Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida.
School of Medicine, University of South Florida, Tampa, Florida.
Cancer. 2022 Feb 1;128(3):461-470. doi: 10.1002/cncr.33892. Epub 2021 Oct 13.
Uncontrolled chemotherapy-induced nausea and vomiting can reduce patients' quality of life and may result in premature discontinuation of chemotherapy. Although nausea and vomiting are commonly grouped together, research has shown that antiemetics are clinically effective against chemotherapy-induced vomiting (CIV) but less so against chemotherapy-induced nausea (CIN). Nausea remains a problem for up to 68% of patients who are prescribed guideline-consistent antiemetics. Despite the high prevalence of CIN, relatively little is known regarding its etiology independent of CIV. This review summarizes a metagenomics approach to the study and treatment of CIN with the goal of encouraging future research. Metagenomics focuses on genetic risk factors and encompasses both human (ie, host) and gut microbial genetic variation. Little work to date has focused on metagenomics as a putative biological mechanism of CIN. Metagenomics has the potential to be a powerful tool in advancing scientific understanding of CIN by identifying new biological pathways and intervention targets. The investigation of metagenomics in the context of well-established demographic, clinical, and patient-reported risk factors may help to identify patients at risk and facilitate the prevention and management of CIN.
未控制的化疗引起的恶心和呕吐会降低患者的生活质量，并可能导致化疗提前终止。尽管恶心和呕吐通常被归为一类，但研究表明，止吐药在临床上对化疗引起的呕吐（CIV）有效，但对化疗引起的恶心（CIN）的效果较差。即使患者使用了符合指南的止吐药，仍有高达 68%的患者会出现恶心问题。尽管 CIN 的患病率很高，但对于其与 CIV 无关的病因，人们知之甚少。这篇综述总结了一种针对 CIN 的宏基因组学研究和治疗方法，旨在鼓励未来的研究。宏基因组学专注于遗传风险因素，包括人类（即宿主）和肠道微生物的遗传变异。迄今为止，很少有工作关注宏基因组学作为 CIN 的潜在生物学机制。通过确定新的生物学途径和干预靶点，宏基因组学有可能成为深入了解 CIN 的有力工具。在既定的人口统计学、临床和患者报告的风险因素背景下研究宏基因组学，可能有助于识别有风险的患者，并促进 CIN 的预防和管理。
