The Multinational Association of Supportive Care in Cancer (MASCC) and European Society for Medical Oncology have updated their consensus recommendations for controlling nausea and vomiting in patients receiving chemotherapy of low or minimal emetic potential.1
Key recommendations include:
- For patients receiving low emetogenic chemotherapy, a single antiemetic such as dexamethasone, a 5HT3 receptor antagonist (eg, ondansetron, granisetron), or a dopamine receptor antagonist (eg, prochlorperazine, olanzapine) may be considered for prevention of vomiting during the acute phase.
- An antiemetic should not be routinely administered to patients receiving chemotherapy of minimal emetogenic potential.
- If patients vomit, they should be treated as if they are receiving chemotherapy of low emetic potential.
- An antiemetic should not be used as prophylaxis of delayed nausea and vomiting caused by low or minimally emetogenic chemotherapy.
These 2016 guidelines are based on findings from a systematic literature review on antiemetics for low emetogenic chemotherapy and chemotherapy of minimal emetic potential. Further research is warranted to determine the incidence of emesis, especially during the delayed phase, in patients receiving low emetogenic chemotherapy.
The authors also note that additional strategies are needed to improve adherence to guidelines for the prevention of chemotherapy-induced nausea and vomiting.
1. Olver I, Ruhlmann CH, Jahn F, et al. 2016 Updated MASCC/ESMO Consensus Recommendations: Controlling nausea and vomiting with chemotherapy of low or minimal emetic potential. Supp Care Cancer. 2016 Aug 30. doi: 10.1007/s00520-016-3391-z. [Epub ahead of print]