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Herrstedt J, Clark-Snow R, Ruhlmann CH, Molassiotis A, Olver I, Rapoport BL, Aapro M, Dennis K, Hesketh PJ, Navari RM, Schwartzberg L, Affronti ML, Garcia-Del-Barrio MA, Chan A, Celio L, Chow R, Fleury M, Gralla RJ, Giusti R, Jahn F, Iihara H, Maranzano E, Radhakrishnan V, Saito M, Sayegh P, Bosnjak S, Zhang L, Lee J, Ostwal V, Smit T, Zilic A, Jordan K, Scotté F. 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. ESMO Open 2024; 9:102195. [PMID: 38458657 PMCID: PMC10937211 DOI: 10.1016/j.esmoop.2023.102195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 03/10/2024] Open
Abstract
•Nausea and vomiting are considered amongst the most troublesome adverse events for patients receiving antineoplastics. •The guideline covers emetic risk classification, prevention and management of treatment-induced nausea and vomiting. •The Consensus Committee consisted of 34 multidisciplinary, health care professionals and three patient advocates. •Recommendations are based on evidence-based data (level of evidence) and the authors’ collective expert opinion (grade). •All recommendations are for the first course of antineoplastic therapy; modifications may be needed in subsequent courses.
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Affiliation(s)
- J Herrstedt
- Department of Clinical Oncology, Zealand University Hospital Roskilde and Naestved, Roskilde; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - R Clark-Snow
- Oncology Supportive Care Consultant, Overland Park, USA
| | - C H Ruhlmann
- Department of Oncology, Odense University Hospital, Odense; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - A Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, UK
| | - I Olver
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - B L Rapoport
- The Medical Oncology Centre of Rosebank, Johannesburg; Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - M Aapro
- Genolier Cancer Center, Genolier, Switzerland
| | - K Dennis
- Division of Radiation Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Canada
| | - P J Hesketh
- Division of Hematology Oncology, Lahey Hospital and Medical Center, Burlington
| | | | - L Schwartzberg
- William N. Pennington Cancer Institute, University of Nevada, Reno School of Medicine, Reno
| | - M L Affronti
- Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham; Duke University School of Nursing, Duke University, Durham, USA
| | - M A Garcia-Del-Barrio
- Pharmacy Department, Clínica Universidad de Navarra, Madrid; School of Pharmacy and Nutrition, Universidad de Navarra, Pamplona, Spain
| | - A Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, USA
| | - L Celio
- Independent Medical Oncologist, Milan, Italy
| | - R Chow
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - M Fleury
- Department of Oncology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - R J Gralla
- Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, USA
| | - R Giusti
- Medical Oncology Unit, Sant' Andrea Hospital of Rome, Rome, Italy
| | - F Jahn
- Clinic for Internal Medicine IV, Oncology - Hematology - Hemostaseology, University Hospital Halle (Saale), Halle, Germany
| | - H Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | | | - V Radhakrishnan
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, India
| | - M Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - P Sayegh
- Department of Pharmacy, OU Health Stephenson Cancer Center, Oklahoma City, USA
| | - S Bosnjak
- Department of Supportive Oncology and Palliative Care, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - L Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - J Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - V Ostwal
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - T Smit
- The Medical Oncology Centre of Rosebank, Johannesburg
| | - A Zilic
- Department of Supportive Oncology and Palliative Care, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - K Jordan
- Department of Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital, Potsdam; Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - F Scotté
- ∗Interdisciplinary Patient Pathway Division, Gustave Roussy, Villejuif, France.
