Toxicological Research

Korean Society of Toxicology & Korea Environmental Mutagen Society (한국독성학회)
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Exploring Chemotherapy-Induced Toxicities through Multivariate Projection of Risk Factors: Prediction of Nausea and Vomiting

  • Yap, Kevin Yi-Lwern (Institute of Digital Healthcare, WMG, University of Warwick, International Digital Laboratory) ;
  • Low, Xiu Hui (Department of Pharmacy, Faculty of Science, National University of Singapore) ;
  • Chan, Alexandre (Department of Pharmacy, Faculty of Science, National University of Singapore)
  • Received : 2012.01.17
  • Accepted : 2012.03.22
  • Published : 2012.06.30
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Abstract

Many risk factors exist for chemotherapy-induced nausea and vomiting (CINV). This study utilized a multivariate projection technique to identify which risk factors were predictive of CINV in clinical practice. A single-centre, prospective, observational study was conducted from January 2007~July 2010 in Singapore. Patients were on highly (HECs) and moderately emetogenic chemotherapies with/without radiotherapy. Patient demographics and CINV risk factors were documented. Daily recording of CINV events was done using a standardized diary. Principal component (PC) analysis was performed to identify which risk factors could differentiate patients with and without CINV. A total of 710 patients were recruited. Majority were females (67%) and Chinese (84%). Five risk factors were potential CINV predictors: histories of alcohol drinking, chemotherapy-induced nausea, chemotherapy-induced vomiting, fatigue and gender. Period (ex-/current drinkers) and frequency of drinking (social/chronic drinkers) differentiated the CINV endpoints in patients on HECs and anthracycline-based, and XELOX regimens, respectively. Fatigue interference and severity were predictive of CINV in anthracycline-based populations, while the former was predictive in HEC and XELOX populations. PC analysis is a potential technique in analyzing clinical population data, and can provide clinicians with an insight as to what predictors to look out for in the clinical assessment of CINV. We hope that our results will increase the awareness among clinician-scientists regarding the usefulness of this technique in the analysis of clinical data, so that appropriate preventive measures can be taken to improve patients' quality of life.

