Abstract
8057 Background: Although weekly administration is a frequent way to administer chemotherapy, current guidelines for the prevention and control of both acute and delayed emesis do not consider such schedule. In this analysis, we retrospectly review the delayed nausea and vomiting pattern of 6 different weekly schedules in 1st line-2nd line chemotherapy for MBC patients (pts). Patients: We gathered 6 databases from 1990 to 2003, comprising of 275 patients participating in phase II trials in MBC pts using weekly chemotherapy. The trials evaluated activity and tolerability of weekly epirubicin (25 mg/m2/wk) with either lonidamine (450 mg/d) (EL, 51 pts), vinorelbine (25 mg/m2/wk) (EN, 52 pts) and paclitaxel (80 mg/m2/wk) (ET, 53 pts), in 1st line, and weekly vinorelbine (N, 25 mg/m2/wk, 40 pts), weekly docetaxel (D, 35 mg/m2/wk, 28 pts), and weekly paclitaxel (80 mg/m2/wk) plus 5-fluorouracil (300 mg/m2/wk) (TF, 51 pts) in 2d line, for 24 weeks. We considered epirubicin-based as moderately emetogenic chemotherapy (MEC), and non- epirubicin-based therapy as low emetogenic chemotherapy (LEC). For acute emesis, pts received dexamethasone 8 mg plus anti-5HT3 day 1 i.v. No antiemetic prophylaxis was given for delayed emesis. Nausea/vomiting grade 1–4 were compared (MEC vs LEC; polychemotherapy vs monochemotherapy). Results: In overall 275 pts, only 1 patient (0.4%) showed delayed G3 nausea/vomiting. No grade 4 was observed. Grade 1 and 2 were observed in 27.2% and 14.2% of the pts. MEC (156 pts) was administered as 1st line treatment, while LEC (119 pts) as 2nd line. Conclusions: In our series of pts, moderate delayed emesis (Grade 2) is not significantly different when comparing weekly MEC versus LEC. Acute antiemetic medication covers delayed emesis well for weekly MEC and LEC. Our results suggest that no prophylactic corticosteroids are needed for delayed emesis, when weekly MEC or LEC are administered. No significant financial relationships to disclose.
Published Version
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