{"title":"Comparing the efficacy of a triplet antiemetic regimen in patients with esophageal cancer patients and diabetes mellitus treated with cisplatin-based chemotherapy: A retrospective study.","authors":"Masahiro Hatori, Shota Fukuoka, Shunya Kimura, Kazuyoshi Kawakami, Kensei Yamaguchi, Masakazu Yamaguchi","doi":"10.1159/000543026","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Cisplatin-based highly emetogenic chemotherapy is recommended in combination with neurokinin-1 receptor antagonist (NK1RA), 5-hydroxytriptamine-3-receptor antagonist (5HT3RA), dexamethasone (DEX), and olanzapine. However, olanzapine is contraindicated in patients with pre-existing diabetes mellitus (DM). This study compared the efficacy of a triplet antiemetic regimen (NK1RA, 5HT3RA, and DEX) in patients with and without pre-existing DM treated with cisplatin-based chemotherapy.</p><p><strong>Methods: </strong>This retrospective study enrolled patients with esophageal cancer with and without pre-existing DM who received fluorouracil and cisplatin (FP) combination chemotherapy as initial therapy with a triplet antiemetic regimen for antiemetic prophylaxis. This data was compared using propensity score matching (PSM). The primary endpoint was the complete response (CR) rate during the first cycle, which was defined as no emetic episodes and no rescue medication use during the overall period (0-120 h). The CR rate was analyzed using univariate and multivariate logistic regression, including previously reported risk factors. The significance level was set at 5%.</p><p><strong>Results: </strong>Out of 210 eligible patients, 39 and 39 were patients with DM and non-DM patients after PSM, respectively. The CR rate measured by multivariate analysis during the overall period with DM and non-DM was 56.4% and 41.0% (adjusted odds ratio of 0.566 [95% confidence intervals: 0.209-1.536], P = 0.264), respectively. The CR rate during the delayed period (24-120 h) with DM and non-DM patients was 84.6% and 46.2% (P = 0.002), respectively.</p><p><strong>Conclusions: </strong>A triplet antiemetic regimen in patients with esophageal cancer with pre-existing DM might be more effective in delayed period compared to non-DM patients.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-19"},"PeriodicalIF":2.5000,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000543026","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Comparing the efficacy of a triplet antiemetic regimen in patients with esophageal cancer patients and diabetes mellitus treated with cisplatin-based chemotherapy: A retrospective study.
Introduction: Cisplatin-based highly emetogenic chemotherapy is recommended in combination with neurokinin-1 receptor antagonist (NK1RA), 5-hydroxytriptamine-3-receptor antagonist (5HT3RA), dexamethasone (DEX), and olanzapine. However, olanzapine is contraindicated in patients with pre-existing diabetes mellitus (DM). This study compared the efficacy of a triplet antiemetic regimen (NK1RA, 5HT3RA, and DEX) in patients with and without pre-existing DM treated with cisplatin-based chemotherapy.
Methods: This retrospective study enrolled patients with esophageal cancer with and without pre-existing DM who received fluorouracil and cisplatin (FP) combination chemotherapy as initial therapy with a triplet antiemetic regimen for antiemetic prophylaxis. This data was compared using propensity score matching (PSM). The primary endpoint was the complete response (CR) rate during the first cycle, which was defined as no emetic episodes and no rescue medication use during the overall period (0-120 h). The CR rate was analyzed using univariate and multivariate logistic regression, including previously reported risk factors. The significance level was set at 5%.
Results: Out of 210 eligible patients, 39 and 39 were patients with DM and non-DM patients after PSM, respectively. The CR rate measured by multivariate analysis during the overall period with DM and non-DM was 56.4% and 41.0% (adjusted odds ratio of 0.566 [95% confidence intervals: 0.209-1.536], P = 0.264), respectively. The CR rate during the delayed period (24-120 h) with DM and non-DM patients was 84.6% and 46.2% (P = 0.002), respectively.
Conclusions: A triplet antiemetic regimen in patients with esophageal cancer with pre-existing DM might be more effective in delayed period compared to non-DM patients.
期刊介绍：
Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
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