Getting it right the first time: recent progress in optimizing antiemetic usage

Support Care Cancer. 2018 Mar;26(Suppl 1):19-27. doi: 10.1007/s00520-018-4116-2. Epub 2018 Mar 19.

Abstract

Recent years have witnessed significant improvements in the prevention and management of chemotherapy-induced nausea and vomiting (CINV), allowing patients to complete their prescribed chemotherapy regimens without compromising quality of life. This reduction in the incidence of CINV can be primarily attributed to the emergence of effective, well-tolerated antiemetic therapies, including serotonin (5-hydroxytryptamine or 5-HT3) receptor antagonists, neurokinin-1 (NK-1) receptor antagonists, and the atypical antipsychotic olanzapine. While 5-HT3 receptor antagonists are highly effective in the prevention of acute CINV, NK-1 receptor antagonists and olanzapine have demonstrated considerable activity against both acute and delayed CINV. Various combinations of these three types of agents, along with dexamethasone and dopamine receptor antagonists, are now becoming the standard of care for patients receiving moderately or highly emetogenic chemotherapy. Optimal use of these therapies requires careful assessment of the unique characteristics of each agent and currently available clinical trial data.

Keywords: 5-HT3 receptor antagonist; CINV; Chemotherapy-induced nausea and vomiting; NK-1 receptor antagonist; Olanzapine; Radiotherapy-induced nausea and vomiting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiemetics / therapeutic use*
  • Female
  • Humans
  • Male
  • Nausea / chemically induced*
  • Quality of Life / psychology*
  • Vomiting / chemically induced*

Substances

  • Antiemetics