A prospective analysis of efficacy of dexamethasone-sparing antiemetic regimens in high and moderate emetogenic chemotherapy

ObjectivesMultiple moderate-to-severe side effects associated with dexamethasone (DEX) were observed by patients undergoing a multi-day DEX regimen for delayed chemotherapy-induced nausea and vomiting (CINV). Therefore, there is increasing demand in clinical practice to lower DEX doses in subsequent emetogenic treatment cycles. This study aimed to evaluate the efficacy of the DEX-sparing antiemetic regimens in high- and moderate- emetogenic chemotherapy (HEC, MEC respectively) and to explore its functional impact on health-related Quality of Life (QoL).Materials and methodsThis is a prospective, observational study that includes 91 patients who received HEC and MEC with DEX. We evaluated the percentage of complete response and complete control of CINV in acute phases (<24 h) and delayed phases (25-120 h). The Functional Living Index-Emesis (FLIE), a 5-day recall tool, was used to evaluate the functional impact of DEX-sparing regimens on health-related QoL. Nausea and vomiting were graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.Statistical analysisThe SPSS version 20.0 was used for the statistical analysis. In the descriptive analysis, the study's parameters were analyzed and their mean (±SD), percentage, and frequency were determined.ResultsIn terms of overall efficacy, the DEX sparing was 86.36% in complete control and 90.91% in complete response. In the CTCAE version 5.0 analyses, only 1.1% of cases were reported with a Grade 3, and none with a Grade 4 or Grade 5. The FLIE score was above 54 in each domain, indicating no impact of CINV on daily life.ConclusionThe use of DEX-sparing antiemetic regimens in clinical settings, which can be better tolerated by patients, is made clear by this study. Consequently, our findings guide clinicians to optimize the use of DEX to preserve anti-emetic efficacy throughout the scheduled cycles of emetogenic chemotherapy.