Auricular Point Stimulation Plus Dexamethasone for Nausea and Vomiting Caused by Gemcitabine Plus Paclitaxel (ADGP)

Auricular Point Stimulation Plus Dexamethasone for Nausea and Vomiting Caused by Gemcitabine Combined With Paclitaxel Protein-bound in Pancreatic Cancer Treatment

The goal of this clinical trial is to learn if auricular point stimulation plus dexamethasone works to effectively prevent or suppress nausea and vomiting caused by gemcitabine combined with paclitaxel protein-bound in pancreatic cancer treatment.

It will also learn about the safety and influence on gastrointestinal function of auricular point stimulation plus dexamethasone. The main questions it aims to answer are:

Can auricular point stimulation plus dexamethasone effectively prevent or suppress nausea and vomiting induced by the gemcitabine plus paclitaxel protein-bound regimen? Can auricular point stimulation plus dexamethasone effectively reduce the incidence of appetite loss, weakened or disordered gastrointestinal function, and other uncomfortable conditions caused by excessive use of antiemetic drugs?

Participants will: Receive auricular acupressure with bean seeds on specific points of one ear, plus intravenous injection of dexamethasone as a preventive antiemetic treatment within half an hour before chemotherapy. Starting from the day of chemotherapy (Day 1) to the following five days (Day 1-Day 5), provide regular stimulation at the acupressure points daily by themselves according to the protocol provided in this trial. Record their nausea and vomiting status, appetite, and gastrointestinal function-related symptomatic indicators from Day 1 to Day 5. Oral antiemetics are also prepared. If nausea and vomiting are significant or the patient feels the need, they may be temporarily administered as an adjunct.

Study Overview

• Status: Recruiting
• Conditions: Nausea and Vomiting Caused by Chemotherapy
• Intervention / Treatment: Other: Auricular point stimulation plus dexamethasone

Detailed Description

Gemcitabine combined with paclitaxel protein-bound is currently one of the commonly used chemotherapy regimens for postoperative adjuvant and palliative treatment of pancreatic cancer. While it improves patient survival rates, it is also associated with certain gastrointestinal adverse reactions. Chemotherapy-related nausea and vomiting are relatively common, with an incidence of approximately 10%. The majority of these symptoms occur on the day of administration and within the following four days. This regimen is currently classified as a low emetic risk treatment in clinical guidelines. The recommended prophylactic antiemetic strategy typically involves corticosteroids (e.g., dexamethasone) and/or 5-HT3 receptor antagonists (e.g., ondansetron, palonosetron). In clinical practice, single-agent antiemetic therapy often fails to effectively prevent delayed nausea and vomiting. Consequently, most physicians opt for dual-agent antiemetic therapy. However, excessive use of antiemetics frequently leads to drug-related gastrointestinal adverse reactions such as anorexia, bloating, constipation, and diarrhea. Studies have shown that the incidence of constipation in chemotherapy patients treated with palonosetron nearly doubles. The intensive use of antiemetics severely impacts patients' gastrointestinal function, quality of life, and even their treatment adherence. Therefore, how to effectively prevent chemotherapy-induced nausea and vomiting while minimizing the side effects of antiemetic therapy itself has become a practical issue that healthcare professionals urgently need to address.

Auricular point pressotherapy is a traditional Chinese medicine (TCM) external therapy. It involves accurately pasting Vaccaria seeds on corresponding auricular points with adhesive tapes and stimulating the points through moderate pressing to regulate physical functions and treat diseases. According to TCM theory, the ear is closely connected to the internal organs and meridians of the human body, and all twelve meridians are directly or indirectly linked to the ear. Auricular point pressotherapy can unblock meridians and balance yin and yang by stimulating corresponding auricular points, thereby alleviating CINV and other adverse reactions. It is an economical, non-invasive, and low-side-effect natural therapy. Meanwhile, auricular point pressotherapy can effectively improve gastrointestinal function, thus significantly reducing gastrointestinal dysfunction caused by chemotherapy and antiemetic drugs, such as anorexia, abdominal distension, constipation, and diarrhea.

Our team summarized the relevant data of patients who voluntarily received auricular point pressotherapy for antiemesis previously. The results showed that among pancreatic cancer patients who received gemcitabine combined with paclitaxel protein-bound for postoperative adjuvant or palliative therapy, 100% of those treated with auricular point pressotherapy plus dexamethasone did not experience grade 2 or above (including grade 2) nausea and had no vomiting on the day of medication and within 3 days thereafter.

Based on the above theoretical and practical basis, this study intends to evaluate the efficacy and safety of auricular point pressotherapy combined with dexamethasone for CINV induced by gemcitabine combined with paclitaxel protein-bound in pancreatic cancer treatment. At the same time, it will assess related indicators such as patients' appetite and gastrointestinal function, and explore the important role of integrated traditional Chinese and Western medicine intervention in improving patients' quality of life during chemotherapy, to provide clinical reference for optimizing the management of adverse reactions of this chemotherapy regimen.

