Prevent CINV from the start
Effective prevention at cycle 1 helps to avoid the risk of future CINV events and associated patient management1
In a retrospective observational analysis of the electronic health records of 10,586 patients who received single-day chemotherapy1:
~4x CINV risk in subsequent cycles when CINV occurs with cycle 1
(compared to patients with no CINV at cycle 1)
Signiﬁcant CINV may require additional patient management, including2-5:
Increased office and/or urgent care visits, emergency room visits, or reassessment of the chemotherapy regimen
Gaps in clinician adherence to HEC CINV guidelines6
In a retrospective study to evaluate gaps in use of triple prophylaxis antiemetic regimens for patients receiving HEC:
ONLY 35% Cisplatin chemotherapy
ONLY 58% AC chemotherapy
Omission of an NK-1 RA was the most common cause for non-adherence
Study design: A retrospective analysis of adult patients (n=4033) receiving cisplatin (n=2543) or AC (n=1490) chemotherapy predominantly in the outpatient setting between October 2012 and August 2018 using the IBM Watson Explorys Electronic Health Record Database was performed to evaluate clinician (n=217) adherence to HEC antiemetic guidelines from organizations such as the Multinational Association of Supportive Care in Cancer in collaboration with the European Society of Medical Oncology (MASCC/ESMO, 2016), the American Society of Clinical Oncology (ASCO, 2017), and the National Comprehensive Cancer Network (NCCN, 2020). HEC antiemetic guideline adherence was defined as triple prophylaxis (NK-1 RA, 5-HT3 RA, dexamethasone) at the initiation of cisplatin or AC chemotherapy. The analysis included clinicians who prescribed ≥5 HEC courses and assessed individual guideline adherence, noting the number of clinicians with >90% adherence. Patients with low-dose and multi-day chemotherapy were excluded.6
5-HT3 RA=5-HT3 receptor antagonist; AC=anthracycline-cyclophosphamide; CINV=chemotherapy-induced nausea and vomiting; HEC=highly emetogenic chemotherapy; NCCN=National Comprehensive Cancer Network; NK-1 RA=neurokinin-1 receptor antagonist.
*Highly adherent is defined as achieving a 90% or greater rate of adherence to guidelines.