[Future trends in chemotherapy and impact on the management of emesis]

The treatment of cancer patients has improved over the few past years. The improvement includes new chemotherapy modalities and the new treatments for side effects. The introduction over the last 5 years of 5-HT3 receptor antagonists, a recent class of antiemetic agents, and hematopoietic growth factors, has allowed oncologists to improve success rates and survival of cancer patients, by developing new cytotoxic agents and increasing drug doses and/or modifying the design and administration of conventional chemotherapy treatment schedules. At present, dose-intensifications of several cytotoxic agents are available. Pharmacomodulation with 5 FU and folinic acid is more emetogenic than 5 FU alone. In contrast, chronomodulation seems to be less emetogenic. For new cytotoxic agents and oral chemotherapy, the emetogenic potential differs according to the drug and the antiemetic treatment must be therefore adapted to each situation.