• Study Type: Interventional
• Enrollment (Estimated): 25
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Juan Wang; Phone Number: 8617816190946; Email: wangjuan.happy@hotmail.com

Study Locations

• China
  • Hangzhou, China
    • Recruiting
    • Second Affiliated Hospital of Zhejiang University School of Medicine
    • Contact: Juan Wang; Phone Number: 8617816190946; Email: wangjuan.happy@hotmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria: Patients must meet the following inclusion criteria for the study:

• Age ≥ 18 years and ≤ 85 years;
• Patients with pancreatic cancer after radical resection or with advanced pancreatic cancer, who require further chemotherapy with the gemcitabine plus paclitaxel albumin-bound regimen;
• ECOG performance status score of 0-2;
• Normal hematological function (platelet count > 80×10⁹/L; white blood cell count > 3×10⁹/L; neutrophil count > 1.5×10⁹/L);
• Serum bilirubin ≤ 1.5 times the upper limit of normal (ULN), and transaminase ≤ 5 times the ULN;
• No ascites, no gastrointestinal obstruction, normal coagulation function, and serum albumin ≥ 30g/L;
• Child-Pugh classification of liver function is Grade A;
• Serum creatinine < ULN, or calculated creatinine clearance rate > 50ml/min.

Exclusion Criteria: Patients who meet any of the following criteria will be excluded from the study:

• Local inflammation or infection of the auricleBleeding tendency or coagulation disorders;
• Severe ascites;
• Gastrointestinal obstruction;
• Hypertensive crisis or hypertensive encephalopathy;
• Severe uncontrolled systemic complications such as infection or diabetes mellitus;
• Clinically severe cardiovascular diseases, including cerebrovascular accident (within 6 months before enrollment), myocardial infarction (within 6 months before enrollment), hypertension that is not well-controlled despite appropriate medication, unstable angina pectoris, congestive heart failure (NYHA Class 2-4), and cardiac arrhythmias requiring drug treatment;
• A history of or physical examination findings indicating central nervous system diseases (e.g., primary brain tumor, epilepsy uncontrolled by standard treatment, any history of brain metastasis or stroke);
• Hypersensitivity to any drugs used in the study;
• Pregnant or lactating women;
• Presence of any other diseases, functional impairment caused by metastatic lesions, or suspicious disorders identified during physical examination, which suggest contraindications to the study drugs or place the patient at high risk of treatment-related complications;
• Inability or unwillingness to comply with the study protocol.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Auricular point stimulation plus dexamethasone group; For pancreatic cancer patients who will receive gemcitabine combined with paclitaxel protein-bound for postoperative adjuvant chemotherapy or palliative treatment, preventive antiemetic treatment consisting of unilateral auricular point stimulation at specific acupoints and dexamethasone will be administered within 30 minutes before chemotherapy. Auricular acupoint stimulation is performed by adhering Vaccaria seeds to specific points with adhesive tape and applying moderate pressure until a certain level of soreness is elicited. Vaccaria seeds are kept on the ear from the day of chemotherapy (Day 1) until the end of Day 5.

Other: Auricular point stimulation plus dexamethasone; On the day of chemotherapy (Day 1): Within half an hour before chemotherapy, administer auricular acupressure on one ear (stimulating the stomach, cardia, and brainstem acupoints for 5 minutes each) along with an intravenous push of 5 mg dexamethasone. From the day of chemotherapy (Day 1) to the following five days (Day 1-Day 5): Stimulate each acupoint once in the morning, noon, and evening, for 5 minutes each time. If nausea or vomiting occurs, immediately apply additional stimulation for 5 minutes as a temporary measure. Oral antiemetics should be prepared and may be used temporarily if nausea and vomiting are significant and the patient feels the need.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of patients experiencing nausea as assessed by NIC-CTC AE4.0	Participants will be asked to fill out a questionnaire to record whether nausea occurs. If nausea occurs, its grade according to the NIC-CTC AE4.0 should be recorded.	from the day of chemotherapy (Day 1) until the end of Day 5

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of patients experiencing vomiting as assessed by NIC-CTC AE4.0	Participants will be asked to fill out a questionnaire to record whether vomiting occurs. If vomiting occurs, its grade according to the NIC-CTC AE4.0 should be recorded.	from the day of chemotherapy (Day 1) until the end of Day 5
Proportion of patients requiring additional antiemetics		from the day of chemotherapy (Day 1) until Day 5

Other Outcome Measures

Outcome Measure	Time Frame
Proportion of patients experiencing chemotherapy-related adverse events as assessed by CTCAE v4.0	from the day of chemotherapy (Day 1) until Day 5

Collaborators and Investigators

• Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University

Publications and helpful links

General Publications

• [1] CONROY T, PFEIFFER P, VILGRAIN V, et al. Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of oncology: official journal of the European Society for Medical Oncology, 2023, 34(11): 987-1002. [2] PUSCEDDU S, GHIDINI M, TORCHIO M, et al. Comparative Effectiveness of Gemcitabine plus Nab-Paclitaxel and FOLFIRINOX in the First-Line Setting of Metastatic Pancreatic Cancer: A Systematic Review and Meta-Analysis. Cancers, 2019, 11(4): [3] KIMURA S, HOSOYA K, OGATA K, et al. Severity of constipation related to palonosetron during first-line chemotherapy: a retrospective observational study. Support Care Cancer, 2021, 29: 4723-32.

Study record dates

Study Major Dates

• Study Start (Actual): November 25, 2025
• Primary Completion (Estimated): November 1, 2026
• Study Completion (Estimated): November 1, 2026

Study Registration Dates

• First Submitted: December 14, 2025
• First Submitted That Met QC Criteria: April 13, 2026
• First Posted (Actual): April 17, 2026

Study Record Updates

• Last Update Posted (Actual): April 17, 2026
• Last Update Submitted That Met QC Criteria: April 13, 2026
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Signs and Symptoms, Digestive; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Nausea; Polycyclic Compounds; Pregnadienes; Pregnanes; Steroids; Fused-Ring Compounds; Steroids, Fluorinated; Pregnadienetriols; Dexamethasone
• Other Study ID Numbers: 20251824

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No