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Identification of a novel marker associated with risk for delayed chemotherapy-induced vomiting

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Abstract

Purpose

Besides chemotherapy drugs, a number of patient-related factors (i.e., gender, age, history of alcohol consumption, and/or motion sickness) may be used to calculate the risk for chemotherapy-induced vomiting. We evaluated data with the intent of identifying a unique variable associated with delayed vomiting in patients receiving moderately emetogenic chemotherapy (MEC).

Methods

From an ongoing research study, the serotonin metabolite, 5-hydroxyindole acetic acid (5-HIAA), creatinine, and substance P were measured over a 72-h period in 25 patients receiving MEC. All patients were treated with a 5-hydroxytryptamine-3 receptor antagonist plus dexamethasone according to published guidelines; none received aprepitant prophylactically. Urine 5-HIAA/creatinine and serum substance P values were grouped according to the development (+) or absence (−) of delayed emesis. Baseline mean values associated with the two neurotransmitters were analyzed by analysis of variance.

Results

Eleven patients developed moderate to severe delayed vomiting; the other 14 were symptom-free. The pretreatment log (mean 5-HIAA/creatinine) was 1.22 and 1.81 in the (+) and (−) emesis groups, respectively, p = 0.0049; the pretreatment log (mean substance P) for the same respective groups was 5.33 and 4.09 pg/mL, p > 0.05. The log (mean ratio of substance P to 5-HIAA/creatinine) between-group difference in those with and without emesis was 4.53 and 2.52, respectively, p = 0.0002. The 5-HIAA/creatinine and ratio of substance P to 5-HIAA/creatinine data were also used to determine cutoff points which resulted in the optimal predictive accuracy.

Conclusions

These preliminary findings suggest that an elevated pretreatment ratio of substance P to 5-HIAA/creatinine >70 is associated with the development of delayed vomiting induced by MEC.

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Conflict of interest

Continuation of the study and this data analysis were made possible through a grant from the West Virginia Senate to two of the investigators (GMH and MLA), both of who have full control of all primary data. No other financial relationship exists between the state Senate and any of the authors. Moreover, we agree to allow the journal to review the study data if requested.

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Authors and Affiliations

  1. Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV, USA

    Gerald M. Higa & Miklos L. Auber

  2. School of Pharmacy, West Virginia University, Morgantown, WV, USA

    Gerald M. Higa

  3. Department of Medicine, Section of Hematology-Oncology, West Virginia University, Morgantown, WV, USA

    Gerald M. Higa & Miklos L. Auber

  4. Department of Statistics, West Virginia University, Morgantown, WV, USA

    Gerry Hobbs

  5. Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9520, 26506-9520, Morgantown, WV, USA

    Gerald M. Higa

Authors
  1. Gerald M. Higa
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  2. Miklos L. Auber
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  3. Gerry Hobbs
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Correspondence to Gerald M. Higa.

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Higa, G.M., Auber, M.L. & Hobbs, G. Identification of a novel marker associated with risk for delayed chemotherapy-induced vomiting. Support Care Cancer 20, 2803–2809 (2012). https://doi.org/10.1007/s00520-012-1402-2

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  • DOI: https://doi.org/10.1007/s00520-012-1402-2

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