Medline ® Abstracts for References 4,6,104
of 'Prevention and treatment of chemotherapy-induced nausea and vomiting in adults'
Antiemetics: American Society of Clinical Oncology Focused Guideline Update.
Hesketh PJ, Bohlke K, Lyman GH, Basch E, Chesney M, Clark-Snow RA, Danso MA, Jordan K, Somerfield MR, Kris MG, American Society of Clinical Oncology
J Clin Oncol. 2016;34(4):381. Epub 2015 Nov 2.
PURPOSE: To update a key recommendation of the American Society of Clinical Oncology antiemetic guideline. This update addresses the use of the oral combination of netupitant (a neurokinin 1 [NK1]receptor antagonist) and palonosetron (a 5-hydroxytryptamine-3 [5-HT3]receptor antagonist) for the prevention of acute and delayed nausea and vomiting in patients receiving chemotherapy.
METHODS: An update committee conducted a targeted systematic literature review and identified two phase III clinical trials and a randomized phase II dose-ranging study.
RESULTS: In one phase III trial, the oral combination of netupitant and palonosetron was associated with higher complete response rates (no emesis and no rescue medications) compared with palonosetron alone in patients treated with anthracycline plus cyclophosphamide chemotherapy (74% v 67% overall; P = .001). In another phase III trial, the oral combination of netupitant and palonosetron was safe and effective across multiple cycles of moderately or highly emetogenic chemotherapies. In the phase II dose-ranging study, each dose of netupitant (coadministered with palonosetron 0.50 mg) produced higher complete response rates than palonosetron alone among patients receiving cisplatin-based chemotherapy. The highest dose of netupitant (ie, 300 mg) was most effective.
RECOMMENDATIONS: All patients who receive highly emetogenic chemotherapy regimens (including anthracycline plus cyclophosphamide) should be offered a three-drug combination of an NK1 receptor antagonist, a 5-HT3 receptor antagonist, and dexamethasone. The oral combination of netupitant and palonosetron plus dexamethasone is an additional treatment option in this setting. The remaining recommendations from the 2011 ASCO guideline are unchanged pending a full update. Additional information is available at www.asco.org/guidelines/antiemetics and www.asco.org/guidelineswiki.
Paul J. Hesketh, Lahey Hospital and Medical Center, Burlington, MA; Kari Bohlke and Mark R. Somerfield, American Society of Clinical Oncology, Alexandria; Michael A. Danso, Virginia Oncology Associates, Norfolk and Virginia Beach, VA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Ethan Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Maurice Chesney, patient representative, Saunderstown, RI; Rebecca Anne Clark-Snow, University of Kansas Cancer Center, Westwood, KS; Karin Jordan, University Hospital, Martin-Luther-University Halle-Wittenberg, Halle, Germany; and Mark G. Kris, Memorial Sloan Kettering Cancer Center, New York, NY.
Antiemetics: American Society of Clinical Oncology Clinical Practice Guideline Update.
Hesketh PJ, Kris MG, Basch E, Bohlke K, Barbour SY, Clark-Snow RA, Danso MA, Dennis K, Dupuis LL, Dusetzina SB, Eng C, Feyer PC, Jordan K, Noonan K, Sparacio D, Somerfield MR, Lyman GH
J Clin Oncol. 2017;35(28):3240. Epub 2017 Jul 31.
