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New Tool Identifies 8 Risk Factors to Predict CINV

Nine researchers from facilities in 7 countries, including the United States, have developed a prediction tool for chemotherapy-induced nausea and vomiting (CINV). Data suggest that as many as 40% of patients receiving chemotherapy experience some degree of nausea and vomiting despite the use of antiemetics.

In addition to the type of chemotherapy (eg, highly emetic vs low emetic potential), several patient-related risk factors for CINV have been identified in previous studies. To incorporate these factors into the optimal selection of prophylactic antiemetics, a repeated measures cycle-based model to predict the risk of ≥ grade 2 CINV (≥ 2 vomiting episodes or a decrease in oral intake due to nausea) from day 0 to 5 postchemotherapy was developed.

Data from 1198 patients enrolled in 1 of 5 non-interventional CINV prospective studies were pooled. Generalized estimating equations were used in a backwards elimination process and a risk scoring algorithm (range, 0-32) was derived. Over 4197 chemotherapy cycles, 42.2% of patients experienced ≥ grade 2 CINV. Eight risk factors were identified:
  1. Patient age <60 years
  2. The first 2 cycles of chemotherapy
  3. Anticipatory nausea and vomiting
  4. History of morning sickness
  5. Hours of sleep the night before chemotherapy
  6. CINV in the prior cycle
  7. Patient self-medication with non-prescribed treatments
  8. Use of platinum or anthracycline-based regimens.
Prior to each cycle of therapy, patients with risk scores >16 units would be considered at high risk for developing ≥ grade 2 CINV. The researchers concluded that clinical application of this CINV prediction tool may help reduce the incidence of CINV. The prediction tool and study findings are available at here.
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