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SEOM clinical guideline emesis (2021)
Margarita Majem1, Ramon de Las Peñas2, Juan Antonio Virizuela3
1Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, c/Sant Antoni Maria Claret 167, 08025, Barcelona, Spain. MMajem@santpau.cat.
Summary
Chemotherapy-induced nausea and vomiting (CINV) affects up to 40% of patients, impacting treatment adherence. Evidence-based antiemetic prophylaxis is crucial for managing CINV effectively across different treatment regimens.
Area of Science:
- Oncology
- Pharmacology
- Patient Care
Background:
- Chemotherapy-induced nausea and vomiting (CINV) is a prevalent and distressing side effect of cancer treatment, affecting up to 40% of patients.
- CINV can significantly impair patients' quality of life, reduce treatment adherence, and necessitate chemotherapy dose reductions, potentially compromising treatment efficacy.
- The occurrence and severity of CINV are influenced by the emetogenicity of antineoplastic drugs and individual patient characteristics.
Purpose of the Study:
- To provide evidence-based recommendations for antiemetic prophylaxis to achieve complete protection against CINV in acute, late, and global phases.
- To address the need for adapted antiemetic strategies based on the varying emetogenicity of different anticancer regimens.
- To offer comprehensive guidance on antiemetic prophylaxis, including oral treatments, multiday regimens, and prevention of radiation-induced emesis.
Main Methods:
- Classification of anticancer treatments based on their emetogenicity level (high, moderate, low, minimal).
- Recommendations based on the use of highly effective antiemetic drugs with a high therapeutic index, including anti-5-HT, anti-NK, and steroids.
- Inclusion of strategies for oral treatments, multiday regimens, and radiation-induced emesis prevention.
Main Results:
- Despite the availability of highly effective antiemetic treatments, current clinical practice indicates underutilization.
- Variability in CINV risk necessitates tailored antiemetic prophylaxis for different antitumor regimens.
- A structured approach to antiemetic prophylaxis, considering emetogenicity and drug classes, is essential for optimal patient outcomes.
Conclusions:
- Evidence-based recommendations are vital to guide clinical decision-making and improve the application of effective antiemetic strategies.
- Optimizing antiemetic prophylaxis is critical for enhancing patient quality of life and maintaining cancer treatment adherence and efficacy.
- Comprehensive guidelines are needed to cover diverse prophylaxis options, ensuring better management of CINV and related emetic events.
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