Abstract
Background
Chemotherapy-induced nausea and vomiting (CINV) remain among the most frequently reported distressing side effects associated with anthracycline-based chemotherapy despite significant advances in antiemetic management. The main risk factor for severity of CINV is the emetogenic potential of the chemotherapeutic agents. However, patient-related risk factors have been identified, including genetic makeup. Although studies have noted that ethnicity influences nausea and vomiting in other contexts, there is a paucity of research regarding the impact of ethnicity on CINV. This study was undertaken to evaluate whether Asian women receiving anthracycline-based chemotherapy experience more CINV than non-Asians.
Methods
A retrospective, comparative, correlational chart review was performed to abstract the relevant variables.
Results
Data from a convenience sample of 358 women with breast cancer who received chemotherapy with doxorubicin between 2004 and 2008 at City of Hope in Duarte, California, were evaluated. The sample consisted of Caucasians (45%), Hispanics (27.7%), Asians (19.8%), and African Americans (7.5%). The results indicate that Asian women with breast cancer undergoing anthracycline-based chemotherapy experienced statistically significantly more clinically important CINV than their non-Asian counterparts.
Limitations
The data were collected retrospectively, with a certain population distribution at a specific time.
Conclusion
This study provides interesting preliminary evidence that Asian ethnicity plays a role in the development of severe CINV. When managing chemotherapy toxicities in women with breast cancer, health-care providers should tailor therapy to individual risk profiles. Specifically, consideration of antiemetic therapy should accommodate patient characteristics, such as Asian descent.
Breast cancer is the most common cancer among American women, with an estimated 207 090 new cases and 39 840 breast cancer-related deaths in 2010.1 Many early-stage breast cancer patients will receive adjuvant chemotherapy following surgical resection, to reduce their risks of recurrence. Currently, anthracycline-based chemotherapy in combination with cyclophosphamide and/or taxane is one of the commonly prescribed adjuvant regimens for early-stage breast cancer and for anthracycline-naive stage IV breast cancer, although taxane-based regimens are increasingly prominent. [2] and [3] Nausea and vomiting are commonly known adverse effects of anthracycline and cyclophosphamide, occurring in approximately 40%-80% of all patients. Despite the development of drugs such as aprepitant, nausea and vomiting continue to be significant and distressing side effects of adjuvant chemotherapy.4