Delayed chemotherapy-induced nausea – Occurrence and corelates in an international multi-center study in adult oncology patients in clinical practice (CINrate)

Abstract Purpose Nausea and vomiting negatively impact patients' quality of life and may influence systemic antitumoral therapy (CHT). Delayed chemotherapy-induced nausea (dCIN), with low and minimally emetogenic CHT, is often underestimated in clinical practice. This study aims to assess dCIN occurrence, focusing on low and minimally emetogenic CHT.Methods In an international multicenter cross-sectional study, patients rated dCIN on a 0-100 scale for five days. The primary endpoint was dCIN in low and minimally emetogenic CHT. Secondary endpoints included known risk factors for CIN and vomiting, like diagnosis, gender etc. The relationship between dCIN and secondary endpoints was determined with a multiple logistic regression model.Results In three day-clinics of accredited cancer centers, 2 in Switzerland and 1 in Southern Germany, 172 patients were recruited. Of these, 31 (18%) received minimally, 65 (38%) low, 61 (36%) moderately and 15 (9%) highly emetogenic CHT. Occurrence of dCIN in low emetogenic CHT was 18.5% (n = 12 of n = 65; 95%CI 10.5–29.1), in minimally emetogenic CHT 3% (n = 1 of n = 31; 95%CI 0.04/14.1). Overall occurrence of dCIN was 18.0% (95%CI 12.8/24.3). Only 3 patients (1.7%; 95% CI 0.5/4.6) experienced vomiting. Stable risk factors for dCIN were diagnosis with a gastrointestinal tumor and younger age. Emetogenicity of antitumoral therapy, fear and nausea in former cycles did not remain in the model.Discussion In clinical settings, acute CIN and vomiting are generally well-managed, but dCIN still poses some challenges. Known risk factors and current antiemetic regimens offer only limited support for the prevention of the remaining occurrence of dCIN.