Patient-specific factors as predictors of chemotherapy-induced nausea and vomiting: Insights from a lower-middle-income setting.

• DOI: 10.1200/jco.2025.43.16_suppl.e24075
• Publication Date: 2025-05-28T17:47:41Z
• Authors: Mayank Kapoor; Deepak Sundriyal; Amit Sehrawat; Yogesh A. Bahurupi

e24075

Background: Chemotherapy-induced nausea and vomiting (CINV) affects approximately 40% of cancer patients, despite the availability of effective antiemetic therapies. Existing prevention guidelines focus on chemotherapy regimens and do not fully account for patient-specific factors that may influence the risk of CINV. These patient-related variables, in conjunction with chemotherapy regimen type, may serve as key predictors of CINV and should be considered in the optimization of preventive strategies. Methods: A total of 141 patients undergoing carboplatin and paclitaxel treatment for various malignancies were included in this study, all receiving standardized antiemetic prophylaxis. The primary objective was to identify patient-specific factors predictive of CINV, defined as CTCAE grade ≥ 3, occurring between days 0 and 5 after chemotherapy. Analyzed variables included age, gender, hemoglobin levels, creatinine clearance, albumin levels, C-reactive protein levels, alcohol consumption (≥ 5 standard drinks per week), history of motion sickness, expectation of CINV, anxiety (GAD-7 score ≥ 10), meal consumption prior to chemotherapy, body mass index (BMI), disease stage (metastatic vs non-metastatic), and the anatomical site of primary cancer. Multivariate logistic regression analysis was employed to identify significant predictors of CINV. Results: The cohort had a median age of 54.5 (± 11.6) years, with 96 (68%) female participants. Of the cohort, 71 (50.3%) had upfront metastatic disease. The distribution of primary cancer sites was: gynecological (46.1%), lung (24.8%), breast (14.2%), gastrointestinal (11.3%), and others (3.6%). The incidence of CINV was 43.9%. Univariate analysis identified seven preliminary factors associated with CINV: age < 60 years (OR = 1.98), female gender (OR = 2.56), history of motion sickness (OR = 1.58), alcohol consumption (OR = 0.53), BMI ≥ 23 (OR = 1.55), hemoglobin value (OR=0.86), and primary cancer site in the lung (OR = 0.28). On multivariate analysis, only female sex (OR = 2.68) was significantly associated with an increased likelihood of CINV. Conclusions: This study underscores the critical importance of considering patient-specific factors, particularly gender, in the optimization of antiemetic strategies. Despite adherence to universal guideline-approved antiemetic prophylaxis, a significant proportion of patients in lower-middle-income countries (LMICs) continue to experience CINV. This persistent burden of CINV in LMICs may be attributed, in part, to the suboptimal quality of antiemetic medications available in these regions. Thus, there is an urgent need for both enhanced personalized preventive strategies and improved access to high-quality pharmaceuticals to effectively manage CINV. Female patients, in particular, may require additional antiemetic interventions beyond the standard regimens.