleviation of vomiting and nausea in pregnant women in Iran country

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2020-0308 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Sahar Saadatnia ◽

Azita Tiznobaik ◽

Amir Saber

Keyword(s):

Pregnant Women ◽

Couple Therapy ◽

Psychological Intervention ◽

Nausea And Vomiting ◽

Control Group ◽

Negative Effects ◽

Psychological Counseling ◽

Significant Difference ◽

Group 2 ◽

Short Time

Abstract Objectives Nausea and vomiting have psychological negative effects on some pregnant women during gestation. Different strategies have been used for the treatment of nausea and vomiting during pregnancy, such as acupressure and psychological interventions. This study was conducted to evaluate the effects of psychological counseling and acupressure based on couple therapy procedures on vomiting and nausea in pregnant women in Iran. Methods Two hundred and eight women were divided into four groups (n=52): 1) they did not any intervention (control group), 2) they received the psychological intervention, 3) they received acupressure intervention, and 4) they received a combination of psychological + acupressure interventions. To investigate the effects of interventions on nausea and vomiting, the Rhodes index of nausea, vomiting and retching were used. The counseling period has lasted for 4 weeks. The pressure intervention on the site was conducted in clockwise form for 1 min and anticlockwise form for another 1 min. Results Groups did not have a significant difference for abortion and income (p>0.05). The effects of counseling, and acupressure interventions on severity and period of vomiting and nausea were not significant (p>0.05), but the intervention based on counseling and acupressure decreased severity of vomiting and nausea (p<0.05). Conclusions The intervention based on counseling and acupressure could not reduce nausea and vomiting during the gestation, but the intervention based on a combination of both decreased nausea and vomiting. It can be suggested to apply an intervention based on a combination of counseling and acupressure in short-time period for decreasing nausea and vomiting in women during pregnancy.

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LEMON AROMATHERAPY AS AN ALTERNATIVE TO REDUCE THE INTENSITY OF CHEMOTHERAPY-RELATED NAUSEA AND VOMITING EXPERIENCED BY THE BREAST CANCER PATIENTS

INTERNATIONAL JOURNAL OF NURSING AND MIDWIFERY SCIENCE (IJNMS) ◽

10.29082/ijnms/2021/vol5/iss2/350 ◽

2021 ◽

Vol 5 (2) ◽

pp. 125-130

Author(s):

Puji Hastuti ◽

Yuli Nurhayati ◽

Dwi Ernawati ◽

Christina Yuliastuti ◽

Merina Widyastuti

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Sampling Technique ◽

Complementary Therapy ◽

Nausea And Vomiting ◽

Wilcoxon Test ◽

Control Group ◽

Breast Cancer Patients ◽

Post Test ◽

Abnormal Tissue

ABSTRACT Introduction : The mechanism of breast cancer is the cells growing and breeding become appear abnormal tissue of breast. One of the common treatments for it is chemotherapy using cytotoxic drugs. However, chemotherapy may cause nausea and vomiting as its side effects. Lemon aromatherapy is a complementary therapy in patients with breast cancer who experience nausea or vomiting. The study’s purpose was to know the effect of lemon aromatherapy on the intensity of nausea and vomiting experienced by the breast cancer patients as an effect of chemoterapy in the Chemo Center Room of RSAL Dr. Ramelan Surabaya. Material and Methods : The study was the pre-experimental design with pre-post test without control group. There are two variables, lemon aromatherapy is independent, and the intensity of nausea and vomiting is dependent. The sampling technique was nonprobability purposive sampling, with 34 breast cancer patients taken as the sample. A questionnaire was the instrument for collecting the data. The Data collected were analyzed using the Wilcoxon Test (α = 0,05). Results : The study’s result indicated that the lemon aromatherapy was effectively to decrease of the intensity of nausea and vomiting exeperienced by the respondents, with the value of Wilcoxon test p < 0.001. Conclusion : Lemon aromatherapy stimulates the raphe nucleus to produce serotonin. Which function to generate a sense of comfort and calm. For that reason, it can be used as an alternative for taking care of nausea and vomiting experienced by patients with breast cancer as the side effect of chemotherapy. Keywords: Lemon Aromatherapy, Nausea, Vomiting, Chemotherapy

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EFFECT OF MINDFULNESS INTERVENTION ON THE INTENSITY OF PAIN IN NASOPHARINGEAL CANCER PATIENTS UNDERGOING RADIATION TREATMENT

Belitung Nursing Journal ◽

10.33546/bnj.128 ◽

2018 ◽

Vol 4 (2) ◽

pp. 195-201

Author(s):

Anna Jumatul Laely ◽

Awal Prasetyo ◽

Chandra Bagus Ropyanto

Keyword(s):

Cancer Patients ◽

Radiation Treatment ◽

Nasopharyngeal Cancer ◽

Psychological Trauma ◽

Control Group ◽

Intensity Level ◽

Control Group Design ◽

Mindfulness Intervention ◽

Significant Difference ◽

Before And After

Background: Physical responses that occur in patients with nasopharyngeal cancer are the emergence of pain due to the effects of treatment. The problem of pain in these patients at the stage of treatment remains critical to solve because it can cause comorbidity, psychological trauma and mortality. Mindfulness intervention is considered useful in transforming consciousness into the stage of acceptance.Objective: This study aims to determine the effect of mindfulness intervention on the intensity of pain in nasopharyngeal cancer patients undergoing radiation treatment.Methods: This was a quasy-experimental study with pretest posttest control group design. Thirty patients were selected using consecutive sampling, which divided into experiment and control group. Visual Analogue Scale (VAS) was used to measure pain. Each respondent received mindfulness intervention for 6 sessions, divided into 3 meetings. Paired t-test was used for data analysis.Results: The results showed a significant reduction of pain from 4.12 (moderate pain) to 3.06 (mild pain) in the experiment group. There was a significant difference in pain level before and after mindfulness intervention (p= 0.001).Conclusion: Mindfulness is effective in reducing pain intensity level in nasopharyngeal cancer patients undergoing radiation therapy.

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