Purpose To update the ASCO guideline for antiemetics in oncology. Methods ASCO convened an Expert Panel and conducted a systematic review of the medical literature for the period of November 2009 to June 2016. Results Forty-one publications were included in this systematic review. A phase III randomized controlled trial demonstrated that adding olanzapine to antiemetic prophylaxis reduces the likelihood of nausea among adult patients who are treated with high emetic risk antineoplastic agents. Randomized controlled trials also support an expanded role for neurokinin 1 receptor antagonists in patients who are treated with chemotherapy. Recommendation Key updates include the addition of olanzapine to antiemetic regimens for adults who receive high-emetic-risk antineoplastic agents or who experience breakthrough nausea and vomiting; a recommendation to administer dexamethasone on day 1 only for adults who receive anthracycline and cyclophosphamide chemotherapy; and the addition of a neurokinin 1 receptor antagonist for adults who receive carboplatin area under the curve≥4 mg/mL per minute or high-dose chemotherapy, and for pediatric patients who receive high-emetic-risk antineoplastic agents. For radiation-induced nausea and vomiting, adjustments were made to anatomic regions, risk levels, and antiemetic administration schedules. Rescue therapy alone is now recommended for low-emetic-risk radiation therapy. The Expert Panel reiterated the importance of using the most effective antiemetic regimens that are appropriate for antineoplastic agents or radiotherapy being administered. Such regimens should be used with initial treatment, rather than first assessing the patient's emetic response with less-effective treatment. Additional information is available at www.asco.org/supportive-care-guidelines and www.asco.org/guidelineswiki .
Paul J. Hesketh, Lahey Hospital and Medical Center, Burlington; Kimberly Noonan, Dana-Farber Cancer Institute, Boston, MA; Mark G. Kris, Memorial Sloan Kettering Cancer Center, New York, NY; Ethan Basch and Stacie B. Dusetzina, University of North Carolina at Chapel Hill, Chapel Hill; Sally Y. Barbour, Duke University Medical Center, Durham, NC; Kari Bohlke and Mark R. Somerfield, American Society of Clinical Oncology, Alexandria; Michael A. Danso, Virginia Oncology Associates, Virginia Beach; Michael A. Danso, Virginia Oncology Associates, Norfolk, VA; Rebecca Anne Clark-Snow, University of Kansas Cancer Center, Westwood, KS; Cathy Eng, The University of Texas MD Anderson Cancer Center, Houston, TX; Dee Sparacio, Patient Representative, Hightstown, NJ; Gary H. Lyman, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA; Kristopher Dennis, The Ottawa Hospital and University of Ottawa, Ottawa; L. Lee Dupuis, The Hospital for Sick Children, University of Toron
2016 updated MASCC/ESMO consensus recommendations: Anticipatory nausea and vomiting in children and adults receiving chemotherapy.
Dupuis LL, Roscoe JA, Olver I, Aapro M, Molassiotis A
Support Care Cancer. 2017 Jan;25(1):317-321.
PURPOSE: We aimed to update the 2011 recommendations for the prevention and treatment of anticipatory nausea and vomiting in children and adults receiving chemotherapy.
METHODS: The original systematic literature search was updated. Randomized studies were included in the evidence to support this guideline if they as follows: were primary studies published in a journal in full text (i.e., abstracts, letters, book chapters, and dissertations were excluded); published in English; evaluated an intervention for the prevention or treatment of anticipatory nausea and vomiting; reported the proportion of patients experiencing complete control of anticipatory nausea and vomiting consistently and; included at least ten participants per study arm for comparative studies and at least ten participants overall for noncomparative studies.
RESULTS: Eighty-eight new citations were identified. Of these, nine were brought to full-text screening; none met inclusion criteria. The guideline panel continues to recommend that anticipatory nausea and vomiting are best prevented through optimization of acute and delayed phase chemotherapy-induced nausea and vomiting control. Benzodiazepines and behavioral therapies, in particular progressive muscle relaxation training, systematic desensitization and hypnosis, continue to be recommended for the treatment of anticipatory nausea and vomiting.
CONCLUSIONS: No new information regarding interventions aimed at treating or preventing ANV that met criteria for inclusion in this systematic review was identified. The 2015 MASCC recommendations affirm the content of the 2009 MASCC recommendations for the prevention and treatment of anticipatory nausea and vomiting.
Department of Pharmacy and Research Institute, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. firstname.lastname@example.org.