Keywords

References

  1. Abali, H. and Celik, I. (2007). Tropisetron, ondansetron, and granisetron for control of chemotherapy-induced emesis in Turkish cancer patients: a comparison of efficacy, side-effect profile, and cost. Cancer Invest., 25, 135-139. https://doi.org/10.1080/07357900701208709
  2. Abbrederis, K., Lorenzen, S., Rothling, N., Ihbe-Heffinger, A., Schuster, T., Peschel, C. and Lordick, F. (2009). Chemotherapyinduced nausea and vomiting in the treatment of gastrointestinal tumors and secondary prophylaxis with aprepitant. Onkologie, 32, 30-34. https://doi.org/10.1159/000183735
  3. Al-Kandari, N.M. and Jolliffe, I.T. (2001). Variable selection and interpretation of covariance principal components. Communications in Statistics - Simulation and Computation, 30, 339-354. https://doi.org/10.1081/SAC-100002371
  4. Arpornwirat, W., Albert, I., Hansen, V.L., Levin, J., Bandekar, R.R. and Grunberg, S.M. (2009). Phase 2 trial results with the novel neurokinin-1 receptor antagonist casopitant in combination with ondansetron and dexamethasone for the prevention of chemotherapy-induced nausea and vomiting in cancer patients receiving moderately emetogenic chemotherapy. Cancer, 115, 5807-5816. https://doi.org/10.1002/cncr.24630
  5. Beck, A.T., Epstein, N., Brown, G. and Steer, R.A. (1988). An inventory for measuring clinical anxiety: psychometric properties. J. Consult. Clin. Psychol., 56, 893-897. https://doi.org/10.1037/0022-006X.56.6.893
  6. Bloechl-Daum, B., Deuson, R.R., Mavros, P., Hansen, M. and Herrstedt, J. (2006). Delayed nausea and vomiting continue to reduce patients' quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J. Clin. Oncol., 24, 4472-4478. https://doi.org/10.1200/JCO.2006.05.6382
  7. Booth, C.M., Clemons, M., Dranitsaris, G., Joy, A., Young, S., Callaghan, W., Trudeau, M. and Petrella, T. (2007). Chemotherapy- induced nausea and vomiting in breast cancer patients: a prospective observational study. J. Support. Oncol., 5, 374-380.
  8. Cengiz, B. and Kuruo lu, H.R. (2006). Interpretation of the repetitive nerve stimulation test results using principal component analysis. Clin. Neurophysiol., 117, 2073-2078. https://doi.org/10.1016/j.clinph.2006.05.023
  9. Chow, E., Fan, G., Hadi, S., Wong, J., Kirou-Mauro, A. and Filipczak, L. (2008). Symptom clusters in cancer patients with brain metastases. Clin. Oncol. (R. Coll. Radiol.), 20, 76-82. https://doi.org/10.1016/j.clon.2007.09.007
  10. Cohen, L., de Moor, C.A., Eisenberg, P., Ming, E.E. and Hu, H. (2007). Chemotherapy-induced nausea and vomiting: incidence and impact on patient quality of life at community oncology settings. Support. Care Cancer, 15, 497-503. https://doi.org/10.1007/s00520-006-0173-z
  11. de Kok, I.M., Wong, C.S., Chia, K.S., Sim, X., Tan, C.S., Kiemeney, L.A. and Verkooijen, H.M. (2008). Gender differences in the trend of colorectal cancer incidence in Singapore, 1968- 2002. Int. J. Colorectal Dis., 23, 461-467. https://doi.org/10.1007/s00384-007-0421-9
  12. Dranitsaris, G., Joy, A., Young, S., Clemons, M., Callaghan, W. and Petrella, T. (2009). Identifying patients at high risk for nausea and vomiting after chemotherapy: the development of a practical prediction tool. I. Acute nausea and vomiting. J. Support. Oncol., 7, W1-W8.
  13. Dunteman, G.H. (1989). Principal Components Analysis (1st edition), Sage Publications, Inc., Newbury Park, CA
  14. Erazo Valle, A., Wisniewski, T., Figueroa Vadillo, J.I., Burke, T.A. and Martinez Corona, R. (2006). Incidence of chemotherapyg induced nausea and vomiting in Mexico: healthcare provider predictions versus observed. Curr. Med. Res. Opin., 22, 2403-2410. https://doi.org/10.1185/030079906X154033
  15. Gralla, R., Lichinitser, M., Van Der Vegt, S., Sleeboom, H., Mezger, J., Peschel, C., Tonini, G., Labianca, R., Macciocchi, A. and Aapro, M. (2003). Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Ann. Oncol., 14, 1570-1577. https://doi.org/10.1093/annonc/mdg417
  16. Gralla, R.J., de Wit, R., Herrstedt, J., Carides, A.D., Ianus, J., Guoguang-Ma, J., Evans, J.K. and Horgan, K.J. (2005). Antiemetic efficacy of the neurokinin-1 antagonist, aprepitant, plus a 5HT3 antagonist and a corticosteroid in patients receiving anthracyclines or cyclophosphamide in addition to high-dose cisplatin: analysis of combined data from two Phase III randomized clinical trials. Cancer, 104, 864-868. https://doi.org/10.1002/cncr.21222
  17. Grunberg, S.M., Deuson, R.R., Mavros, P., Geling, O., Hansen, M., Cruciani, G., Daniele, B., De Pouvourville, G., Rubenstein, E.B. and Daugaard, G. (2004). Incidence of chemotherapyinduced nausea and emesis after modern antiemetics: perception versus reality. Cancer, 100, 2261-2268. https://doi.org/10.1002/cncr.20230
  18. Hadi, S., Fan, G., Hird, A.E., Kirou-Mauro, A., Filipczak, L.A. and Chow, E. (2008). Symptom clusters in patients with cancer with metastatic bone pain. J. Palliat. Med., 11, 591-600. https://doi.org/10.1089/jpm.2007.0145
  19. Herrstedt, J., Apornwirat, W., Shaharyar, A., Aziz, Z., Roila, F., Van Belle, S., Russo, M.W., Levin, J., Ranganathan, S., Guckert, M. and Grunberg, S.M. (2009). Phase III trial of casopitant, a novel neurokinin-1 receptor antagonist, for the prevention of nausea and vomiting in patients receiving moderately emetogenic chemotherapy. J. Clin. Oncol., 27, 5363-5369. https://doi.org/10.1200/JCO.2009.21.8511
