2016 Updated MASCC/ESMO Consensus Recommendations: Controlling nausea and vomiting with chemotherapy of low or minimal emetic potential

Ian Olver*, Christina H. Ruhlmann, Franziska Jahn, Lee Schwartzberg, Bernardo Rapoport, Cynthia N. Rittenberg, Rebecca Clark-Snow

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Purpose: The purpose of this review is to update the MASCC (Multinational Association of Supportive Care in Cancer) guidelines for controlling nausea and vomiting with chemotherapy of low or minimal emetic potential. Methods: The antiemetic study group of MASCC met in Copenhagen in 2015 to review the MASCC antiemetic guidelines. A subgroup performed a systematic literature review on antiemetics for low emetogenic chemotherapy (LEC) and chemotherapy of minimal emetic potential and the chair presented the update recommendation to the whole group for discussion. They then voted with an aim of achieving 67 % or greater consensus. Results: For patients receiving low emetogenic chemotherapy, a single antiemetic such as dexamethasone, a 5HT3 receptor antagonist, or a dopamine receptor antagonist may be considered for prophylaxis of acute emesis. For patients receiving chemotherapy of minimal emetogenicity, no antiemetic should be routinely administered. If patients vomit, they should be treated as for chemotherapy of low emetic potential. No antiemetic should be administered for prevention of delayed nausea and vomiting induced by low or minimally emetogenic chemotherapy. Conclusions: More research is needed to determine the incidence of emesis, particularly delayed emesis, in the LEC group. Prospective studies are required to evaluate antiemetic strategies. The risk of emesis within LEC may be more accurately determined by adding the patient risk factors for emesis to those of the chemotherapy drugs. Improved strategies for promoting adherence to guidelines are required.

Original languageEnglish
JournalSupportive Care in Cancer
Volume25
Issue number1
Pages (from-to)297-301
ISSN0941-4355
DOIs
Publication statusPublished - Jan 2017

Keywords

  • Antiemetic
  • Low emetogenic chemotherapy (LEC)
  • Minimal emetogenic chemotherapy
  • Minimal emetogenicity
  • Nausea
  • Vomiting
  • Prospective Studies
  • Nausea/chemically induced
  • Humans
  • Emetics/adverse effects
  • Consensus
  • Vomiting/chemically induced
  • Antineoplastic Agents/adverse effects
  • Antiemetics/therapeutic use
  • Practice Guidelines as Topic

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