Prediction of Moderate to Severe Delayed Chemotherapy-Induced Nausea Using a Novel Algorithm Incorporating Individual...

Chemotherapy-induced vomiting and nausea (CINV) is difficult to accurately predict, especially in the delayed phase and can negatively affect a patient's' quality of life as well as reduce their motivation to continue lifesaving therapy. We have previously reported on a blood-based assay that can be used to tailor an individualized antiemetic prophylaxis. The purpose of this current study was to validate our previous finding in a larger cohort of patients treated with a platinum-containing regimen.

Blood samples and patient reported outcomes from 202 cancer patients aged 18 years and older who started treatment with a platinum agent during February 15, 2016, through May 18, 2023, were analyzed. The glutathione recycling capacity in red blood cells was compared to reported nausea during the delayed phase and verified by comparison to notes in medical records. An algorithm for risk score prediction was generated and predicted risk scores were compared to observed delayed nausea severity.

Patients with a low glutathione recycling capacity, indicating prolonged exposure to oxidative stress, were experiencing moderate/severe delayed chemotherapy-induced delayed nausea more than those who had an efficient recycling capacity to offset the excess radical oxygen formed by chemotherapy. Calculated risk scores from participating patients demonstrated a good correlation between predicted and observed outcomes for the risk score groups.

Risk score, based on glutathione recycling and other intrinsic factors, can predict the risk of delayed nausea for patients undergoing chemotherapy, allowing for a more aggressive preventive treatment upfront to avoid or reduce delayed nausea symptoms.