Chemotherapy-induced nausea and vomiting: can we do better?

Abstract

Purpose of review: Although the management of nausea and vomiting induced by cancer treatments has evolved, several questions remain unanswered.

Recent findings: New antiemetics have been developed these last decades with therapeutic indications to be defined according to the anticancer regimen and partly as a consequence of the assessment of individual patient risk factors. Guidelines still seem to have a low level of knowledge and compliance, with a role for scientific societies in term of dissemination and education. A number of persistent issues relating to emesis still need improvement in prevention and management. Nausea remains a subjective semantic whose evaluation should possibly benefit from educational programs. The risk classification of anticancer drugs must be regularly updated, requiring regular literature reviews and the integration of data from clinical trials relating to emerging anticancer drugs. Recent data, particularly in the context of emerging drugs, highlight the importance to consider emesis' impact beyond the 5-day period, with a potential adaptation of antiemetic prophylaxis, including the mode of administration of oral drugs.

Summary: Guidelines update is presented with literature answers to the current issues in order to improve quality of patient's management in the context of emesis related to anticancer therapies.