title: Incidence and predictors of anticipatory nausea and vomiting in Asia Pacific clinical practice--a longitudinal analysis.
abstract: OBJECTIVE
  Some patients experience nausea and/or vomiting (NV) before receipt of chemotherapy. Our objective was to evaluate the impact of prior chemotherapy-induced NV (CINV) on the incidence of anticipatory NV in later cycles.
  
  
  METHODS
  This multicenter, prospective non-interventional study enrolled chemotherapy-naïve adults scheduled to receive highly or moderately emetogenic chemotherapy (HEC/MEC) for cancer in six Asia Pacific countries, excluding those with emesis within 24 h before cycle 1 chemotherapy. On day 1 before chemotherapy, patients answered four questions regarding emesis in the past 24 h, nausea, expectation of post-chemotherapy nausea, and anxiety in the past 24 h, the latter three scored from 0-10 (none-maximum). Multivariate logistic regression was used to assess the impact of prior CINV on anticipatory NV in cycles 2 and 3.
  
  
  RESULTS
  Five hundred ninety-eight patients (59% female) were evaluable in cycle 2 (49% HEC, 51% MEC). The incidence of anticipatory emesis was low before cycles 2 and 3 (1.5-2.3%). The incidence of clinically significant anticipatory nausea (score of ≥3) was 4.8, 7.9, and 8.3% before cycles 1, 2, and 3, respectively, with adjusted odds ratio (OR), 3.95 (95% confidence interval (CI), 2.23-7.00; p < 0.001) for patients with clinically significant nausea in prior cycles, compared with none. The adjusted ORs for other anticipatory NV endpoints ranged from 4.54-4.74 for patients with prior CINV. The occurrence of clinically significant anxiety in the prior cycle also resulted in a significantly increased likelihood of anticipatory nausea.
  
  
  CONCLUSIONS
  These findings highlight the importance of preventing CINV in cycle 1 to reduce anticipatory NV in subsequent cycles.
authors.affiliation: National University of Singapore, Singapore, Singapore, phaac@nus.edu.sg.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Chan
authors.forename: Hoon-Kyo
authors.initials: HK
authors.lastname: Kim
authors.forename: Ruey Kuen
authors.initials: RK
authors.lastname: Hsieh
authors.forename: Shiying
authors.initials: S
authors.lastname: Yu
authors.forename: Gilberto
authors.initials: G
authors.lastname: de Lima Lopes
authors.forename: Wu-Chou
authors.initials: WC
authors.lastname: Su
authors.forename: Ana
authors.initials: A
authors.lastname: Baños
authors.forename: Sandeep
authors.initials: S
authors.lastname: Bhatia
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Burke
authors.forename: Dorothy M K
authors.initials: DM
authors.lastname: Keefe
mesh_terms: D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001208:Asia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology*; D009369:Neoplasms / Q000188:drug therapy; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology*; D014840:Vomiting, Anticipatory / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents
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