Controlling emesis: evolving challenges, novel strategies.

Control of nausea and vomiting following chemotherapy, radiation therapy, and surgery has significantly improved in recent years due to the development of novel, effective, and better-tolerated antiemetic therapies. However, the incidence and severity of emesis are often underestimated by the medical community and remain among the most distressing outcomes following treatment. Inadequately controlled nausea and vomiting can negatively impact several aspects of emetogenic therapy, including quality of life, cost of therapy, compliance, and possibly treatment outcomes. To address these concerns, antiemetic therapy continues to evolve along several avenues, such as the development and use of novel 5-hydroxytryptamine and neurokinin-1 receptor antagonists, refinement of antiemetic therapeutic guidelines, identification of additional risk factors for acute and delayed nausea and vomiting, and additional research toward the role of nonpharmacologic complementary therapies. In addition to improved treatment options, the development of alternative oral drug delivery systems, including orally dissolving tablets and film strips, should further improve the overall convenience of antiemetic therapy.