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Type: Journal article
Title: Personalized estimate of chemotherapy-induced nausea and vomiting: development and external validation of a nomogram in cancer patients receiving highly/moderately emetogenic chemotherapy
Author: Hu, Z.
Liang, W.
Yang, Y.
Keefe, D.
Ma, Y.
Zhao, Y.
Xue, C.
Huang, Y.
Zhao, H.
Chen, L.
Chan, A.
Zhang, L.
Citation: Medicine, 2016; 95(2):e2476-1-e2476-6
Publisher: Wolters Kluwer
Issue Date: 2016
ISSN: 0025-7974
Statement of
Zhihuang Hu, Wenhua Liang, Yunpeng Yang, Dorothy Keefe, Yuxiang Ma, Yuanyuan Zhao, Cong Xue, Yan Huang, Hongyun Zhao, Likun Chen, Alexandre Chan, and Li Zhang
Abstract: Chemotherapy-induced nausea and vomiting (CINV) is presented in over 30% of cancer patients receiving highly/moderately emetogenic chemotherapy (HEC/MEC). The currently recommended antiemetic therapy is merely based on the emetogenic level of chemotherapy, regardless of patient's individual risk factors. It is, therefore, critical to develop an approach for personalized management of CINV in the era of precision medicine. A number of variables were involved in the development of CINV. In the present study, we pooled the data from 2 multi-institutional investigations of CINV due to HEC/MEC treatment in Asian countries. Demographic and clinical variables of 881 patients were prospectively collected as defined previously, and 862 of them had full documentation of variables of interest. The data of 548 patients from Chinese institutions were used to identify variables associated with CINV using multivariate logistic regression model, and then construct a personalized prediction model of nomogram; while the remaining 314 patients out of China (Singapore, South Korea, and Taiwan) entered the external validation set. C-index was used to measure the discrimination ability of the model. The predictors in the final model included sex, age, alcohol consumption, history of vomiting pregnancy, history of motion sickness, body surface area, emetogenicity of chemotherapy, and antiemetic regimens. The C-index was 0.67 (95% CI, 0.62-0.72) for the training set and 0.65 (95% CI, 0.58-0.72) for the validation set. The C-index was higher than that of any single predictor, including the emetogenic level of chemotherapy according to current antiemetic guidelines. Calibration curves showed good agreement between prediction and actual occurrence of CINV. This easy-to-use prediction model was based on chemotherapeutic regimens as well as patient's individual risk factors. The prediction accuracy of CINV occurrence in this nomogram was well validated by an independent data set. It could facilitate the assessment of individual risk, and thus improve the personalized management of CINV.
Keywords: Chemotherapy-induced nausea and vomiting
Rights: Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. This is an open access article distributed under the Creative Commons Attribution- NonCommercial License, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be used commercially
RMID: 0030042158
DOI: 10.1097/MD.0000000000002476
Appears in Collections:Medicine publications

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