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Related Experiment Videos

Acute emesis: moderately emetogenic chemotherapy.

Jørn Herrstedt1, Jim M Koeller, Fausto Roila

  • 1Department of Oncology 54 B1, Copenhagen University Hospital, DK-2730 Herlev, Denmark. jrhe@herlevhosp.kbhamt.dk

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
|November 27, 2004
PubMed
Summary
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The best way to prevent chemotherapy-induced nausea and vomiting is using a combination of a serotonin (5-HT3) receptor antagonist and dexamethasone. Newer agents like palonosetron offer alternatives for moderately emetogenic chemotherapy.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Chemotherapy-induced nausea and vomiting (CINV) remains a significant challenge for patients undergoing cancer treatment.
  • Previous consensus guidelines from 1997 informed antiemetic prophylaxis strategies.

Purpose of the Study:

  • To review updated recommendations for preventing acute emesis from moderately emetogenic chemotherapy.
  • To incorporate new research published since the 1997 consensus conference.

Main Methods:

  • Review of studies on antiemetic prophylaxis published between 1997 and 2004.
  • Analysis of different antiemetic classes: corticosteroids, serotonin (5-HT3) receptor antagonists, dopamine D(2) receptor antagonists, and neurokinin (NK(1)) receptor antagonists.
  • Evaluation of antiemetic prophylaxis for multiple chemotherapy cycles.

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Main Results:

  • Optimal dosing and scheduling for serotonin (5-HT3) receptor antagonists and dexamethasone were established.
  • Palonosetron emerged as a viable alternative to established serotonin (5-HT3) receptor antagonists (ondansetron, granisetron, tropisetron, dolasetron).
  • The combination of a serotonin (5-HT3) receptor antagonist and dexamethasone remains the optimal prophylaxis for moderately emetogenic chemotherapy.

Conclusions:

  • The combination of a serotonin (5-HT3) receptor antagonist and dexamethasone is the current standard for preventing CINV.
  • Future recommendations may evolve with the integration of neurokinin (NK(1)) receptor antagonists into combination therapy.