Chemotherapy-induced nausea and vomiting: current and new standards in the antiemetic prophylaxis and treatment

Nausea and vomiting are considered as two of the most distressing side-effects of chemotherapy. Chemotherapy-induced nausea and vomiting have been classified into acute, delayed and anticipatory based on the time of onset. The frequency of nausea and vomiting depends primarily on the emetogenic pote...

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Bibliographic Details
Published in:European journal of cancer (1990) 2005, Vol.41 (2), p.199-205
Main Authors: Jordan, Karin, Kasper, Christoph, Schmoll, Hans-Joachim
Format: Article
Language:English
Subjects:
5-HT 3 receptor-antagonists
Acute Disease
Anti-emetic therapy
Antiemetics - standards
Antiemetics - therapeutic use
Antineoplastic Agents - adverse effects
Benzodiazepines - therapeutic use
Biological and medical sciences
Cannabinoids - therapeutic use
Chemotherapy
Dopamine Antagonists - therapeutic use
Histamine H1 Antagonists - therapeutic use
Humans
MASCC-guidelines
Medical sciences
Nausea - chemically induced
Nausea - prevention & control
NCCN-guidelines
Neurokinin-1 Receptor Antagonists
Pharmacology. Drug treatments
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Steroids
Steroids - therapeutic use
Tumors
Vomiting - chemically induced
Vomiting - prevention & control
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Summary:Nausea and vomiting are considered as two of the most distressing side-effects of chemotherapy. Chemotherapy-induced nausea and vomiting have been classified into acute, delayed and anticipatory based on the time of onset. The frequency of nausea and vomiting depends primarily on the emetogenic potential of the chemotherapeutic agents used. With the introduction of the 5-HT 3 receptor-antagonists in combination with dexamethasone in the early 1990s approximately 70% of patients receiving highly emetogenic chemotherapy were protected from acute emesis. However, 40% of patients have symptoms in the delayed phase. Another group of antiemetics, the neurokinin-1-receptor-antagonists, have recently been introduced. The addition of neurokinin receptor (NK1 receptor)-antagonists to standard therapy significantly improves emesis protection in the acute and in particular in the delayed phase by approximately 20%. Due to these new developments, revised antiemetic guidelines have been set. Here, the most recent developments in antiemetic therapy, including these guidelines, are reviewed.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2004.09.026