Hydration requirements in patients receiving highly emetogenic chemotherapy

• Published in: Future oncology (London, England) England), 2019-03, Vol.15 (7), p.753-761
• Main Authors: Erickson, Randy, Nebughr, Neil, Mosier, Michael C, Nibley, William
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antiemetics - therapeutic use; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast cancer; Cancer therapies; Chemotherapy; chemotherapy-induced nausea and vomiting; CINV; Clinical medicine; Cost control; Delayed-Action Preparations - therapeutic use; Dexamethasone - therapeutic use; extended-release granisetron; Female; Fluid Therapy - standards; Fluid Therapy - statistics & numerical data; Granisetron - therapeutic use; highly emetogenic chemotherapy; Humans; Hydration; Male; Middle Aged; moderately emetogenic chemotherapy; Morpholines - therapeutic use; Nausea; Nausea - chemically induced; Nausea - prevention & control; Neoplasms - drug therapy; Neurokinin-1 Receptor Antagonists - therapeutic use; Oncology; palonosetron; Palonosetron - therapeutic use; Patients; Prevention; Retrospective Studies; Serotonin 5-HT3 Receptor Antagonists - therapeutic use; Vomiting; Vomiting - chemically induced; Vomiting - prevention & control; Young Adult
• ISSN: 1479-6694; 1744-8301
• DOI: 10.2217/fon-2018-0787

Chemotherapy-induced nausea and vomiting diminishes quality of life and increases healthcare resource use. This retrospective medical records analysis evaluated hydration requirements with emetogenic chemotherapy. Cancer patients received moderately emetogenic chemotherapy (MEC) or highly emetogenic chemotherapy (HEC), and antiemetics palonosetron or granisetron extended-release subcutaneous (GERSC), neurokinin 1 receptor antagonist and dexamethasone. Unscheduled hydration event rates were determined. For 186 patients (92 palonosetron, 94 GERSC) overall, mean hydration rate was significantly higher with palonosetron (0.6 vs 0.2; p = 0.0005). Proportion of patients with ≥1 hydration event was significantly higher with palonosetron overall (54 vs 33%; p = 0.0033) and in cycles 2-4 and the HEC subgroup. GERSC within a three-drug antiemetic regimen may reduce unscheduled hydration requirements with MEC or HEC. Chemotherapy-induced nausea and vomiting (CINV) can affect the quality of life and daily functioning of patients with cancer. Additionally, it can lead to increased hospital visits, use of additional medications, and needs for hydration with an iv. saline solution. Although guidelines from several organizations recommend combinations of drugs, known as antiemetics, to prevent CINV, there is still a need to improve CINV control. This study evaluated the need for hydration in patients with cancer who were receiving chemotherapy and an antiemetic drug combination including either palonosetron or granisetron extended-release subcutaneous (GERSC). Over half of patients who received palonosetron needed unscheduled hydration, compared with about a third of patients who received GERSC. Also, during each of the four cycles of chemotherapy given, the percentage of patients who needed hydration was higher with palonosetron than with GERSC. These results suggest that GERSC may be preferred over palonosetron in a three-drug antiemetic combination, by reducing the need for unscheduled hydration. This could reduce healthcare costs and improve patients' quality of life.