OBJECTIVES

The last two decades witnessed significant advances in antiemetic therapy for prevention of chemotherapy-induced nausea and vomiting (CINV). The aim of this study is to describe the trends in antiemetic drugs use in treated cancer patients between 2007 and 2017.

METHODS

This cross-sectional study used data from Cancerology database in France. Physicians were asked to complete case report forms for treated cancer patients. Data were extrapolated to the entire French population based on hospital activity level and type of hospital. Analyses focused on antiemetic medication use and emetogenicity of antineoplastic drugs as defined according to the European Society of Medical Oncology and the Multinational Association of Supportive Care in Cancer classification system.

RESULTS

In the overall population of 335,671 patients in 2007 and 428,242 patients in 2017, 5-hydroxytryptamine type-3 receptor antagonists (5HT3-RAs)/setrons were the most commonly prescribed antiemetic drugs. Between 2007 and 2017, antiemetic drugs use decreased for all types of drugs except aprepitant. Specifically, 5HT3-RAs/setrons use decreased from 71.7% to 51.2%, classic antiemetic drugs decreased from 39.4% to 21.2%, and corticosteroids indicated for CINV prophylaxis decreased from 56.0% to 36.0%. Aprepitant use increased from 14.3% to 31.3%. Use of low emetogenic antineoplastic treatment regimens increased by 2.8%, and that of minimally, moderately and highly emetogenic regimens decreased by 0.9%, 3.0% and 2.5% respectively. The overall trends in antiemetic therapy use were similar across all cancer types except for kidney cancer where corticosteroids use increased. Antiemetic prophylaxis decreased in myeloma, melanoma, bone cancer and soft-tissue sarcoma for all drugs including aprepitant and increased in uterus cancer for all drugs except classic antiemetic agents.

CONCLUSIONS

According to our French Cancerology data, antiemetic drugs use has decreased but remains significant despite the emergence of targeted therapy and immunotherapy with low emetogenic risk in cancer treatment.