Clinical Edge

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Chemo for Early-Stage Breast Ca

RMG antiemetic prophylaxis vs physician’s choice

Risk model-guided (RMG) antiemetic prophylaxis led to improved control of acute and delayed chemotherapy-induced nausea and vomiting (CINV) compared with physician’s choice of therapy for early-stage breast cancer, according to a clinical trial of 324 patients with early-stage breast cancer undergoing chemotherapy for the first time. Patients were randomized to either the RMG arm (n=154) or the PC control arm (n=170) and prior to each cycle of chemotherapy, patients in the RMG group were categorized as low or high risk for CINV, and their antiemetic treatments adjusted accordingly. In the acute period, researchers found:

• Significantly more patients in the RMG group reported no nausea (53.7% vs 41.6%), and no vomiting (91.8% vs 82.2%) compared with the PC control group.

• Similarly, significantly more patients in the RMG group reported no nausea (39.6% vs 30.7%) and no vomiting (87.1% vs 78.0%) in the delayed period compared with the PC control group.

Citation: Clemons M, Bouganim N, Smith S, et al. Risk model-guided antiemetic prophylaxis vs physician’s choice in patients receiving chemotherapy for early-stage breast cancer: a randomized clinical trial. [Published online ahead of print November 12, 2015]. JAMA Oncol. doi:10.1001/jamaoncol.2015.3730.