Real-world incidence of nausea and vomiting induced by antineoplastic agents: insights and future directions from the Japanese adverse drug event report database

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: High incidence noted for platinum compounds and irinotecan; notable incidence for oral antimetabolites and tyrosine kinase inhibitors

• Primary Outcome: Incidence patterns of nausea and vomiting by antineoplastic agent class

• Nnt Or Sensitivity: Reported odds ratios for silodosin and meropenem as potential adjunctive therapies (specific values not provided)

• Confidence Interval: Not reported in abstract

Clinical Application

Findings may inform antiemetic prescribing patterns but require validation in controlled studies Limited direct applicability due to different population genetics and healthcare practices; TGA-approved antiemetics may differ from Japanese practice; could inform PBS considerations for novel antiemetic approaches Cancer patients receiving antineoplastic therapy, particularly those on oral agents

Abstract

PURPOSE: Antineoplastic treatment commonly leads to nausea and vomiting (NV), which considerably affects the quality of life and adherence to therapy of patients. This study aimed to analyze the incidence of NV induced by antineoplastic agents using the Japanese Adverse Drug Event Report (JADER) database and to explore novel antiemetic therapies for oral antineoplastic agents. METHODS: Data from April 2004 to March 2023 were extracted from the JADER database. The analysis considered guideline-recommended antiemetics and involved the temporal evaluation of cases with NV. The onset patterns of NV were analyzed for each oral antineoplastic agent. The reported odds ratio was used to identify adjunctive medications that showed inverse associations with these symptoms. RESULTS: A large number of NV cases were reported for platinum compounds and irinotecan. Among the oral agents, a notable incidence of NV was induced by antimetabolites and tyrosine kinase inhibitors. A decreasing trend in the use of single-agent antiemetic therapy was observed from 2010. Distinct NV patterns were identified. Silodosin and meropenem emerged as potential adjunct therapies to suppress NV induced by oral agents. CONCLUSION: Although there is a trend toward improvement in NV management with increased adherence to antiemetic therapies, a substantial gap remains between guidelines and actual practice. The need for tailored management strategies based on the onset patterns of NV for specific agents has been emphasized. Investigating the mechanisms underlying the antiemetic effects of adjunctive therapies, such as silodosin and meropenem, may pave the way for new antiemetic options for oral antineoplastic agents.

References

1. 1.Matsuo, H., Tanaka, H., & Ishii, T. (2026). Real-world incidence of nausea and vomiting induced by antineoplastic agents: insights and future directions from the Japanese adverse drug event report database. Supportive Care in Cancer. https://doi.org/10.1248/yakushi.20-00196-1