Delayed Chemotherapy-Induced Nausea – A Nurse-Led International Observational Study in Routine Oncology Practice (CINrate)

Background Nausea and vomiting negatively impact patients’ quality of life and may influence systemic antitumour therapy (CHT). While delayed CHT-associated nausea (dCIN) is most commonly linked to moderate or highly emetogenic regimens, evidence suggests that it may also occur with low (LEC) and minimally emetogenic CHT (MinEC). This study aims to assess the occurrence and characteristics of dCIN in real-world clinical settings, with an emphasis on patients receiving LEC and MinEC. Methods In a prospective multicentre international cross-sectional study, adult oncology outpatients receiving systemic antitumour therapy rated the intensity of dCIN daily on a 0–100 visual analogue scale (VAS) for five consecutive days. The primary endpoint was dCIN occurrence in LEC and MinEC. Secondary endpoints included known risk factors and the relationship between dCIN and patient characteristics. Results Among 172 patients, 65 (38%) received LEC and 31 (18%) MinEC. Most patients received antiemetic therapy in accordance with MASCC/ESMO and ASCO guidelines. dCIN occurred in 18.5% (n = 12; 95% CI [10.5, 29.1]) of LEC and 3% (n = 1; 95% CI [0.04, 14.1]) of MinEC patients. Only 3 patients (1.7%) reported vomiting. Younger age and gastrointestinal tumours were independent risk factors for dCIN. Emetogenicity of therapy, fear, and prior CHT-associated vomiting did not remain significant in the model. Conclusions A considerable proportion of patients receiving LEC still experience dCIN in real-world clinical settings. These findings highlight the need for improved symptom management and tailored interventions beyond traditional emetogenic risk classification. The trial was registered at clinicaltrials.gov NCT04342780 (Date of registration: 03/25/2020).