Chemotherapy Induced Nausea and Vomiting (CINV) in the Αsia-Pacific (ΑΡ) Region – The Australian Perspective from the Ρan-Australasian Chemotherapy Induced Emesis Study (PrACTICE) — ASN Events
  1. Schedule
  2. Best of the Best Orals: Supportive care
  3. Chemotherapy Induced Nausea and Vomiting (CINV) in the Αsia-Pacific (ΑΡ) Region – The Australian Perspective from the Ρan-Australasian Chemotherapy Induced Emesis Study (PrACTICE)

Chemotherapy Induced Nausea and Vomiting (CINV) in the Αsia-Pacific (ΑΡ) Region – The Australian Perspective from the Ρan-Australasian Chemotherapy Induced Emesis Study (PrACTICE) (#104)

Dorothy Keefe 1 , Hoon-Kyo Kim 2 , Alexandre Chan 3 , Ruey Kuen Hsieh 4 , Shi Ying Yu 5 , Ana Banos Hernandez 6 , Thomas Burke 7
  1. Royal Adelaide Hospital, Adelaide, SA, Australia
  2. St. Vincent's Hospital, Suwon, South Korea
  3. National University of Singapore, Singapore
  4. Mackay Memorial Hospital, Taipei, Taiwan
  5. Tongji Hospital of Tongji Medical College of Huazhong, University of Science and Technology, Wuhan, China
  6. OptumInsight, Stockholm, Sweden
  7. Merck & Co. Inc., Whitehouse Station, NJ, USA

Background: There are limited data on CINV in AP, which had diverse healthcare systems and standards of care. This prospective, observational study of highly and moderately emetogenic chemotherapy (HEC/MEC) in 648 chemotherapy-naive adults from 6 AP countries enrolled 74 Australian subjects with mean age 60.8 years and 74.3% female (other countries, 54.9 years and 57%).

Methods: Primary objective was to estimate country-specific percentages of patients with complete response (CR): no emesis and no rescue medication use in overall phase (0-120 hours) during cycle 1 by regimen emetogenicity. Most common regimens included AC (26/42; 61.9%) for HEC, and carboplatin-based (18/32; 56.3%) for MEC. Australian results are presented.

Results: CR was 55.4% (CI:43.4,67.0) for Australia for overall phase (78.4% in other countries). Significant differences between countries were observed for overall and delayed phase (each p<0.001) and not for acute phase (p=0.855).

During overall phase, ‘no emesis’ significantly differed between countries (p<0.001). Australia had highest emesis control with 91.9% (68/74). In both HEC and MEC, incidence of anticipatory nausea was the same (9.1%) with similar incidence of clinically significant anticipatory nausea (5.0%,4.5%, respectively). Australia had the fewest non-drinkers (35.1%) vs. other countries (86.9%).

Chemotherapy was only given on an outpatient basis in Australia and Singapore. In China, 85.0% was given on inpatient basis. Highest usage of rescue medication was in Australia and Singapore (41.9%, 28.1%,respectively). 34.4% Australian patients receiving MEC required rescue medication. Unlike others, the majority of Australian patients received a rescue medication prescription.

Antiemesis guidelines were widely consulted. Australia’s adherence to guidelines was higher (83.3%) vs. other countries (China:0%; India:37.2%; Singapore:55.0%; South Korea:57.5%; Taiwan:26.8%).
Conclusions: Australia demonstrated: outpatient chemotherapy administration, fewest non-drinkers vs. other countries, highest adherence to guidelines and optimal emesis control. There is considerable room to improve CINV outcomes and use of recommended antiemetic prophylaxis in AP.