The Impact on Quality of Life of Highly Effective Antiemetic Therapy among Breast Cancer Patients Receiving Anthracycline Plus Cyclophosphamide-based Regimen

Treatment for chemotherapy-induced nausea and vomiting （CINV） has improved significantly with the development of antiemetic drugs. We conducted a prospective observational study to clarify the quality of life （QOL） impact of antiemetic therapy recommended by the Japanese Cancer Therapy Association （JSCO） guidelines for Japanese breast cancer patients receiving an anthracycline plus cyclophosphamide regimen （ACR）. This was an open, single-center, prospective observational study conducted in Yokohama City University Medical Center. Antiemetic therapy recommended by the JSCO guidelines was implemented for all cases treated therein （i.e., aprepitant, dexamethasone, and palonosetron）. The primary endpoint was no impact on daily living （NIDL） rate during a 120-hour period following chemotherapy （i.e., overall phase）. We use the Japanese version of the Functional Living Index?Emesis （FLIE） to evaluate the impact of CINV on QOL. There were 118 analyzable cases. The NIDL rate during the overall phase was 44.9％, and was significantly lower than the complete response （CR） rate of 58.5％ （i.e., no emetic responses and no rescue medication; P＝0.037）. Age＜55 years （P＝0.008） and a history of morning sickness （P＝0.005） were identified as independent risk factors of NIDL （P＜0.05）. Among Japanese breast cancer patients receiving ACR and a combination of aprepitant, dexamethasone, and palonosetron, the NIDL rate was relatively low at approximately 45％. A more effective antiemetic therapy should therefore be developed for patients’ QOL that takes NIDL risk factors into account. In addition, our results suggested that the CR rate is insufficient for evaluating the effect of antiemetic therapy on a patient’s QOL