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:
- Patient age <60 years
- The first 2 cycles of chemotherapy
- Anticipatory nausea and vomiting
- History of morning sickness
- Hours of sleep the night before chemotherapy
- CINV in the prior cycle
- Patient self-medication with non-prescribed treatments
- Use of platinum or anthracycline-based regimens.