Abstract
Chemotherapy-induced nausea and vomiting (CINV) is a major determinant of quality of life in cancer patients. In addition, the perceptions that oncology professionals have about CINV quite often do not coincide with reality. Antineoplastic agents and their combinations can be categorised according to their emetogenic level, and this categorisation is helpful for classifying the severity of CINV and treating it. All CINV treatment guidelines emphasise the need to administer prophylaxis to patients who receive highly or moderately emetogenic chemotherapy. With the introduction of NK1 receptor antagonists, the control of acute and delayed CINV after highly or moderately emetogenic chemotherapy schedules has improved in the great majority of patients. NK1 receptor antagonists have been demonstrated to improve the control of CINV in all risk subgroups of patients.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Watcha MF, White PF (1992) Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 77:162–184
Sanger GJ, Andrews PL (2006) Treatment of nausea and vomiting: gaps in our knowledge. Auton Neurosci 129:3–16
Ingle RJ, Burish TG, Wallston KA (1984) Conditionability of cancer chemotherapy patients. Oncol Nurs Forum 11:97–102
Higgins GA, Kilpatrick GJ, Bunce KT et al (1989) 5-HT3 receptor antagonists injected into the area postrema inhibit cisplatin-induced emesis in the ferret. Br J Pharmacol 97:247–255
Horn CC, Ciucci M, Chaudhury A (2007) Brain Fos expression during 48 h after cisplatin treatment: neural pathways for acute and delayed visceral sickness. Auton Neurosci 132:44–51
Strominger NL, Knox AP, Carpenter DO (1994) The connectivity of the area postrema in the ferret. Brain Res Bull 33:33–47
Zagon A, Totterdell S, Jones RS (1994) Direct projections from the ventrolateral medulla oblongata to the limbic forebrain: anterograde and retrograde tract-tracing studies in the rat. J Comp Neurol 340:445–468
Hornby PJ (2001) Central neurocircuitry associated with emesis. Am J Med 111[Suppl 8A]:106S–112S
Miller AD, Grelot S (1997) Neural control of respiratory muscle activation during vomiting. In: Miller AD, Bianchi AL, Bishop BP (eds) Neural control of the respiratory muscles. CRC Press, Boca Raton, FL, pp 239–248
Friedman LS, Isselbacher KJ (1998) Nausea, vomiting, and indigestion. In: Fauci AS, Brownwald E, Isselbacher KJ et al (eds) Harrison’s principles of internal medicine, 14th edn. Mc Graw-Hill, New York, pp 230–231
Gralla R (2001) Management of nausea and vomiting. Cancer management: a multidisciplinary approach, 5th edn. Available from: http://www.cancernetwork.com/handbook/Nausea.htm
Roila F, Boschetti E, Tonato M et al (1991) Predictive factors of delayed emesis in cisplatin-treated patients and antiemetic activity and tolerability of metoclopramide or dexamethasone. A randomized single-blind study. Am J Clin Oncol 14:238–242
Jacobsen PB, Redd WH (1988) The development and management of chemotherapy-related anticipatory nausea and vomiting. Cancer Invest 6:329–336
Moher D, Arthur AZ, Pater JL (1984) Anticipatory nau sea and/or vomiting. Cancer Treat Rev 11:257–264
Hesketh PJ, Grunberg SM, Gralla RJ et al (2003) The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin-the Aprepitant Protocol 052 Study Group. J Clin Oncol 21:4112–4119
Poli-Bigelli S, Rodrigues-Pereira J, Carides AD et al (2003) Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America. Cancer 97:3090–3098
Perwitasari DA, Gelderblom H, Atthobari J et al (2011) Anti-emetic drugs in oncology: pharmacology and individualization by pharmacogenetics. Int J Clin Pharm 33:33–43
Kris MG, Gralla RJ, Clark RA et al (1985) Incidence, course, and severity of delayed nausea and vomiting following the administration of high-dose cisplatin. J Clin Oncol 3:1379–1384
Ettinger DS, Armstrong DK (2011) NCCN Clinical Practice Guidelines in Oncology. http://www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf. Accessed: 8 August 2011
Basch E, Prestrud AA, Hesketh PJ et al (2011) Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 29:4189–4198
Roila F, Herrstedt J, Aapro M et al (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol 21[Suppl 5]:v232–243
Garcia Gomez J, Perez Lopez ME, Garcia Mata J et al (2010) SEOM clinical guidelines for the treatment of antiemetic prophylaxis in cancer patients receiving chemotherapy. Clin Transl Oncol 12:770–774
NCI (2010) Common Terminology Criteria for Adverse Events (CTCAE) v4.0. http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf. Accessed: 14 June 2010
Hesketh PJ, Kris MG, Grunberg SM et al (1997) Proposal for classifying the acute emetogenicity of cancer chemotherapy. J Clin Oncol 15:103–109
Pollera CF, Giannarelli D (1989) Prognostic factors influencing cisplatin-induced emesis. Definition and validation of a predictive logistic model. Cancer 64:1117–1122