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Olver I, Clark-Snow R, Ruhlmann CH, Garcia-Del-Barrio MA, Schwartzberg L, Rapoport BL, Jahn F. 2023 updated MASCC/ESMO consensus recommendations: controlling nausea and vomiting with chemotherapy of low or minimal emetic potential. Support Care Cancer 2023; 32:37. [PMID: 38110581 DOI: 10.1007/s00520-023-08223-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE Review the literature to update the MASCC guidelines from 2016 for controlling nausea and vomiting with systemic cancer treatment of low and minimal emetic potential. METHODS A working group performed a systematic literature review using Medline, Embase, and Scopus databases between June 2015 and January 2023 of the management of antiemetic prophylaxis for anticancer therapy of low or minimal emetic potential. A consensus committee reviewed recommendations and required a consensus of 67% or greater and a change in outcome of at least 10%. RESULTS Of 293 papers identified, 15 had information about managing systemic cancer treatment regimens of low or minimal emetic potential and/or compliance with previous management recommendations. No new evidence was reported that would change the current MASCC recommendations. No antiemetic prophylaxis is recommended for minimal emetic potential therapy, and single agents recommended for low emetic potential chemotherapy for acute emesis, but no prophylaxis is recommended for delayed emesis. Commonly, rescue medication includes antiemetics prescribed for the next higher level of emesis. CONCLUSION There is insufficient data to change the current guidelines. Future studies should seek to more accurately determine the risk of emesis with LEC beyond the emetogenicity of the chemotherapy to include patient-related risk assessment.
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Affiliation(s)
- Ian Olver
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South, 5000, Australia.
| | | | | | - Maria-Angeles Garcia-Del-Barrio
- Pharmacy Department, School of Pharmacy and Nutrition, Clínica Universidad de Navarra, Universidad de Navarra, Madrid HeadquartersMadrid, Spain
| | | | - Bernardo Leon Rapoport
- The Medical Oncology Centre of Rosebank, 129 Oxford Road, Saxonwold 2196, Johannesburg, South Africa
- Department of Immunology, Faculty of Health Sciences, University of Pretoria, Corner Doctor Savage Road and Bophelo Road, Pretoria, 0002, South Africa
| | - Franziska Jahn
- Department of Hematology and Oncology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Hayashi T, Shimokawa M, Matsuo K, Miyoshi T, Toriyama Y, Yokota C, Taniguchi J, Hanada K, Tsumagari K, Okubo N, Koutake Y, Sakata K, Kawamata Y, Goto T, Tsurusaki Y, Koyabu M. Risk factors for delayed chemotherapy-induced nausea and vomiting with low-emetic-risk chemotherapy: a prospective, observational, multicenter study. Cancer Manag Res 2018; 10:4249-4255. [PMID: 30323680 PMCID: PMC6177523 DOI: 10.2147/cmar.s176574] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Improvement in the control of delayed chemotherapy-induced nausea and vomiting (CINV) is needed. There is limited information on antiemetic prophylaxis for patients undergoing low-emetic-risk chemotherapy (LEC), and the optimal antiemetic treatment is not well understood. Therefore, we analyzed the risk factors for delayed CINV to aid in the development of individualized treatments. Patients and methods This prospective multicenter study was conducted in 13 hospitals and included patients with solid cancers undergoing LEC. A total of 222 patients were enrolled between September 2013 and November 2014. The participants completed a daily diary for 5 days after the commencement of the first cycle of LEC to describe the daily incidence of CINV (yes/no). Furthermore, the participants described the severity of nausea and the amount of food intake with the help of VAS. Results Two hundred and ten patients provided their data that were analyzed using multivariate logistic regression to examine the risk factors for delayed CINV. History of CINV, Eastern Cooperative Oncology Group performance status score ≥1, acute CINV, and single-day antiemetic prophylaxis were identified as independent risk factors for delayed CINV. Conclusion The current use of antiemetic prophylaxis according to the recommended guideline appears to effectively control delayed CINV in patients undergoing LEC. Therefore, patients with the abovementioned risk factors should be carefully observed, and their treatment should be adjusted according to their symptoms. The use of multiple-day dexamethasone may be beneficial for those patients who develop acute CINV, especially when it is accompanied by anorexia.
