A New Guide for Using Antiemetics

A significant proportion of all cancer patients experience nausea or vomiting during the course of their treatment. Nausea and vomiting have long been common adverse effects from certain types of cancer therapy and can lead to postponement or refusal of potentially curative treatments in some patients. In addition to reducing quality of life, these side effects often impede patients’ ability to maintain active lifestyles. With the emergence of serotonin receptor antagonists in the early 1990s and, more recently, the NK1 receptor antagonists, there have been steady improvements in the control of nausea and vomiting. In 1999, the American Society of Clinical Oncology (ASCO) published its first guideline on the use of antiemetic therapies to combat nausea and vomiting in cancer patients. In 2006, the guideline was revised based upon substantial developments, including the introduction of the NK1 receptor antagonists. In 2011, ASCO updated its guideline again to integrate new data that have emerged over the past 5 years (Table 1). “Clinicians need to communicate with their patients to optimize results.” “As knowledge about nausea and vomiting has emerged, so too have safe and effective treatments to battle this dreaded complication for patients,” says, Paul J. Hesketh, MD, who served on the steering committee for ASCO’s 2011 guideline. “The new guideline from ASCO emphasizes how the appropriate use of antiemetic therapies can vastly improve a patient’s treatment experience and quality of life by minimizing these side effects. In general, we have more effective and well-tolerated antiemetic agents than ever before. More recently, we’ve learned how to use these agents in more effective ways.” Reclassifying Risk for Vomiting & Nausea An...