{"id":"https://openalex.org/W7225800319","doi":"https://doi.org/10.21203/rs.3.rs-10615919/v1","title":"Steroid-Sparing De-escalation of Antiemetic Prophylaxis After Initial Control with a Four-Drug Regimen in Anthracycline/Cyclophosphamide Chemotherapy","display_name":"Steroid-Sparing De-escalation of Antiemetic Prophylaxis After Initial Control with a Four-Drug Regimen in Anthracycline/Cyclophosphamide Chemotherapy","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7225800319","doi":"https://doi.org/10.21203/rs.3.rs-10615919/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-10615919/v1","doi":"https://doi.org/10.21203/rs.3.rs-10615919/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10615919/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.21203/rs.3.rs-10615919/v1","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5087903422","display_name":"Yoshihiro Yamamoto","orcid":"https://orcid.org/0000-0003-2088-8724","observed_orcids":["https://orcid.org/0000-0003-2088-8724"]},"institutions":[{"id":"https://openalex.org/I195444995","display_name":"Aichi Gakuin University","ror":"https://ror.org/01rwx7470","country_code":"JP","type":"education","lineage":["https://openalex.org/I195444995"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Yoshihiro Yamamoto","raw_affiliation_strings":["Aichi Gakuin University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Aichi Gakuin University","institution_ids":["https://openalex.org/I195444995"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5007654592","display_name":"Tomohiro Fukuoka","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210146677","display_name":"Komaki City Hospital","ror":"https://ror.org/04eht1y76","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210146677"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Tomohiro Fukuoka","raw_affiliation_strings":["Komaki City Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Komaki City Hospital","institution_ids":["https://openalex.org/I4210146677"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5041725712","display_name":"Norio Watanabe","orcid":"https://orcid.org/0000-0001-9768-993X","observed_orcids":["https://orcid.org/0000-0001-9768-993X"]},"institutions":[{"id":"https://openalex.org/I195444995","display_name":"Aichi Gakuin University","ror":"https://ror.org/01rwx7470","country_code":"JP","type":"education","lineage":["https://openalex.org/I195444995"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Norio Watanabe","raw_affiliation_strings":["Aichi Gakuin University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Aichi Gakuin University","institution_ids":["https://openalex.org/I195444995"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112160787","display_name":"Hiroki Hayashi","orcid":"https://orcid.org/0000-0002-8508-827X","observed_orcids":["https://orcid.org/0000-0002-8508-827X"]},"institutions":[{"id":"https://openalex.org/I4210146677","display_name":"Komaki City Hospital","ror":"https://ror.org/04eht1y76","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210146677"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Hiroki Hayashi","raw_affiliation_strings":["Komaki City Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Komaki City Hospital","institution_ids":["https://openalex.org/I4210146677"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5025321094","display_name":"Motozumi Ando","orcid":"https://orcid.org/0000-0003-2473-0588","observed_orcids":["https://orcid.org/0000-0003-2473-0588"]},"institutions":[{"id":"https://openalex.org/I195444995","display_name":"Aichi Gakuin University","ror":"https://ror.org/01rwx7470","country_code":"JP","type":"education","lineage":["https://openalex.org/I195444995"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Motozumi Ando","raw_affiliation_strings":["Aichi Gakuin University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Aichi Gakuin University","institution_ids":["https://openalex.org/I195444995"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161421270","display_name":"Midori Furukawa","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210146677","display_name":"Komaki City Hospital","ror":"https://ror.org/04eht1y76","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210146677"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Midori Furukawa","raw_affiliation_strings":["Komaki City Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Komaki