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PubmedHPO

Id	Subject	Object	Predicate	Lexical cue
T1	300-306	HP_0002018	denotes	nausea
T2	311-319	HP_0002013	denotes	vomiting

Allie

Id	Subject	Object	Predicate	Lexical cue
SS1_22823909_2_0	139-179	expanded	denotes	5-hydroxytryptamine receptor antagonists
SS2_22823909_2_0	181-190	abbr	denotes	5-HT3 RAs
SS1_22823909_2_1	274-286	expanded	denotes	chemotherapy
SS2_22823909_2_1	288-290	abbr	denotes	CT
SS1_22823909_2_2	364-391	expanded	denotes	highly emetogenic CT agents
SS2_22823909_2_2	393-396	abbr	denotes	HEC
SS1_22823909_3_0	554-574	expanded	denotes	emergency department
SS2_22823909_3_0	576-578	abbr	denotes	ED
SS1_22823909_5_0	645-658	expanded	denotes	breast cancer
SS2_22823909_5_0	660-662	abbr	denotes	BC
SS1_22823909_5_1	699-725	expanded	denotes	lung cancer on carboplatin
SS2_22823909_5_1	727-741	abbr	denotes	LC-carboplatin
AE1_22823909_2_0	SS1_22823909_2_0	SS2_22823909_2_0	abbreviatedTo	5-hydroxytryptamine receptor antagonists,5-HT3 RAs
AE1_22823909_2_1	SS1_22823909_2_1	SS2_22823909_2_1	abbreviatedTo	chemotherapy,CT
AE1_22823909_2_2	SS1_22823909_2_2	SS2_22823909_2_2	abbreviatedTo	highly emetogenic CT agents,HEC
AE1_22823909_3_0	SS1_22823909_3_0	SS2_22823909_3_0	abbreviatedTo	emergency department,ED
AE1_22823909_5_0	SS1_22823909_5_0	SS2_22823909_5_0	abbreviatedTo	breast cancer,BC
AE1_22823909_5_1	SS1_22823909_5_1	SS2_22823909_5_1	abbreviatedTo	lung cancer on carboplatin,LC-carboplatin

PubMed_Structured_Abstracts

Id	Subject	Object	Predicate	Lexical cue
T1	124-591	BACKGROUND	denotes	1st generation 5-hydroxytryptamine receptor antagonists (5-HT3 RAs), and palonosetron, a 2nd generation 5-HT3 RA, are indicated for the prevention of chemotherapy (CT)-induced nausea and vomiting (CINV) associated with moderately (MEC) and highly emetogenic CT agents (HEC). This study explores the impact of step therapy policies requiring use of an older 5-HT3 RA before palonosetron on risk of CINV associated with hospital or emergency department (ED) admissions.
T2	601-1281	METHODS	denotes	Patients who received cyclophosphamide post breast cancer (BC) surgery or who were diagnosed with lung cancer on carboplatin (LC-carboplatin) or cisplatin (LC-cisplatin) were selected from PharMetrics' (IMS LifeLink) claims dataset (2005-2008). Patients were followed for 6 months from initial CT administration for CINV events identified through ICD-9-CM codes. Patients were grouped into those initiated with older, generic 5-HT3 RAs (ondansetron, granisetron, and dolasetron) and those initiated and maintained on palonosetron throughout study follow-up. CINV events and CINV days were analyzed using multivariate regressions controlling for demographic and clinical variables.
T3	1291-2214	RESULTS	denotes	Eligible patients numbered 3,606 in BC, 4,497 in LC-carboplatin and 1,154 in LC-cisplatin cohorts, with 52%, 40%, and 34% in the palonosetron group, respectively. There was no significant difference between the two 5-HT3 RA groups in age or Charlson Comorbidity Index among the two MEC cohorts (BC and LC-carboplatin). Among the LC-cisplatin cohort, palonosetron users were older with more males than the older 5-HT3 RA group (age: 60.1 vs. 61.3; males, 66.9% vs. 56.9%). Compared to the older 5-HT3 RAs, the palonosetron groups incurred 22%-51% fewer 5-HT3 RA pharmacy claims, had fewer patients with CINV events (3.5% vs. 5.5% in BC, 9.5% vs. 12.8% in LC-carboplatin, 16.4% vs. 21.7% in LC-cisplatin), and had lower risk for CINV events (odds ratios 0.62, 0.71, or 0.71, respectively; p<0.05). The BC and LC-carboplatin palonosetron groups experienced 50% and 30% fewer CINV days than the generic 5-HT3 RA group (p<0.05).
T4	2228-2524	CONCLUSIONS	denotes	Patients with breast or lung cancer initiated and maintained on palonosetron were at significantly lower risk for potentially costly CINV versus those on older 5-HT3 RAs. Further studies on impact of step therapy policy are warranted in order to minimize the clinical and economic burden of CINV.