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Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
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Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents-updated MASCC/ESMO consensus

Karin Jordan1,2, Alexandre Chan3, Richard J Gralla4

  • 1Department of Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital Potsdam, Charlottenstraße 72, 14467, Potsdam, Germany. karin.jordan@med.uni-heidelberg.de.

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
|December 21, 2023
PubMed
Abstract

Insights

This study identified 107 new anticancer agents and classified their emetic potential, revising risk categories for oral agents to improve antiemetic guideline accuracy.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Pharmacy

Background:

  • Antiemetic guidelines are crucial for managing chemotherapy-induced nausea and vomiting (CINV).
  • Recent advancements in oncology have led to numerous new anticancer agents requiring updated emetic potential classification.
  • The Multinational Association of Supportive Care in Cancer (MASCC) and European Society for Medical Oncology (ESMO) previously updated antiemetic guidelines in 2016.

Purpose of the Study:

  • To identify new anticancer agents approved by the US Food and Drug Administration (FDA) and European Medical Agency (EMA) since the 2016 MASCC/ESMO antiemetic update.
  • To classify the emetic potential of these newly approved antineoplastic agents.
  • To provide updated information for antiemetic guideline development and clinical practice.

Main Methods:

  • The MASCC/ESMO Expert Panel reviewed randomized controlled trials, product labeling, and international guidelines.
  • A revised emetogenic classification system was developed for oral anticancer agents, with two categories: minimal-low and moderate-high.
  • The existing four-category system for intravenously administered antineoplastic agents was maintained.

Main Results:

  • A total of 107 new antineoplastic agents were identified between June 2015 and January 2023.
  • Of these, 44 were administered intravenously and 63 orally.
  • Significant variability in reported vomiting incidence was observed across studies, particularly for oral agents.

Conclusions:

  • The study provides an updated classification of the emetic potential for new anticancer agents.
  • Limitations include imprecision in classifying the emetic risk of oral agents due to data variability.
  • The findings offer a reasonable approximation of emetic risk to inform antiemetic guidelines and patient care.
Keywords:
Antineoplastic agentsEmetogenicityNauseaRisk classificationVomiting

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