Efficacy of one-day versus multiple-day dexamethasone for chemotherapy-induced nausea and vomiting in lung cancer patients receiving carboplatin-based chemotherapy: a propensity score-matched analysis.
PURPOSE
Dexamethasone (DEX)-sparing strategies (one-day DEX) with palonosetron as doublet antiemetic prophylaxis have previously been studied. However, DEX-sparing regimens with 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) and aprepitant (APR), as triplet antiemetic prophylaxis, have not been evaluated. This study aimed to evaluate the efficacy of a combination of 5-HT3RA, APR, and DEX on day 1 of carboplatin (CBDCA)-based chemotherapy in patients with lung cancer.


METHODS
Data were pooled from a nationwide, multicenter, prospective observational study using propensity score-matched analysis to compare the incidence of chemotherapy-induced nausea and vomiting (CINV) between one- and multiple-day DEX regimens in combination with 5-HT3RA plus APR.


RESULTS
Incidence of delayed nausea was significantly higher in the one-day than in the multiple-day DEX group. Incidence of nausea was also significantly higher in the one-day than in the multiple-day DEX group on days 3-5. Kaplan-Meier curves for nausea showed a significant difference between the two groups; however, there was no significant difference in the occurrence of vomiting or the Kaplan-Meier curves of time to vomiting.


CONCLUSION
To the best of our knowledge, this study is the first to evaluate the efficacy of a DEX-sparing regimen by comparing one- and multiple-day DEX combined with 5-HT3RA and APR concerning CINV incidence in lung cancer patients receiving CBDCA-based chemotherapy. Antiemetic regimens of one-day DEX result in poor control of delayed nausea; therefore, we recommend the application of the DEX-sparing strategy only after careful patient selection while considering the development of nausea.
['Hayashi|Toshinobu|T|http://orcid.org/0000-0001-6183-4939', 'Shimokawa|Mototsugu|M|', 'Mizuki|Fumitaka|F|', 'Matsuo|Koichi|K|', 'Kawada|Kei|K|', 'Nakano|Takafumi|T|', 'Egawa|Takashi|T|']
D000932:Antiemetics D000970:Antineoplastic Agents D016190:Carboplatin D003907:Dexamethasone D006801:Humans D008175:Lung Neoplasms D009325:Nausea D057216:Propensity Score D014839:Vomiting
Dexamethasone Chemotherapy-induced nausea and vomiting Lung cancer Antiemetics Carboplatin Steroid-sparing