Prediction of chemotherapy-induced nausea during irinotecan-based treatment based on prior oxaliplatin-induced symptoms in colorectal cancer.

Chemotherapy-induced nausea and vomiting (CINV) is a common adverse event associated with oxaliplatin- and irinotecan-based chemotherapy regimens. Because these agents are typically administered sequentially in colorectal cancer (CRC) treatment and have similar emetogenic risk, we assessed the real-world feasibility of predicting CINV during irinotecan treatment based on response to prior oxaliplatin. Patients with metastatic CRC who subsequently received an irinotecan-fluoropyrimidine-based regimen after prior treatment with an oxaliplatin-fluoropyrimidine-based regimen were retrospectively evaluated. Patients were divided into a control group (those who achieved total control [TC] during the first cycle of the oxaliplatin-based regimen) and a CINV-experience group (those who did not achieve TC during this cycle).

The primary endpoint was TC rate during the delayed phase (24-120 h after treatment initiation) of the first irinotecan-based regimen. TC rate in the delayed phase was significantly lower in the CINV-experience group than that in the control group (31.8% and 81.8%, P