Rolapitant plus 5-HT3 receptor antagonist and dexamethasone is well tolerated and more effectively controls chemotherapy-induced nausea and vomiting compared with 5-HT3 and dexamethasone alone.
Nausea and Vomiting
Researchers found that combining palonosetron, aprepitant, and dexamethasone represents an effective and well-tolerated treatment to prevent CINV in testicular cancer patients receiving cisplatin.
Aprepitant plus palonosetron and dexamethasone showed early promise for preventing chemotherapy-induced nausea and vomiting among patients with colorectal cancer who are undergoing FOLFOX chemotherapy, according to results of a small pilot study.
The FDA has approved rolapitant injectable emulsion in combination with other antiemetics in adults to prevent delayed chemotherapy-induced nausea and vomiting.
Adherence to antiemetic regimens for patients undergoing emetogenic cancer chemotherapy is poor, according to an online survey of oncology nurses in the United States.
Adding ginger extract capsules to a standard prophylactic antiemetic did not improve chemotherapy-induced nausea and vomiting in patients undergoing high-dose cisplatin chemotherapy.
This article will address changes in CINV guidelines over the past 5 years and provide updates on recently approved agents and agents that are expected to be approved, based on published phase III trials. It will also explore other factors affecting optimal CINV control, including the role of patient-related risk factors and the role of physician adherence to antiemetic guidelines in reducing the residual risk of CINV.
Beyond the current recommendations for management of chemotherapy-induced nausea and vomiting, recent research has shown significant improvement in emesis control with use of triplet therapy using dexamethasone, an NK1 receptor antagonist, and a 5-HT3 receptor antagonist in patients undergoing non–anthracycline-plus-cyclophosphamide-based moderately emetogenic chemotherapy.
Adding the antipsychotic drug olanzapine to a standard antiemetic regimen significantly improved prevention of nausea caused by emetogenic chemotherapy.
The FDA has approved the first single-dose intravenous NK1 receptor antagonist, fosaprepitant dimeglumine (Emend), for the treatment of nausea and vomiting that can accompany the use of moderately and highly emetogenic chemotherapy.