City Hospital","institution_ids":["https://openalex.org/I4210146677"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161479405","display_name":"Go Hirano","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210146677","display_name":"Komaki City Hospital","ror":"https://ror.org/04eht1y76","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210146677"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Go Hirano","raw_affiliation_strings":["Komaki City Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Komaki City Hospital","institution_ids":["https://openalex.org/I4210146677"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112398327","display_name":"Sumiyo Noda","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210146677","display_name":"Komaki City Hospital","ror":"https://ror.org/04eht1y76","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210146677"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Sumiyo Noda","raw_affiliation_strings":["Komaki City Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Komaki City Hospital","institution_ids":["https://openalex.org/I4210146677"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5112404552","display_name":"Yuko Deguchi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210146677","display_name":"Komaki City Hospital","ror":"https://ror.org/04eht1y76","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210146677"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Yuko Deguchi","raw_affiliation_strings":["Komaki City Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Komaki City Hospital","institution_ids":["https://openalex.org/I4210146677"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5087903422"],"corresponding_institution_ids":["https://openalex.org/I195444995"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11785","display_name":"Nausea and vomiting management","score":0.9897000193595886,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11785","display_name":"Nausea and vomiting management","score":0.9897000193595886,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10178","display_name":"Cancer survivorship and care","score":0.0013000000035390258,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11752","display_name":"Cancer Treatment and Pharmacology","score":0.0012000000569969416,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9107000231742859},{"id":"https://openalex.org/C2780580376","wikidata":"https://www.wikidata.org/wiki/Q186889","display_name":"Nausea","level":2,"score":0.767300009727478},{"id":"https://openalex.org/C2780401358","wikidata":"https://www.wikidata.org/wiki/Q422252","display_name":"Dexamethasone","level":2,"score":0.7432000041007996},{"id":"https://openalex.org/C2780852908","wikidata":"https://www.wikidata.org/wiki/Q127076","display_name":"Vomiting","level":2,"score":0.6582000255584717},{"id":"https://openalex.org/C2780884295","wikidata":"https://www.wikidata.org/wiki/Q575136","display_name":"Antiemetic","level":3,"score":0.6570000052452087},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.5997999906539917},{"id":"https://openalex.org/C2781413609","wikidata":"https://www.wikidata.org/wiki/Q7308373","display_name":"Regimen","level":2,"score":0.5727999806404114},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.536300003528595},{"id":"https://openalex.org/C2776694085","wikidata":"https://www.wikidata.org/wiki/Q974135","display_name":"Chemotherapy","level":2,"score":0.5006999969482422},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.4875999987125397},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.4016000032424927},{"id":"https://openalex.org/C2778715236","wikidata":"https://www.wikidata.org/wiki/Q55622662","display_name":"Discontinuation","level":2,"score":0.3894999921321869},{"id":"https://openalex.org/C2776804153","wikidata":"https://www.wikidata.org/wiki/Q210420","display_name":"Corticosteroid","level":2,"score":0.37130001187324524},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.35580000281333923},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3276999890804291},{"id":"https://openalex.org/C188198153","wikidata":"https://www.wikidata.org/wiki/Q1613840","display_name":"Limiting","level":2,"score":0.3183000087738037},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.3140000104904175},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.2971000075340271},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