Combination Antiemetic Therapy for Chemotherapy-Induced Nausea and Vomiting in Patients with NSCLC Receiving Carboplatin-Based Chemotherapy

Figures & data

Figure 1 Patient selection diagram. Pooled data from 240 patients with non-small cell lung cancer (NSCLC) who received carboplatin (CBDCA)-based chemotherapy regimens (CBDCA + pemetrexed [PEM]/CBDCA + paclitaxel [PTX]) were selected among 2468 patients from two prospective observational studies.

Abbreviations: CINV, chemotherapy-induced nausea and vomiting; HEC, highly emetogenic chemotherapy; MEC, moderately emetogenic chemotherapy; GI, gastrointestinal; PEM, pemetrexed; PTX, paclitaxel.

Table 1 Patients’ Baseline Characteristics

Characteristics	Study A (N = 134)^Citation18	Study B (N = 106)^Citation19	Overall (N = 240)
	n (%)	n (%)	n (%)
Age
<70 years	81 (60.4)	74 (69.8)	155 (64.6)
≥70 years	53 (39.6)	32 (30.2)	85 (35.4)
Sex
Male	92 (68.7)	81 (76.4)	173 (72.1)
Female	42 (31.3)	25 (23.6)	67 (27.9)
Motion sickness
No	125 (93.3)	96 (90.6)	221 (92.1)
Yes	9 (6.7)	10 (9.4)	19 (7.9)
Drinking habits
No	86 (64.2)	44 (41.5)	130 (54.2)
Yes	48 (35.8)	62 (58.5)	110 (45.8)
Regimen
CBDCA + PEM	87 (64.9)	48 (45.3)	135 (56.3)
CBDCA + PTX	47 (35.1)	58 (54.7)	105 (43.8)
Number of antiemetics
2	80 (59.7)	106 (100.0)	186 (77.5)
3	54 (40.3)	0 (0.0)	54 (22.5)

Abbreviations: CBDCA, carboplatin; PEM, pemetrexed; PTX, paclitaxel.

Table 2 Unweighted and Weighted Baseline Characteristics of Patients with NSCLC Treated with CBDCA Categorized by the Number of Antiemetic Regimens

Characteristics	Unweighted, n (%)			Weighted, %
	2 Antiemetics	3 Antiemetics	p	2 Antiemetics	3 Antiemetics	p	SD
Total	186 (100)	54 (100)
Age
<70 years	124 (66.7)	31 (57.4)	0.2104	66.7	70.5	0.4193	0.08
≥70 years	62 (33.3)	23 (42.6)		33.3	29.5
Sex
Male	139 (74.7)	34 (63.0)	0.0897	74.7	80.4	0.1854	0.12
Female	47 (25.3)	20 (37.0)		25.3	19.6
Drinking habits
No	91 (48.9)	39 (72.2)	0.0025	48.9	44.1	0.3427	−0.10
Yes	95 (51.1)	15 (27.8)		51.1	55.9
Motion sickness
No	171 (91.9)	50 (92.6)	0.8749	91.9	92.9	0.7205	0.04
Yes	15 (8.1)	4 (7.4)		8.1	7.1
Regimen
CBDCA + PEM	95 (51.1)	40 (74.1)	0.0027	51.1	50.1	0.8531	0.02
CBDCA + PTX	91 (48.9)	14 (25.9)		48.9	49.9

Abbreviations: CBDCA, carboplatin; PEM, pemetrexed; PTX, paclitaxel; SD, standard deviation.

Figure 2 Incidence of delayed nausea and vomiting. The incidence of delayed nausea and vomiting was significantly higher in the two-antiemetic group than that in the three-antiemetic group.

Table 3 Risk Factors for Delayed Nausea and Delayed Vomiting

	Delayed Nausea				Delayed Vomiting
	Univariate		Multivariate		Univariate		Multivariate
	OR (95% CI)	p	OR (95% CI)	p	OR (95% CI)	p	OR (95% CI)	p
Age: <70 years vs ≥70 years	1.934 (1.233–3.033)	0.0041	2.233 (1.366–3.650)	0.0013	0.824 (0.453–1.500)	0.5270	0.743 (0.380–1.454)	0.3863
Sex: female vs male	2.896 (1.757–4.774)	<0.0001	1.441 (0.798–2.603)	0.2259	5.134 (2.782–9.474)	<0.0001	3.372 (1.632–6.967)	0.0010
Motion sickness: yes vs no	4.889 (2.042–11.706)	0.0004	3.472 (1.399–8.616)	0.0073	1.375 (0.498–3.793)	0.5387	0.677 (0.218–2.105)	0.5008
Drinking habits: yes vs no	2.082 (1.366–3.174)	0.0006	1.972 (1.209–3.218)	0.0065	3.188 (1.685–6.032)	0.0004	2.272 (1.097–4.707)	0.0272
Regimen: CBDCA + PEM vs CBDCA + PTX	2.413 (1.575–3.697)	<0.0001	2.041 (1.266–3.291)	0.0034	2.819 (1.491–5.332)	0.0014	2.314 (1.136–4.714)	0.0209
2 antiemetics vs 3 antiemetics	1.944 (1.276–2.961)	0.0020	1.926 (1.225–3.029)	0.0045	5.604 (2.691–11.669)	<0.0001	6.830 (1.136–4.714)	<0.0001

Abbreviations: CBDCA, carboplatin; PEM, pemetrexed; PTX, paclitaxel; OR, odds ratio; CI, confidence interval.

Tsuji Y, Baba H, Takeda K, et al. Chemotherapy-induced nausea and vomiting (CINV) in 190 colorectal cancer patients: a prospective registration study by the CINV study group of Japan. Expert Opin Pharmacother. 2017;18(8):753–758. doi:10.1080/14656566.2017.1317746

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