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Historically, CINV prevention trials used complete remission as the primary end point, and prevention trials focused on emesis control in both the acute and delayed phases of CINV. In this study, the researchers contend that a lack of understanding of its underlying pathophysiology and less-than-optimal trial design have hindered the study of nausea control. Subsequently, the development of effective agents to prevent nausea have been significantly hampered. Dr Gilmore and colleagues theorize that the use of a stringent no-nausea end point in clinical trials and a better understanding of the underlying pathophysiology could significantly improve nausea control. 

Due to the continued occurrence of CINV, an acute need for greater adherence to guidelines and better understanding of patient characteristics and genetic differences still exist. The investigators hope that future research on 5HT3-RA pharmacogenetics will lead to a better understanding of variability in patient response to antiemetics.

“Nurses are often very involved with educating and monitoring patients about the side effects of chemotherapy including CINV. Their awareness of all available antiemetic strategies is important. Nurses can also play a role in making sure [physicians] are following national guidelines as they relate to CINV management,” said Dr Gilmore.

Samantha West, RN, BSN, a nurse manager at Roswell Park Comprehensive Cancer Center, Buffalo, New York, notes that although recent advancements provide exciting prospects for patients, these advancements have created the ever-increasing challenge of disseminating the new knowledge and translating it to the bedside in a timely manner. “I believe that we are, indeed, in a new era when it comes to treatment regimens, which is changing the treatment paradigm. New drugs, new technologies, and new methods in how we treat cancer are coming at such a rapid rate that it has been difficult to assure that all oncology nurses are keeping current in advances in oncology care,” Ms West told Oncology Nurse Advisor.

John Schieszeris a medical reporter based in Seattle, Washington. 


Gilmore J, D’Amato S, Griffith N, Schwartzberg L. Recent advances in antiemetics: new formulations of 5HT3-receptor antagonists. Cancer Manag Res.2018;10:1827-1857.