Fraunholz I, Grau K, Weiss C et al (2011) Patient- and treatment-related risk factors for nausea and emesis during concurrent chemoradiotherapy. Strahlenther Onkol 187:1–6
Hesketh PJ, Aapro M, Street JC et al (2010) Evaluation of risk factors predictive of nausea and vomiting with current standard-of-care antiemetic treatment: analysis of two phase III trials of aprepitant in patients receiving cisplatin-based chemotherapy. Support Care Cancer 18:1171–1177
Warr DG, Street JC, Carides AD (2011) Evaluation of risk factors predictive of nausea and vomiting with current standard-of-care antiemetic treatment: analysis of phase 3 trial of aprepitant in patients receiving adriamycin-cyclophosphamide-based chemotherapy. Support Care Cancer 19: 807–813
Osoba D, Zee B, Warr D et al (1997) Effect of postchemotherapy nausea and vomiting on health-related quality of life. The Quality of Life and Symptom Control Committees of the National Cancer Institute of Canada Clinical Trials Group. Support Care Cancer 5:307–313
Grunberg SM, Deuson RR, Mavros P et al (2004) Incidence of chemotherapy-induced nausea and emesis after modern antiemetics. Cancer 100:2261–2268
Majem M, Moreno ME, Calvo N et al (2011) Perception of healthcare providers versus patient reported incidence of chemotherapy-induced nausea and vomiting after the addition of NK-1 receptor antagonists. Support Care Cancer 19:1983–1990
Grunberg SM, Osoba D, Hesketh PJ et al (2005) Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity: an update. Support Care Cancer 13:80–84
Zaglama NE, Rosenblum SL, Sartiano GP et al (1986) Single, high-dose intravenous dexamethasone as an antiemetic in cancer chemotherapy. Oncology 43:27–32
Chiara S, Campora E, Lionetto R et al (1987) Methylprednisolone for the control of CMF-induced emesis. Am J Clin Oncol 10:264–267
Aapro MS (1991) Present role of corticosteroids as antiemetics. Recent Results Cancer Res 121:91–100
Ioannidis JP, Hesketh PJ, Lau J (2000) Contribution of dexamethasone to control of chemotherapy-induced nausea and vomiting: a meta-analysis of randomized evidence. J Clin Oncol 18:3409–3422
Billio A, Morello E, Clarke MJ (2010) Serotonin receptor antagonists for highly emetogenic chemotherapy in adults. Cochrane Database Syst Rev CD006272
Wong EH, Clark R, Leung E et al (1995) The interaction of RS 25259-197, a potent and selective antagonist, with 5-HT3 receptors, in vitro. Br J Pharmacol 114:851–859
Stoltz R, Cyong JC, Shah A et al (2004) Pharmacokinetic and safety evaluation of palonosetron, a 5-hydroxytryptamine-3 receptor antagonist, in U.S. and Japanese healthy subjects. J Clin Pharmacol 44:520–531
Gralla R, Lichinitser M, Van Der Vegt S et al (2003) Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Ann Oncol 14:1570–1577
Saito M, Aogi K, Sekine I et al (2009) Palonosetron plus dexamethasone versus granisetron plus dexamethasone for prevention of nausea and vomiting during chemotherapy: a double-blind, double-dummy, randomised, comparative phase III trial. Lancet Oncol 10:115–124
Grunberg S, Chua D, Maru A et al (2011) Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with cisplatin therapy: randomized, double-blind study protocol—EASE. J Clin Oncol 29:1495–1501
Cubeddu LX (2009) Iatrogenic QT abnormalities and fatal arrhythmias: mechanisms and clinical significance. Curr Cardiol Rev 5:166–176
Hofman M, Morrow GR, Roscoe JA et al (2004) Cancer patients’ expectations of experiencing treatment-related side effects: a University of Rochester Cancer Center-Community Clinical Oncology Program study of 938 patients from community practices. Cancer 101:851–857
Warr DG, Hesketh PJ, Gralla RJ et al (2005) Efficacy and tolerability of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients with breast cancer after moderately emetogenic chemotherapy. J Clin Oncol 23:2822–2830
Rapoport BL, Jordan K, Boice JA et al (2010) Aprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with a broad range of moderately emetogenic chemotherapies and tumor types: a randomized, double-blind study. Support Care Cancer 18:423–431
Grunberg S, Clark-Snow RA, Koeller J (2010) Chemotherapy-induced nausea and vomiting: contemporary approaches to optimal management: Proceedings from a symposium at the 2008 Multinational Association of Supportive Care in Cancer (MASCC) Annual Meeting. Support Care Cancer (in press)
Olver I, Molassiotis A, Aapro M et al (2011) Antiemetic research: future directions. Support Care Cancer 19[Suppl 1]:S49–55
Author information
Authors and Affiliations
Corresponding author
Additional information
Supported by an unrestricted educational grant from MSD Oncology
Rights and permissions
About this article
Cite this article
Bayo, J., Fonseca, P.J., Hernando, S. et al. Chemotherapy-induced nausea and vomiting: pathophysiology and therapeutic principles. Clin Transl Oncol 14, 413–422 (2012). https://doi.org/10.1007/s12094-012-0818-y
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s12094-012-0818-y