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Nausea and Vomiting

Nausea and Vomiting

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.

The American Society of Clinical Oncology (ASCO) updated their antiemetic guideline to include the use of a novel antiemetic combination for cancer patients.

A phase III study showed that APF530 could improve control of emesis in cancer patients receiving highly emetogenic chemotherapy.

The US Food and Drug Administration has approved rolapitant for the prevention of delayed phase nausea and vomiting associated with chemotherapy.


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