Efficacy and safety of multi-day antiemetic treatment for patients undergoing multi-day chemotherapy: A systematic review of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clinical Oncology

Author:

Nakashima Kazuhisa1,Harashima Saki2,Kaneko Rena3,Tanaka Ryuhei4,Abe Masakazu5,Wada Makoto6,Iino Keiko7,Akechi Tatuso8,Iihara Hirotoshi9,Imamura Chiyo K.10,Okuyama Ayako11,Ozawa Keiko12,Kim Yong-il13,Satomi Eriko14,Takeda Masayuki15,Nakajima Takako Eguchi16,Nakamura Naoki17,Nishimura Junichi6,Noda Mayumi18,Hayashi Kazumi19,Higashi Takahiro20,Boku Narikazu21,Matsumoto Koji22,Matsumoto Yoko23,Okita Kenji24,Yamamoto Nobuyuki25,Aogi Kenjiro26,Sasaki Hidenori27

Affiliation:

1. Shimane University Hospital: Shimane Daigaku Igakubu Fuzoku Byoin

2. University of Tokyo Hospital: Tokyo Daigaku Igakubu Fuzoku Byoin

3. Kanto Rosai Hospital: Kanto Rosai Byoin

4. Saitama Medical University International Medical Center: Saitama Ika Daigaku Kokusai Iryo Center

5. Hamamatsu University School of Medicine: Hamamatsu Ika Daigaku

6. Osaka International Cancer Institute: Osaka Kokusai Gan Center

7. National College of Nursing

8. Nagoya City University Graduate School of Medical Sciences and Medical School: Nagoya Shiritsu Daigaku Daigakuin Igaku Kenkyuka Igakubu

9. Gifu University Hospital: Gifu Daigaku Igakubu Fuzoku Byoin

10. Showa University: Showa Daigaku

11. St Luke's International University: Sei Roka Kokusai Daigaku

12. National Cancer Center

13. Yodogawa Christian Hospital

14. National Cancer Center Hospital: Kokuritsu Gan Kenkyu Center Chuo Byoin

15. Nara Medical University: Nara Kenritsu Ika Daigaku

16. Kyoto University Graduate School of Medicine Faculty of Medicine: Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu

17. St Marianna University School of Medicine: Sei Marianna Ika Daigaku

18. Non-profit Organization Sasaeau-kai "Alpha"

19. The Jikei University School of Medicine: Tokyo Jikeikai Ika Daigaku

20. The University of Tokyo: Tokyo Daigaku

21. IMSUT Hospital: Tokyo Daigaku Ikagaku Kenkyujo Fuzoku Byoin

22. Hyogo Cancer Center: Hyogo Kenritsu Gan Center

23. Non-Profit Organization Ehime Cancer Support Orange-No-Kai

24. Otaru Ekisaikai Hospital

25. Wakayama Medical University: Wakayama Kenritsu Ika Daigaku

26. Shikoku Cancer Center: Kokuritsu Byoin Shikoku Gan Center

27. Fukuoka University Hospital: Fukuoka Daigaku Byoin

Abstract

Abstract

Background A standardized multi-day antiemetic regimen for multi-day chemotherapy remains elusive. This systematic review evaluated the efficacy and safety of multi-day antiemetic regimens in patients undergoing undergoing multi-day intravenous chemotherapy Methods We conducted a comprehensive search of PubMed, Cochrane Library, and Ichushi-Web databases for relevant studies published from January 1990 to December 2020. We included studies comparing multi-day and single-day antiemetic regimens for preventing chemotherapy-induced nausea and vomiting. Results No studies directly comparing multi-day versus single-day antiemetic regimens were found. Despite expanding control group criteria beyond “single-day antiemetic therapy” limited high-quality studies and variations in cancer types, chemotherapy regimens, and antiemetic treatments precluded meta-analysis. Among the included studies, some randomized controlled trials (RCTs) focused on complete response and vomiting rates. Two studies comparing two- and three-drug combinations reported higher complete response and no-vomiting rates with the three-drug regimen. Limited RCTs explored “nausea control” and “cost,” and assessing “adverse events” proved challenging due to inconsistent reporting. Conclusion Research on multi-day antiemetic therapy is limited, necessitating further investigation. Nonetheless, our findings suggest that three-drug combination therapy, including aprepitant, may offer superior antiemetic efficacy compared to two-drug regimens. Multi-day antiemetic therapy is strongly recommended during multi-day intravenous administration of cytotoxic anticancer drugs.

Publisher

Springer Science and Business Media LLC

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