Pharmacotherapy Considerations in Antiemetic Prophylaxis for Chemotherapy-Induced Nausea and Vomiting

Abstract

Objectives. Although several guidelines are available aiming for optimal chemotherapy-induced nausea and vomiting (CINV) control, there still remain critical therapeutic challenges: (i) recommendations are mainly drug-based, not protocol-based; (ii) the risk of antiemetics-related interactions is not highlighted; (iii) the emetogenicity of a regimen may vary over the cycle; and (iv) the impact of the underlying malignancy is overlooked. Apparently, the existing approach seems not to be generally efficient and puts patients at risk of insufficient use of antiemetics as well as poor emesis control. Evidence Acquisition. This study has re-evaluated the emetogenicity of chemotherapy regimens based on administered medications on each day, drug-drug interactions, combination therapy, and delayed CINV. Results. A literature review was done to re-evaluate the emetogenicity of the commonly accepted chemotherapy regimens based on administered medications on each day, drug interactions, combination therapy, and delayed CINV. Conclusion. The revised CINV prophylaxis protocols with sorted recommendations for hematologic malignancies and solid tumors have been represented, with respect to the availability of prophylactic medications.