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Affiliation(s)
- Toshinobu Hayashi
- Department of Pharmacy, Clinical Research Institute, National Kyushu Medical Center, Fukuoka, Japan, .,Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan,
| | - Mototsugu Shimokawa
- Cancer Biostatistics Laboratory, Clinical Research Institute, National Kyushu Cancer Center, Fukuoka, Japan
| | - Koichi Matsuo
- Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan,
| | - Takanori Miyoshi
- Department of Pharmacy, National Hospital Organization Beppu Medical Center, Oita, Japan
| | - Yoko Toriyama
- Department of Pharmacy, National Hospital Organization Beppu Medical Center, Oita, Japan
| | - Chiaki Yokota
- Department of Pharmacy, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Jun Taniguchi
- Department of Pharmacy, National Hospital Organization Ureshino Medical Center, Saga, Japan
| | - Kiyonori Hanada
- Department of Pharmacy, National Hospital Organization Kumamoto Saishunso National Hospital, Kumamoto, Japan
| | - Kyouichi Tsumagari
- Department of Pharmacy, National Hospital Organization Miyakonojo Medical Center, Miyazaki, Japan
| | - Noriko Okubo
- Department of Pharmacy, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yoshimichi Koutake
- Department of Pharmacy, National Hospital Organization Fukuoka National Hospital, Japan
| | - Kohei Sakata
- Department of Pharmacy, National Hospital Organization Kumamoto South National Hospital, Kumamoto, Japan
| | - Yosei Kawamata
- Department of Pharmacy, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Takashi Goto
- Department of Pharmacy, National Hospital Organization Kokura Medical Center, Kitakyushu, Japan
| | - Yasufumi Tsurusaki
- Department of Pharmacy, National Hospital Organization Saga National Hospital, Saga, Japan
| | - Makiko Koyabu
- Department of Pharmacy, Clinical Research Institute, National Kyushu Medical Center, Fukuoka, Japan,
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A prospective, observational, multicenter study on risk factors and prophylaxis for low emetic risk chemotherapy-induced nausea and vomiting. Support Care Cancer 2017; 25:2707-2714. [PMID: 28341971 DOI: 10.1007/s00520-017-3679-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The incidence of and the risk factors for nausea and vomiting in patients undergoing low emetic risk chemotherapy (LEC) are unclear. The aim of the study was to provide information on these topics by performing a multicenter, observational, prospective study. METHODS The study consisted of patients who were administered first-time LEC that was consistent or inconsistent with current guidelines. Using the visual analog scale, patients recorded their daily food intake and the occurrence and severity of nausea over a 5-day treatment period. RESULTS The overall incidence of chemotherapy-induced nausea and vomiting did not differ significantly between patients undergoing guideline-consistent (n = 89) or guideline-inconsistent (n = 121) prophylaxis (30.3 vs. 22.3%, respectively; P = 0.19). Logistic regression analysis identified a history of nausea and LEC other than taxanes as independent risk factors associated with nausea and vomiting in patients undergoing LEC. The mean daily visual analog scale scores for nausea severity and a decrease in food intake were <25 mm throughout the entire observation period. CONCLUSIONS Guideline-consistent prophylaxis appeared to control nausea and vomiting effectively in patients undergoing LEC. However, patients with a history of nausea and receiving LEC other than taxanes should be carefully observed and treatment should be adjusted according to their symptoms.
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Olver I, Ruhlmann CH, Jahn F, Schwartzberg L, Rapoport B, Rittenberg CN, Clark-Snow R. 2016 Updated MASCC/ESMO Consensus Recommendations: Controlling nausea and vomiting with chemotherapy of low or minimal emetic potential. Support Care Cancer 2016; 25:297-301. [DOI: 10.1007/s00520-016-3391-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/19/2016] [Indexed: 11/25/2022]
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Flank J, Robinson PD, Holdsworth M, Phillips R, Portwine C, Gibson P, Maan C, Stefin N, Sung L, Dupuis LL. Guideline for the Treatment of Breakthrough and the Prevention of Refractory Chemotherapy-Induced Nausea and Vomiting in Children With Cancer. Pediatr Blood Cancer 2016; 63:1144-51. [PMID: 26960036 DOI: 10.1002/pbc.25955] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 01/28/2016] [Indexed: 11/06/2022]
Abstract
This clinical practice guideline provides an approach to the treatment of breakthrough chemotherapy-induced nausea and vomiting (CINV) and the prevention of refractory CINV in children. It was developed by an international, interprofessional panel and is based on systematic literature reviews. Evidence-based interventions for the treatment of breakthrough and prophylaxis of refractory CINV are recommended. Gaps in the evidence used to support the recommendations made in this clinical practice guideline were identified. The contribution of these recommendations to breakthrough and refractory CINV control in children requires prospective evaluation.
