Recent developments in the prevention of chemotherapy-induced nausea and vomiting (CINV): a comprehensive review

Ann Oncol. 2015 Jun;26(6):1081-1090. doi: 10.1093/annonc/mdv138. Epub 2015 Mar 9.

Abstract

The prevention of chemotherapy-induced nausea and vomiting (CINV) has been revolutionized over the past 25 years. Guideline-based treatment means that vomiting can be prevented in the majority, but not in all patients. Therefore, antiemetic research continues with the goal of optimizing CINV control for all patients. This comprehensive review summarizes the research efforts in this field over the past few years. Emerging from this research are two new antiemetic agents, netupitant/palonosetron, the first antiemetic combination agent and rolapitant, a new NK1RA. In addition, studies have evaluated the benefits of olanzapine and ginger, explored optimal combinations of agents for delayed CINV prevention, confirmed that dexamethasone-sparing regimens are effective, and demonstrated the value of NK1RAs in high-dose chemotherapy settings as well as with certain moderately emetogenic chemotherapies such as carboplatin. Research has also validated the correlation between antiemetic guideline adherence and improved CINV control. Finally, regulatory authorities have utilized extreme caution in retiring some 5-HT3RAs or decreasing their maximum dose.

Keywords: NEPA; antiemetics; chemotherapy-induced nausea and vomiting CINV; guidelines; olanzapine; rolapitant.

Publication types

  • Review

MeSH terms

  • Animals
  • Antiemetics / therapeutic use*
  • Antineoplastic Agents / adverse effects*
  • Drug Combinations
  • Drug Discovery / trends*
  • Guideline Adherence
  • Humans
  • Isoquinolines / therapeutic use
  • Nausea / chemically induced
  • Nausea / prevention & control*
  • Neurokinin-1 Receptor Antagonists / therapeutic use
  • Practice Guidelines as Topic
  • Pyridines / therapeutic use
  • Quinuclidines / therapeutic use
  • Serotonin Antagonists
  • Spiro Compounds / therapeutic use
  • Treatment Outcome
  • Vomiting / chemically induced
  • Vomiting / prevention & control*

Substances

  • Antiemetics
  • Antineoplastic Agents
  • Drug Combinations
  • Isoquinolines
  • Neurokinin-1 Receptor Antagonists
  • Pyridines
  • Quinuclidines
  • Serotonin Antagonists
  • Spiro Compounds
  • netupitant, palosentron drug combination
  • rolapitant