Antiemetic research: future directions

Ian Olver, Alexander Molassiotis, Matti Aapro, Jørn Herrstedt, Steven Grunberg, Garry Morrow

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

PURPOSE AND METHODS: As a part of reviewing the Multinational Association of Supportive Care in Cancer (MASCC) antiemetic guidelines in Perugia in 2009, an expert group identified directions for future antiemetic research. RESULTS AND CONCLUSIONS: In future trials, the prediction of nausea and vomiting may combine algorithms based on observed prognostic factors relating to the patient and the anticancer therapy, the identification of the genes that code for receptors, and pharmacogenetic studies of the metabolism of drugs. Design issues for future trials include standardising the emetic stimulus across studies and finding the minimum tolerated effective dose and schedule of an antiemetic. Also control of delayed emesis is not independent of the control of acute emesis. The full range of side effects and the impact on global quality of life scores should be part of the routine assessment of an antiemetic. With current high rates of control of acute vomiting, future trials will need to consider new primary endpoints such as nausea, a complex symptom, where improvement is needed. Economic endpoints should be incorporated to ascertain the cost benefit of antiemetic prophylaxis, taking into account the impact of nausea on work capacity. New antiemetic drugs may be targeted at different receptors, such as opioid, cannabinoid and peptide YY receptors. New research is needed into determining the extent of corticosteroid use. The emetic potential of a range of newer cytotoxics particularly when used in combinations and different scheduling, such as prolonged oral dosing of cytotoxics and use of targeted therapies, are all areas in need of research. More antiemetic studies are needed in niche areas such as in patients receiving high dose chemotherapy, radiation therapy or combined modality therapy. Further evidence of the efficacy of newer antiemetic agents is required in children.
OriginalsprogEngelsk
TidsskriftSupportive Care in Cancer
Vol/bind19
Udgave nummer1
Sider (fra-til)S49-55
ISSN0941-4355
DOI
StatusUdgivet - 2011

Fingeraftryk

Research
Emetics
Opioid Peptides
Direction compound
Cost-Benefit Analysis
Adrenal Cortex Hormones
Quality of Life
Guidelines
Pharmaceutical Preparations
Neoplasms

Bibliografisk note

Accepted: 22 October 2010
Published online: 10 November 2010

Citer dette

Olver, I., Molassiotis, A., Aapro, M., Herrstedt, J., Grunberg, S., & Morrow, G. (2011). Antiemetic research: future directions. Supportive Care in Cancer, 19(1), S49-55. https://doi.org/10.1007/s00520-010-1036-1
Olver, Ian ; Molassiotis, Alexander ; Aapro, Matti ; Herrstedt, Jørn ; Grunberg, Steven ; Morrow, Garry. / Antiemetic research: future directions. I: Supportive Care in Cancer. 2011 ; Bind 19, Nr. 1. s. S49-55.
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Olver, I, Molassiotis, A, Aapro, M, Herrstedt, J, Grunberg, S & Morrow, G 2011, 'Antiemetic research: future directions', Supportive Care in Cancer, bind 19, nr. 1, s. S49-55. https://doi.org/10.1007/s00520-010-1036-1

Antiemetic research: future directions. / Olver, Ian; Molassiotis, Alexander; Aapro, Matti; Herrstedt, Jørn; Grunberg, Steven; Morrow, Garry.

I: Supportive Care in Cancer, Bind 19, Nr. 1, 2011, s. S49-55.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Antiemetic research: future directions

AU - Olver, Ian

AU - Molassiotis, Alexander

AU - Aapro, Matti

AU - Herrstedt, Jørn

AU - Grunberg, Steven

AU - Morrow, Garry

N1 - Accepted: 22 October 2010 Published online: 10 November 2010

PY - 2011

Y1 - 2011

N2 - PURPOSE AND METHODS: As a part of reviewing the Multinational Association of Supportive Care in Cancer (MASCC) antiemetic guidelines in Perugia in 2009, an expert group identified directions for future antiemetic research. RESULTS AND CONCLUSIONS: In future trials, the prediction of nausea and vomiting may combine algorithms based on observed prognostic factors relating to the patient and the anticancer therapy, the identification of the genes that code for receptors, and pharmacogenetic studies of the metabolism of drugs. Design issues for future trials include standardising the emetic stimulus across studies and finding the minimum tolerated effective dose and schedule of an antiemetic. Also control of delayed emesis is not independent of the control of acute emesis. The full range of side effects and the impact on global quality of life scores should be part of the routine assessment of an antiemetic. With current high rates of control of acute vomiting, future trials will need to consider new primary endpoints such as nausea, a complex symptom, where improvement is needed. Economic endpoints should be incorporated to ascertain the cost benefit of antiemetic prophylaxis, taking into account the impact of nausea on work capacity. New antiemetic drugs may be targeted at different receptors, such as opioid, cannabinoid and peptide YY receptors. New research is needed into determining the extent of corticosteroid use. The emetic potential of a range of newer cytotoxics particularly when used in combinations and different scheduling, such as prolonged oral dosing of cytotoxics and use of targeted therapies, are all areas in need of research. More antiemetic studies are needed in niche areas such as in patients receiving high dose chemotherapy, radiation therapy or combined modality therapy. Further evidence of the efficacy of newer antiemetic agents is required in children.

AB - PURPOSE AND METHODS: As a part of reviewing the Multinational Association of Supportive Care in Cancer (MASCC) antiemetic guidelines in Perugia in 2009, an expert group identified directions for future antiemetic research. RESULTS AND CONCLUSIONS: In future trials, the prediction of nausea and vomiting may combine algorithms based on observed prognostic factors relating to the patient and the anticancer therapy, the identification of the genes that code for receptors, and pharmacogenetic studies of the metabolism of drugs. Design issues for future trials include standardising the emetic stimulus across studies and finding the minimum tolerated effective dose and schedule of an antiemetic. Also control of delayed emesis is not independent of the control of acute emesis. The full range of side effects and the impact on global quality of life scores should be part of the routine assessment of an antiemetic. With current high rates of control of acute vomiting, future trials will need to consider new primary endpoints such as nausea, a complex symptom, where improvement is needed. Economic endpoints should be incorporated to ascertain the cost benefit of antiemetic prophylaxis, taking into account the impact of nausea on work capacity. New antiemetic drugs may be targeted at different receptors, such as opioid, cannabinoid and peptide YY receptors. New research is needed into determining the extent of corticosteroid use. The emetic potential of a range of newer cytotoxics particularly when used in combinations and different scheduling, such as prolonged oral dosing of cytotoxics and use of targeted therapies, are all areas in need of research. More antiemetic studies are needed in niche areas such as in patients receiving high dose chemotherapy, radiation therapy or combined modality therapy. Further evidence of the efficacy of newer antiemetic agents is required in children.

U2 - 10.1007/s00520-010-1036-1

DO - 10.1007/s00520-010-1036-1

M3 - Journal article

C2 - 21063733

VL - 19

SP - S49-55

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

IS - 1

ER -

Olver I, Molassiotis A, Aapro M, Herrstedt J, Grunberg S, Morrow G. Antiemetic research: future directions. Supportive Care in Cancer. 2011;19(1):S49-55. https://doi.org/10.1007/s00520-010-1036-1