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Affiliation(s)
- Jacqueline Flank
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | | | - Mark Holdsworth
- College of Pharmacy, University of New Mexico, Albuquerque, New Mexico
| | - Robert Phillips
- Regional Department of Haematology and Oncology, Leeds Children's Hospital, Leeds, United Kingdom.,Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Carol Portwine
- Division of Hematology/Oncology, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Paul Gibson
- Pediatric Hematology/Oncology, Children's Hospital, London Health Sciences Centre, London, Canada
| | - Cathy Maan
- Pediatric Hematology/Oncology, Children's Hospital, London Health Sciences Centre, London, Canada
| | - Nancy Stefin
- Division of Hematology/Oncology, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Lillian Sung
- Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.,Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - L Lee Dupuis
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Research Institute, The Hospital for Sick Children, Toronto, Canada
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Zhou M, Popovic M, Pasetka M, Pulenzas N, Ahrari S, Chow E, DeAngelis C. Update on the management of chemotherapy-induced nausea and vomiting - focus on palonosetron. Ther Clin Risk Manag 2015; 11:713-29. [PMID: 25999723 PMCID: PMC4435088 DOI: 10.2147/tcrm.s68130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose Nausea and vomiting are major adverse effects of chemotherapy and can greatly impact patients’ quality of life. Although chemotherapy-induced nausea and vomiting (CINV) prevalence is high, treatment remains difficult. Palonosetron is a 5-hydroxytryptamine receptor antagonist (5-HT3RA) approved for treatment of CINV. The purpose of this review is to discuss existing and emerging therapeutic options, and examine studies focusing on palonosetron with regards to efficacy, pharmacology, tolerability, safety, and patient-derived outcomes. Methods A literature search was conducted using Ovid MEDLINE and EMBASE to identify relevant studies using palonosetron alone or in combination with other antiemetics. Studies were extracted if they included complete response (CR), complete control (CC), no nausea, no vomiting, and no rescue medications as an endpoint. Studies were also included if safety endpoints were examined. Results Palonosetron alone has been shown to improve CR and CC rates for patients receiving low, moderate, or high emetogenic chemotherapy. Rates were further improved with the addition of dexamethasone, a corticosteroid. Furthermore, the addition of neurokinin-1 receptor antagonists, such as netupitant markedly improved efficacy profiles compared to palonosetron alone. Aprepitant is an antiemetic that has exhibited positive results in combination with palonosetron. Recently, a new drug consisting of netupitant and palonosetron (NEPA) has demonstrated significantly more efficacious prevention of CINV. Regardless of the combination, palonosetron has been well tolerated. The most common adverse events were constipation, headache, fatigue, and dizziness, with the majority of patients describing them as only mild or moderate. Conclusion Palonosetron, alone or with other antiemetics, has improved CINV treatment due to its ability to significantly reduce delayed phases of CINV, compared to similar 5-HT3RAs. Palonosetron is both more effective than first generation 5-HT3RAs and safer, as it results in a smaller prolongation of the QTc interval, compared to other 5-HT3RAs.
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Affiliation(s)
- Michelle Zhou
- Department of Pharmacy, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Marko Popovic
- Department of Pharmacy, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Mark Pasetka
- Department of Pharmacy, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Natalie Pulenzas
- Department of Pharmacy, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Soha Ahrari
- Department of Pharmacy, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Edward Chow
- Department of Pharmacy, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
| | - Carlo DeAngelis
- Department of Pharmacy, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada
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