Chemotherapy-Induced Nausea and Vomiting: Pathogenesis, Recommendations, and New Trends

Area of Science:

• Oncology
• Pharmacology

Background:

• Chemotherapy-induced nausea and vomiting (CINV) significantly affects cancer patients' quality of life and treatment adherence.
• CINV presents in five main forms: acute, delayed, anticipatory, breakthrough, and refractory, each requiring tailored management strategies.

Purpose of the Study:

• To review the challenges and unmet needs in managing chemotherapy-induced nausea and vomiting.
• To highlight the limitations of current antiemetic regimens and identify areas for future research.

Main Methods:

• Review of existing literature on CINV management.
• Analysis of current antiemetic drug classes, including 5-HT3 receptor antagonists, NK1 receptor antagonists, and corticosteroids.
• Identification of specific CINV subtypes and patient populations with inadequate symptom control.

Main Results:

• Despite advancements, effective control of non-acute CINV remains a significant challenge.
• Current treatment protocols may not be optimal for patients undergoing multiple-day chemotherapy cycles.
• A subset of patients experiences CINV refractory to standard antiemetic therapies.

Conclusions:

• Optimizing CINV management requires addressing the needs of patients with non-acute symptoms and those on extended chemotherapy.
• Further research is essential to develop more effective and personalized CINV treatment protocols.
• Improving antiemetic strategies is crucial for enhancing patient quality of life and supporting treatment completion.