Fausto Roila1, David Warr2, Paul J Hesketh3, Richard Gralla4, Jorn Herrstedt5, Karin Jordan6, Matti Aapro7, Enzo Ballatori8, Bernardo Rapoport9. 1. Medical Oncology, Santa Maria Hospital, Via Tristano di Joannuccio 1, 05100, Terni, Italy. roila.fausto@libero.it. 2. Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Canada. 3. Lahey Health Cancer Institute, Burlington, USA. 4. Albert Einstein College of Medicine, Jacobi Medical Center, NY, USA. 5. Department of Oncology, Odense University, 5000, Odense, Denmark. 6. Department of Hematology/Oncology, Martin Luther University Halle-Wittenberg, Halle, Germany. 7. Clinique de Genolier, Multidisciplinary Oncology Institute, Genolier, Switzerland. 8. , Spinetoli, Italy. 9. Medical Oncology Centre of Rosebank, 129 Oxford Road, Johannesburg, South Africa.
Abstract
PURPOSE: An update of the recommendations for the prophylaxis of acute and delayed emesis induced by moderately emetogenic chemotherapy published after the last MASCC/ESMO antiemetic consensus conference in 2009 has been carried out. METHODS: A systematic literature search using PubMed from January 1, 2009 to January 6, 2015 with a restriction to papers in English was conducted. RESULTS: Overall, two randomized phase II and seven randomized phase III studies plus the results of three subgroup analysis of large phase III trials and those of a pilot study have been included. CONCLUSIONS: In carboplatin-treated patients, a moderate benefit from adding an NK1 receptor antagonist to dexamethasone and a 5-HT3 receptor antagonist has been shown. However, in oxaliplatin-treated patients, contrasting results about the role of NK1 receptor antagonists have been obtained. At present, it is not possible to suggest a specific 5-HT3 receptor antagonist to use for the prevention of acute emesis in these patients. No routine prophylaxis for delayed emesis is recommended but in patients receiving moderately emetogenic chemotherapy with known potential for delayed emesis (e.g., oxaliplatin, doxorubicin, cyclophosphamide) the use of dexamethasone for days 2-3 can be considered.
PURPOSE: An update of the recommendations for the prophylaxis of acute and delayed emesis induced by moderately emetogenic chemotherapy published after the last MASCC/ESMO antiemetic consensus conference in 2009 has been carried out. METHODS: A systematic literature search using PubMed from January 1, 2009 to January 6, 2015 with a restriction to papers in English was conducted. RESULTS: Overall, two randomized phase II and seven randomized phase III studies plus the results of three subgroup analysis of large phase III trials and those of a pilot study have been included. CONCLUSIONS: In carboplatin-treated patients, a moderate benefit from adding an NK1 receptor antagonist to dexamethasone and a 5-HT3 receptor antagonist has been shown. However, in oxaliplatin-treated patients, contrasting results about the role of NK1 receptor antagonists have been obtained. At present, it is not possible to suggest a specific 5-HT3 receptor antagonist to use for the prevention of acute emesis in these patients. No routine prophylaxis for delayed emesis is recommended but in patients receiving moderately emetogenic chemotherapy with known potential for delayed emesis (e.g., oxaliplatin, doxorubicin, cyclophosphamide) the use of dexamethasone for days 2-3 can be considered.
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Authors: Alexander Molassiotis; Matti Aapro; Mario Dicato; Pere Gascon; Sylvia A Novoa; Nicolas Isambert; Thomas A Burke; Anna Gu; Fausto Roila Journal: J Pain Symptom Manage Date: 2013-09-24 Impact factor: 3.612
Authors: Marko Popovic; David G Warr; Carlo Deangelis; May Tsao; Kelvin K W Chan; Michael Poon; Cheryl Yip; Natalie Pulenzas; Henry Lam; Liying Zhang; Edward Chow Journal: Support Care Cancer Date: 2014-03-04 Impact factor: 3.603
Authors: Paul J Hesketh; Ian D Schnadig; Lee S Schwartzberg; Manuel R Modiano; Karin Jordan; Sujata Arora; Dan Powers; Matti Aapro Journal: Cancer Date: 2016-05-13 Impact factor: 6.860
Authors: C Weinstein; K Jordan; S A Green; E Camacho; S Khanani; E Beckford-Brathwaite; W Vallejos; L W Liang; S J Noga; B L Rapoport Journal: Ann Oncol Date: 2015-10-08 Impact factor: 32.976
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