Yamamoto Senri, Tsuchiya Masami, Iihara Hirotoshi, Hayasaki Yoh, Hori Kyoko, Kumakura Yasuo, Watanabe Daichi, Sakai Hideki, Nakagawa Satoshi, Kudoh Akiko, Oishi Hajime, Kado Nobuhiro, Go Makiko, Mashima Kota, Uchida Takashi, Yasue Moeka, Maeda Akimitsu, Nishino Kimihiro, Matsumoto Koji, Sato Shinya, Ueda Yutaka, Tomio Kensuke, Hayashi Katsuhisa, Takenaka Motoki, Mori Masahiko, Kajiyama Hiroaki, Bomoto Yoshimasa, Suzuki Shiro, Ishihara Takuma, Suzuki Akio, Abe Masakazu
Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan.
Department of Pharmacy, Miyagi Cancer Center, 47-1 Nodayama, Medeshimashiote, Natori, Miyagi, 981-1293, Japan.
J Cancer. 2024 Jan 21;15(6):1487-1497. doi: 10.7150/jca.91675. eCollection 2024.
Olaparib and niraparib (poly adenosine diphosphate [ADP]-ribose polymerase [PARP] inhibitors) have significant antitumor action in patients with ovarian cancer. However, the incidence of nausea and vomiting among patients on these drugs in clinical trials is rather high. There are no guidelines on antiemetic treatment for nausea caused by oral anticancer agents. This study aimed to investigate the incidence of nausea and vomiting caused by PARP inhibitors and the actual situation of antiemetic therapy in patients with gynecologic cancer. Patients with gynecologic cancer who were scheduled to receive PARP inhibitors were enrolled. Data on PARP inhibitor-induced nausea and vomiting were collected from patient diaries for 21 days. The primary endpoint was the incidence of vomiting during the 21 days after starting olaparib and niraparib. Overall, between January 2020 and March 2023, 134 patients were enrolled. Of the 129 patients who were evaluated, 28 (21.7%) received prophylactic antiemetics for 21 days, and 101 (78.3%) did not. The overall incidence of PARP inhibitor-induced vomiting was 16.3%. The incidence of vomiting in the group that did not receive antiemetic prophylaxis was 13.9%. On dividing the group that did not receive antiemetic prophylaxis into the olaparib and niraparib subgroups, the incidence of vomiting was found to be 18.6% for the olaparib group and 10.3% for the niraparib group. The incidence of emesis without antiemetic prophylaxis among patients on olaparib and niraparib ranged from 10% to 30%. Therefore, olaparib and niraparib can be classified in the low emetogenic risk and prophylactic antiemetic therapy at the time of treatment initiation may be unnecessary.
奥拉帕利和尼拉帕利（聚腺苷二磷酸 [ADP]-核糖聚合酶 [PARP] 抑制剂）对卵巢癌患者具有显著的抗肿瘤作用。然而，在临床试验中，使用这些药物的患者恶心和呕吐的发生率相当高。目前尚无关于口服抗癌药物所致恶心的止吐治疗指南。本研究旨在调查PARP抑制剂所致恶心和呕吐的发生率以及妇科癌症患者止吐治疗的实际情况。纳入计划接受PARP抑制剂治疗的妇科癌症患者。从患者日记中收集21天的PARP抑制剂所致恶心和呕吐数据。主要终点是开始使用奥拉帕利和尼拉帕利后21天内的呕吐发生率。总体而言，在2020年1月至2023年3月期间，共纳入134例患者。在129例接受评估的患者中，28例（21.7%）接受了21天的预防性止吐治疗，101例（78.3%）未接受。PARP抑制剂所致呕吐的总体发生率为16.3%。未接受止吐预防的组中呕吐发生率为13.9%。将未接受止吐预防的组分为奥拉帕利组和尼拉帕利组后，发现奥拉帕利组呕吐发生率为18.6%，尼拉帕利组为10.3%。接受奥拉帕利和尼拉帕利治疗且未进行止吐预防的患者中，呕吐发生率在10%至30%之间。因此，奥拉帕利和尼拉帕利可归类为低致吐风险，治疗开始时可能无需进行预防性止吐治疗。