.2946999967098236},{"id":"https://openalex.org/C75908981","wikidata":"https://www.wikidata.org/wiki/Q28578","display_name":"Appetite","level":2,"score":0.27320000529289246},{"id":"https://openalex.org/C71315377","wikidata":"https://www.wikidata.org/wiki/Q11364","display_name":"Hormone","level":2,"score":0.26820001006126404},{"id":"https://openalex.org/C2776802502","wikidata":"https://www.wikidata.org/wiki/Q417589","display_name":"Anthracycline","level":4,"score":0.25209999084472656}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-10615919/v1","doi":"https://doi.org/10.21203/rs.3.rs-10615919/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10615919/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-10615919/v1","doi":"https://doi.org/10.21203/rs.3.rs-10615919/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10615919/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":13,"referenced_works":["https://openalex.org/W1966606652","https://openalex.org/W2072532597","https://openalex.org/W2106573575","https://openalex.org/W2285443608","https://openalex.org/W2331009428","https://openalex.org/W2460792208","https://openalex.org/W2786363103","https://openalex.org/W2996099006","https://openalex.org/W3000674753","https://openalex.org/W3130234083","https://openalex.org/W4388728054","https://openalex.org/W4396958589","https://openalex.org/W4411362500"],"related_works":[],"abstract_inverted_index":{"Abstract":[0],"Purpose":[1],"The":[2,88],"2023":[3],"Japanese":[4],"provide":[5],"a":[6,14,29,40,205],"weak":[7],"recommendation":[8],"for":[9],"limiting":[10],"dexamethasone":[11,112,128],"administration":[12],"to":[13,57,165,171,177,235,241],"single":[15],"day":[16],"in":[17,48,204,218],"anthracycline/cyclophosphamide":[18],"(AC)":[19],"regimens.":[20],"Since":[21],"April":[22,83,86],"2022,":[23],"our":[24],"institution":[25],"has":[26],"been":[27],"using":[28],"four-drug":[30],"regimen,":[31],"including":[32],"olanzapine.":[33],"To":[34],"reduce":[35],"steroid":[36,157,193],"exposure,":[37],"we":[38],"implemented":[39],"steroid-sparing":[41,216],"strategy":[42],"from":[43,133,163,169,175],"the":[44,59,91,97,134,145,152,159,199,243,248],"second":[45,135],"cycle":[46,99,136],"onward":[47],"patients":[49,74,115,141,154],"with":[50,75,116,198,229],"adequate":[51],"first-cycle":[52,120,146],"control.":[53],"This":[54,68],"study":[55,71],"aimed":[56],"evaluate":[58],"feasibility":[60],"and":[61,85,100,107,127,144,173,185,233,246],"clinical":[62],"outcomes":[63],"of":[64,102,201,208],"this":[65],"approach.":[66],"Methods":[67],"single-center":[69],"retrospective":[70],"included":[72,90],"hospitalized":[73],"breast":[76],"cancer":[77],"who":[78,155],"received":[79],"AC":[80,219],"regimens":[81],"between":[82],"2022":[84],"2024.":[87],"endpoints":[89],"complete":[92],"response":[93],"(CR)":[94],"rate":[95,148,161],"during":[96],"first":[98],"incidence":[101],"nausea,":[103,121],"vomiting,":[104],"appetite":[105],"loss,":[106],"other":[108],"adverse":[109],"events":[110,181],"after":[111,125],"omission.":[113],"In":[114],"no":[117,186],"or":[118,131],"mild":[119],"de-escalation":[122,224,249],"was":[123,129,149,195],"proposed":[124],"explanation,":[126],"reduced":[130],"omitted":[132],"upon":[137],"agreement.":[138],"Results":[139],"Forty":[140],"were":[142,182,189],"analyzed,":[143],"CR":[147,160],"72.5%.":[150],"Among":[151],"13":[153],"underwent":[156],"omission,":[158],"decreased":[162],"69.2%":[164],"46.2%.":[166],"Nausea":[167],"increased":[168],"53.8%":[170],"76.9%":[172],"vomiting":[174],"0%":[176],"23.1%.":[178],"Most":[179],"worsening":[180],"low":[183],"grade,":[184],"severe":[187],"complications":[188],"observed.":[190],"Conclusion":[191],"Early":[192],"omission":[194],"temporally":[196],"associated":[197],"deterioration":[200],"gastrointestinal":[202],"symptoms":[203],"substantial":[206],"proportion":[207],"patients.":[209],"These":[210],"findings":[211],"do":[212],"not":[213],"conclusively":[214],"negate":[215],"strategies":[217],"regimens,":[220],"but":[221],"suggest":[222],"that":[223],"should":[225],"be":[226],"cautiously":[227],"implemented,":[228],"careful":[230],"patient":[231],"selection":[232],"attention":[234],"timing.":[236],"Prospective":[237],"studies":[238],"are":[239],"warranted":[240],"clarify":[242],"optimal":[244],"candidates":[245],"refine":[247],"approaches.":[250]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-11-12T00:00:00"}