  20. Hesketh, P.J. (1999). Defining the emetogenicity of cancer chemotherapy regimens: relevance to clinical practice. Oncologist, 4, 191-196.
  21. Hesketh, P.J., Younger, J., Sanz-Altamira, P., Hayden, M., Bushey, J., Trainor, B., Krentzin, M., Nowd, P., Arnaoutakis, K. and Hesketh, A.M. (2008). Aprepitant as salvage antiemetic therapy in breast cancer patients receiving doxorubicin and cyclophosphamide. Support. Care Cancer, 17, 1065-1070.
  22. Jordan, K., Kinitz, I., Voigt, W., Behlendorf, T., Wolf, H.H. and Schmoll, H.J. (2009). Safety and efficacy of a triple antiemetic combination with the NK-1 antagonist aprepitant in highly and moderately emetogenic multiple-day chemotherapy. Eur. J. Cancer, 45, 1184-1187. https://doi.org/10.1016/j.ejca.2008.11.046
  23. Liau, C.T., Chu, N.M., Liu, H.E., Deuson, R., Lien, J. and Chen, J.S. (2005). Incidence of chemotherapy-induced nausea and vomiting in Taiwan: physicians' and nurses' estimation vs. patients' reported outcomes. Support. Care Cancer, 13, 277-286. https://doi.org/10.1007/s00520-005-0788-5
  24. Lim, A. (2008). Nose cancer is No. 6 killer among men here in The Straits Times, Singapore Press Holdings Ltd., Singapore.
  25. Lohr, L. (2008). Chemotherapy-induced nausea and vomiting. Cancer J., 14, 85-93. https://doi.org/10.1097/PPO.0b013e31816a0f07
  26. Luo, N., Fones, C.S., Thumboo, J. and Li, S.C. (2004). Factors influencing health-related quality of life of Asians with anxiety disorders in Singapore. Qual. Life Res., 13, 557-565. https://doi.org/10.1023/B:QURE.0000018484.89711.e2
  27. Molassiotis, A., Saunders, M.P., Valle, J., Wilson, G., Lorigan, P., Wardley, A., Levine, E., Cowan, R., Loncaster, J. and Rittenberg, C. (2008). A prospective observational study of chemotherapy- related nausea and vomiting in routine practice in a UK cancer centre. Support. Care Cancer, 16, 201-208. https://doi.org/10.1007/s00520-007-0343-7
  28. Molassiotis, A., Yam, B.M., Yung, H., Chan, F.Y. and Mok, T.S. (2002). Pretreatment factors predicting the development of postchemotherapy nausea and vomiting in Chinese breast cancer patients. Support. Care Cancer, 10, 139-145. https://doi.org/10.1007/s00520-001-0321-4
  29. Mueller, F., Jordan, K., Jahn, P., Behlendorf, T., Sippel, C., Kegel, T., Wolf, H.H. and Schmoll, H.J. (2009). The NK-1 antagonist aprepitant (APR) in combination with granisetron and dexamethasone in high dose chemotherapy (HDC). Eur. J. Cancer Suppl., 7, 200-201 (abstr 3087).
  30. National Comprehensive Cancer Network (c2011). NCCN Clinical Practice Guidelines in $Oncology^{TM}$. Antiemesis v.1.2012. Available from: http://www.nccn.org/professionals/physician_gls/PDF/antiemesis.pdf (Accessed 29 December 2011).
  31. National Registry of Diseases Office (2009). Singapore Cancer Registry report: trends in cancer incidence in Singapore 2003-2007. Available from: http://www.nrdo.gov.sg/uploadedFiles/ NRDO/Publications/Cancer%20Trend%20Report%2003-07%20 for%20web%20v2.pdf (Accessed 29 December 2011).
  32. Navari, R.M. and Province, P.S. (2006). Emerging drugs for chemotherapy- induced emesis. Expert Opin. Emerg. Drugs, 11, 137-151. https://doi.org/10.1517/14728214.11.1.137
  33. Osoba, D., Zee, B., Pater, J., Warr, D., Latreille, J. and Kaizer, L. (1997). Determinants of postchemotherapy nausea and vomiting in patients with cancer. Quality of life and symptom control committees of the national cancer institute of canada clinical trials group. J. Clin. Oncol., 15, 116-123. https://doi.org/10.1200/JCO.1997.15.1.116
  34. Pollera, C.F. and Giannarelli, D. (1989). Prognostic factors influencing cisplatin-induced emesis. Definition and validation of a predictive logistic model. Cancer, 64, 1117-1122. https://doi.org/10.1002/1097-0142(19890901)64:5<1117::AID-CNCR2820640525>3.0.CO;2-R
  35. Roscoe, J.A., Morrow, G.R., Colagiuri, B., Heckler, C.E., Pudlo, B.D., Colman, L., Hoelzer, K. and Jacobs, A. (2010). Insight in the prediction of chemotherapy-induced nausea. Support. Care Cancer., 18, 869-876. https://doi.org/10.1007/s00520-009-0723-2
  36. Schnell, F.M. (2003). Chemotherapy-induced nausea and vomiting: the importance of acute antiemetic control. Oncologist, 8, 187-198. https://doi.org/10.1634/theoncologist.8-2-187
  37. Shih, V., Wan, H.S. and Chan, A. (2009). Clinical predictors of chemotherapy-induced nausea and vomiting in breast cancer patients receiving adjuvant doxorubicin and cyclophosphamide. Ann. Pharmacother., 43, 444-452 https://doi.org/10.1345/aph.1L437
  38. Stieler, J.M., Reichardt, P., Riess, H. and Oettle, H. (2003). Treatment options for chemotherapy-induced nausea and vomiting: current and future. Am. J. Cancer, 2, 15-26. https://doi.org/10.2165/00024669-200302010-00002
  39. Yeo, W., Mo, F.K., Suen, J.J., Ho, W.M., Chan, S.L., Lau, W., Koh, J., Yeung, W.K., Kwan, W.H., Lee, K.K., Mok, T.S., Poon, A.N., Lam, K.C., Hui, E.K. and Zee, B. (2009). A randomized study of aprepitant, ondansetron and dexamethasone for chemotherapy-induced nausea and vomiting in Chinese breast cancer patients receiving moderately emetogenic chemotherapy. Breast Cancer Res. Treat., 113, 529-535. https://doi.org/10.1007/s10549-008-9957-9

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