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Symptom Management and Supportive Care

Guidelines for Antiemetic Treatment of Chemotherapy-Induced Nausea and Vomiting: Past, Present, and Future Recommendations

Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle/Wittenberg, Halle/Saale, Germany

Key Words. Antiemetic therapy • ASCO antiemetic guidelines • MASCC antiemetic guidelines • NCCN practice antiemesis guidelines • 5-HT₃ serotonin-receptor antagonists • Neurokinin₁-receptor antagonist

Correspondence: Karin Jordan, M.D., Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle/Wittenberg, Ernst-Grube-Str. 40, 06120 Halle/Saale, Germany. Telephone: 49-345-557-2924; Fax: 49-345-557-2950; e-mail: Karin.jordan{at}medizin.uni-halle.de

Disclosure: No potential conflicts of interest were reported by the authors, planners, reviewers, or staff managers of this article.

Clinicians should be aware that chemotherapy-induced nausea and vomiting (CINV) is still one of the most feared side effects of chemotherapy. With the correct use of antiemetics, CINV can be prevented in almost 70% to up to 80% of patients. Treatment guidelines are useful tools that enable physicians to integrate the latest clinical research into their practices. The large volume of rapidly evolving clinical data has been summarized and incorporated into treatment recommendations by well-known and reliable institutions, including the Multinational Association of Supportive Care in Cancer, the American Society of Clinical Oncology, and the National Comprehensive Cancer Network. Despite the availability of such guidelines, however, there is evidence that adherence to and implementation of treatment recommendations are less than optimal. This review focuses, in particular, on the conformity and differences of these three guidelines. Furthermore, open questions and trends in the field of antiemesis are discussed as well.

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