OBJECTIVES: Cisplatin and carboplatin are recognized by anti-emesis guidelines as highly emetogenic, warranting prophylaxis with a multi-drug + dexamethasone regimen. Multiple studies have evaluated the need for similar prophylaxis for oxaliplatin in colorectal cancer (CRC) (where mean age at diagnosis for males is 68 and for females is 72), without consistent results. Based on work by Suzuki (2016) suggesting that the combination of the known risk factors of younger age and female sex synergistically increase risk of CINV among CRC patients, we evaluated incidence rates of CINV among US oxaliplatin patients based on age, sex, and body mass index (BMI) status.

METHODS: Using the IBM Watson Health Explorys dataset of electronic health records (EHR) for over 55 million patients, initial administrations of oxaliplatin through January 2018 were evaluated. EHR records of nausea or emesis were tracked for 30 days post-initiation; incidence rates were calculated. Patients were stratified by age group, sex, and BMI status (Obese/30+, others).

RESULTS: CONCLUSIONS: Patients receiving oxaliplatin face differential risk of CINV based on age and sex. Younger female patients are at most risk and may most benefit from more intensive antiemetic prophylaxis.