The National Comprehensive Cancer Network (NCCN) recently announced updates to the NCCN Antiemesis Guidelines. The NCCN Clinical Practice Guidelines in Oncology are used extensively by managed care companies and by Medicare as the basis for coverage policies. The guidelines have a new recommendation for breakthrough treatment—Nabilone (Cesamet, Valeant)—for chemotherapy-induced nausea/vomiting.

The guidelines table describing the emetogenic potential of different anti-neoplastic agents has been revised. Bortezomib (Velcade), dasatinib (Sprycel), decitabine (Dacogen), lenalidomide (Revlimid), nelarabine (Arranon), sorafenib (Nexavar), sunitinib (Sutent), thalidomide (Thalomid), and trastuzumab (Herceptin) are all now considered to have minimal emetic risk.

Metoclopramide (Reglan) and diphenhydramine (Benadryl) are no longer recommended for delayed emesis prevention for patients receiving moderate-emetic-risk chemotherapy.

NCCN Clinical Practice Guidelines in Oncology are developed and updated through a consensus-driven process with explicit review of the scientific evidence by multidisciplinary panels of expert physicians from NCCN member institutions. The most recent version of this and all the guidelines are available free of charge at www.nccn.org.