What risk factors are associated with chemotherapy-induced nausea and vomiting in breast cancer?
Chemotherapy-induced nausea and vomiting (CINV) is a common side effect in breast cancer treatment, affecting about 48% of patients 1. Knowing your personal risk factors can help your doctor choose the best antiemetic (anti-nausea) medicines to prevent CINV. The main risk factors identified in research are younger age, a history of motion sickness, and having more chemotherapy cycles.
What the research says
A meta-analysis of 12 studies in breast cancer patients found that the overall rate of CINV was 48% 1. Younger age (45 years or younger) was a strong risk factor, increasing the odds of CINV by about 2.4 times in multivariate analysis 1. A history of motion sickness also raised the odds by about 2 times 1. Having three or more chemotherapy cycles increased the odds by about 2.3 times 1. Anxiety and other health conditions (comorbidities) were not significant risk factors in this analysis 1.
Other studies in different cancer types support the role of younger age. A 2020 study of patients receiving high or moderate emetogenic chemotherapy found that age under 49 years and tobacco use were risk factors for CINV 6. Another study in colorectal cancer patients noted that younger age (under 65) combined with low body mass index (BMI under 20) increased the risk of CINV 8.
Current guidelines from MASCC/ESMO emphasize the importance of individual patient risk factors for CINV, including age, sex, and history of motion sickness 7. These guidelines recommend tailoring antiemetic regimens based on risk factors and the emetogenicity of the chemotherapy drugs 7.
What to ask your doctor
- Given my age and history of motion sickness, what is my personal risk for CINV?
- Should I receive a stronger antiemetic regimen (like adding a NK1 receptor antagonist) because of my risk factors?
- How will my antiemetic plan change if I need more than three cycles of chemotherapy?
- Are there non-drug options, such as acupressure, that could help prevent nausea in my case?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.