Guidelines for the control of nausea and vomiting with chemotherapy of low or minimal emetic potential.
OBJECTIVE
The purpose of this study is to update the guidelines for antiemetic therapy to be used with anticancer agents of low to minimal emetic potential.


METHODS
Experts from the Multinational Association of Supportive Care in Cancer (MASCC) met in Perugia in 2009 to revise the MASCC antiemetic consensus guidelines. There is an increasing number of anticancer agents which are classified as being associated with a low or minimal risk of nausea and vomiting. However, the emetic potential of such agents and particularly those given as prolonged oral therapy is not well documented, and neither is the optimal antiemetic therapy.


RESULTS
The consensus is that patients receiving anticancer therapy of low emetic potential should receive single-agent antiemetic prophylaxis such as dexamethasone, 5 hydroxytryptamine3 (5HT3) receptor antagonists, or dopamine receptor antagonists. Those receiving anticancer therapy of minimal emetic potential and who have no prior history of nausea and vomiting should not receive antiemetic prophylaxis. Those who experience nausea and vomiting subsequently can receive single-agent dexamethasone, 5HT3 receptor antagonists, or dopamine receptor antagonists.


CONCLUSIONS
More data are needed on the emetic potential and the outcome of antiemetic treatment with agents likely to fall into the low or minimal emetic potential category.
Olver
Ian
I
Cancer Council Australia, GPO Box 4708, Sydney, NSW, Australia 2001. ian.olver@cancer.org.au
Clark-Snow
Rebecca A
RA
Ballatori
Enzo
E
Espersen
Birgitte T
BT
Bria
Emilio
E
Jordan
Karin
K
D000932:Antiemetics / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003907:Dexamethasone / Q000008:administration & dosage; D018492:Dopamine Antagonists / Q000008:administration & dosage; D006801:Humans; D009325:Nausea / Q000139:chemically induced* / Q000188:drug therapy / Q000517:prevention & control*; D064729:Neurokinin-1 Receptor Antagonists; D017410:Practice Guidelines as Topic; D012702:Serotonin Antagonists / Q000008:administration & dosage; D014839:Vomiting / Q000139:chemically induced* / Q000188:drug therapy / Q000517:prevention & control*
D000932:Antiemetics; D000970:Antineoplastic Agents; D018492:Dopamine Antagonists; D064729:Neurokinin-1 Receptor Antagonists; D012702:Serotonin Antagonists; D003907:Dexamethasone
Oncologist. 2007 Sep;12(9):1143-50
17914084
N Engl J Med. 1981 Oct 15;305(16):905-9
7024807
J Clin Oncol. 2006 Jun 20;24(18):2932-47
16717289
Support Care Cancer. 2005 Jul;13(7):529-34
15700131
J Clin Oncol. 2000 Oct 1;18(19):3409-22
11013282
Support Care Cancer. 2005 Feb;13(2):109-11
15714358
Ann Oncol. 1998 Jul;9(7):759-65
9739443
Tumori. 2001 Nov-Dec;87(6):379-82
11989589
Clin Invest Med. 1986 Nov;9(4):225-31
3542325
Drugs. 1983 Feb;25 Suppl 1:63-73
6682376
Support Care Cancer. 2006 Dec;14(12):1262-5
16896880
BMJ. 2001 Jul 7;323(7303):16-21
11440936
J Clin Oncol. 1997 Jan;15(1):103-9
8996130
N Engl J Med. 2008 Jun 5;358(23):2482-94
18525044
J Clin Oncol. 2004 Feb 15;22(4):725-9
14966097
Support Care Cancer. 2005 Feb;13(2):80-4
15599601
J Clin Oncol. 1984 Jun;2(6):691-5
6374058
Support Care Cancer. 2004 Jun;12(6):446-53
15045572
Rev Recent Clin Trials. 2006 Jan;1(1):61-6
18393781