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JCOM Abstract

J Clin Outcomes Manage 
2013 Aug;20(8):377-384
Chemotherapy-induced nausea and vomiting: identifying and addressing unmet needs.
Boccia RV

ABSTRACT Objective: To review current issues in chemotherapy-induced nausea and vomiting (CINV) management and consider practical options to optimize antiemetic use and improve outcomes. Methods: Practical review of current evidence and examination of management strategies. Results: Management of CINV is primarily guided by evidence-based recommendations from the American Society of Clinical Oncology (ASCO), the Multi-national Association of Supportive Care in Cancer (MASCC), and the National Comprehensive Cancer Network (NCCN), which recommend selection of antiemetics based on the emetogenicity of the chemotherapy regimen. 5-HT3 antagonists, often heralded as one of the most significant advances in the treatment of CINV, and newer NK-1 antagonists play a predominant role for moderately and highly emetogenic chemotherapy. However, limited adherence to guidelines is a concern. Strategies to improve outcomes therefore initially focus on ensuring optimal selection and use of antiemetic agents. Beyond antiemetic selection, more sophisticated approaches can be proposed to improve outcomes across the breadth of supportive care by involving multidisciplinary expertise in integrated care strategies. Conclusion: Despite significant advances with anti-emetics, CINV remains an important problem for many cancer patients. Developing integrated approaches to improve the care of at-risk patients represents a crucial step towards improving outcomes.

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