Efficacy and safety of multi-day antiemetic treatment for patients undergoing multi-day chemotherapy: a systematic review of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clinical Oncology

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发表日期：

2024年11月12日

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Kazuhisa Nakashima,
Saki Harashima,
Rena Kaneko,
Ryuhei Tanaka,
Masakazu Abe,
Makoto Wada,
Keiko Iino,
Tatsuo Akechi,
Hirotoshi Iihara,
Chiyo K. Imamura,
Ayako Okuyama,
Keiko Ozawa,
Yong-il Kim,
Eriko Satomi,
Masayuki Takeda,
Takako Eguchi Nakajima,
Naoki Nakamura,
Junichi Nishimura,
Mayumi Noda,
Kazumi Hayashi,
Takahiro Higashi,
Narikazu Boku,
Koji Matsumoto,
Yoko Matsumoto,
Kenji Okita,
Nobuyuki Yamamoto,
Kenjiro Aogi,
Hidenori Sasaki

摘要

Background

A standardized multi-day antiemetic regimen for multi-day chemotherapy remains elusive. This systematic review evaluated the efficacy and safety of multi-day antiemetic regimens in patients undergoing multi-day intravenous chemotherapy.

Methods

We conducted a comprehensive search of PubMed, Cochrane Library, and Ichushi-Web databases for relevant studies published from January 1990 to December 2020. We included studies comparing multi-day and single-day antiemetic regimens for preventing chemotherapy-induced nausea and vomiting.

Results

No studies directly comparing multi-day versus single-day antiemetic regimens were found. Despite expanding control group criteria beyond “single-day antiemetic therapy” limited high-quality studies and variations in cancer types, chemotherapy regimens, and antiemetic treatments precluded meta-analysis. Among the included studies, some randomized controlled trials (RCTs) focused on complete response and vomiting rates. Two studies comparing two- and three-drug combinations reported higher complete response and no-vomiting rates with the three-drug regimen. Limited RCTs explored “nausea control” and “cost,” and assessing “adverse events” proved challenging due to inconsistent reporting.

Conclusion

The research on multi-day antiemetic therapy is limited, necessitating further investigation. Nonetheless, our findings suggest that three-drug combination therapy, including aprepitant, may offer superior antiemetic efficacy compared to two-drug regimens. Multi-day antiemetic therapy is strongly recommended during multi-day intravenous administration of cytotoxic anticancer drugs.