Antiemetics: American Society of Clinical Oncology clinical practice guideline update Journal Article


Authors: Basch, E.; Prestrud, A. A.; Hesketh, P. J.; Kris, M. G.; Feyer, P. C.; Somerfield, M. R.; Chesney, M.; Clark-Snow, R. A.; Flaherty, A. M.; Freundlich, B.; Morrow, G.; Rao, K. V.; Schwartz, R. N.; Lyman, G. H.
Article Title: Antiemetics: American Society of Clinical Oncology clinical practice guideline update
Abstract: Purpose: To update the American Society of Clinical Oncology (ASCO) guideline for antiemetics in oncology. Methods: A systematic review of the medical literature was completed to inform this update. MEDLINE, the Cochrane Collaboration Library, and meeting materials from ASCO and the Multinational Association for Supportive Care in Cancer were all searched. Primary outcomes of interest were complete response and rates of any vomiting or nausea. Results: Thirty-seven trials met prespecified inclusion and exclusion criteria for this systematic review. Two systematic reviews from the Cochrane Collaboration were identified; one surveyed the pediatric literature. The other compared the relative efficacy of the 5-hydroxytryptamine-3 (5-HT3) receptor antagonists. Recommendations: Combined anthracycline and cyclophosphamide regimens were reclassified as highly emetic. Patients who receive this combination or any highly emetic agents should receive a 5-HT3 receptor antagonist, dexamethasone, and a neurokinin 1 (NK1) receptor antagonist. A large trial validated the equivalency of fosaprepitant, a single-day intravenous formulation, with aprepitant; either therapy is appropriate. Preferential use of palonosetron is recommended for moderate emetic risk regimens, combined with dexamethasone. For low-risk agents, patients can be offered dexamethasone before the first dose of chemotherapy. Patients undergoing high emetic risk radiation therapy should receive a 5-HT3 receptor antagonist before each fraction and for 24 hours after treatment and may receive a 5-day course of dexamethasone during fractions 1 to 5. The Update Committee noted the importance of continued symptom monitoring throughout therapy. Clinicians underestimate the incidence of nausea, which is not as well controlled as emesis. © 2011 by American Society of Clinical Oncology.
Keywords: cancer chemotherapy; treatment response; cisplatin; doxorubicin; drug efficacy; antineoplastic agents; cancer radiotherapy; cytarabine; carboplatin; dacarbazine; unindexed drug; nausea; vomiting; drug administration schedule; radiotherapy; bendamustine; cyclophosphamide; dexamethasone; practice guideline; carmustine; chlormethine; risk assessment; questionnaires; systematic review; morpholines; daunorubicin; medical society; dactinomycin; granisetron; ondansetron; antiemetic agent; antiemetics; idarubicin; anthracycline; infusions, intravenous; metoclopramide; prochlorperazine; clofarabine; alemtuzumab; azacitidine; drug formulation; serotonin 3 antagonist; aprepitant; streptozocin; health care disparity; isoquinolines; dolasetron mesilate; palonosetron; tropisetron; receptors, neurokinin-1; serotonin antagonists; quinuclidines; neurokinin 1 receptor antagonist; american society of clinical oncology
Journal Title: Journal of Clinical Oncology
Volume: 29
Issue: 31
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2011-11-01
Start Page: 4189
End Page: 4198
Language: English
DOI: 10.1200/jco.2010.34.4614
PROVIDER: scopus
PUBMED: 21947834
PMCID: PMC4876353
DOI/URL:
Notes: --- - "Export Date: 9 December 2011" - "CODEN: JCOND" - "Source: Scopus"
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MSK Authors
  1. Ethan Martin Basch
    156 Basch
  2. Mark Kris
    597 Kris