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New therapies for antiemetic prophylaxis for chemotherapy

A number of new advances have occurred in the management of chemotherapy-related nausea and vomiting (CINV). A new neurokinin-1 receptor antagonist (NK1RA), netupitant, has been combined with palonosetron in a single oral tablet for treating the effects of moderately emetogenic chemotherapy (MEC) and highly emetogenic chemotherapy (HEC). Rolapitant, another NK1RA, unlike aprepitant, has a long half-life and does not block CYP-3A4 and therefore has fewer drug interactions. Olanzapine reduces nausea more effectively than aprepitant in patients who are receiving HEC and is a better rescue antiemetic than is metoclopramide. Ginger lacks efficacy as an antiemetic agent for CINV. Although there was some evidence in a pilot study of gabapentin as an antiemetic, it was no better in reducing CINV than was placebo. Compliance to guidelines in multiple settings ranges from 50%-60% but is improved by computerized order entry of antiemetics and recommendations displayed with chemotherapy.

 

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The Journal of Community and Supportive Oncology - 14(1)
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Page Number
11-20
Legacy Keywords
antiemetic prophylaxis, chemotherapy-related nausea and vomiting, CINV, neurokinin-1 receptor antagonist, NK1RA, netupitant, palonosetron, moderately emetogenic chemotherapy, MEC, highly emetogenic chemotherapy, HEC, rolapitant, aprepitant, CYP-3A4, olanzapine, rescue antiemetic, metoclopramide, ginger, gabapentin
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A number of new advances have occurred in the management of chemotherapy-related nausea and vomiting (CINV). A new neurokinin-1 receptor antagonist (NK1RA), netupitant, has been combined with palonosetron in a single oral tablet for treating the effects of moderately emetogenic chemotherapy (MEC) and highly emetogenic chemotherapy (HEC). Rolapitant, another NK1RA, unlike aprepitant, has a long half-life and does not block CYP-3A4 and therefore has fewer drug interactions. Olanzapine reduces nausea more effectively than aprepitant in patients who are receiving HEC and is a better rescue antiemetic than is metoclopramide. Ginger lacks efficacy as an antiemetic agent for CINV. Although there was some evidence in a pilot study of gabapentin as an antiemetic, it was no better in reducing CINV than was placebo. Compliance to guidelines in multiple settings ranges from 50%-60% but is improved by computerized order entry of antiemetics and recommendations displayed with chemotherapy.

 

Click on the PDF icon at the top of this introduction to read the full article.

 

A number of new advances have occurred in the management of chemotherapy-related nausea and vomiting (CINV). A new neurokinin-1 receptor antagonist (NK1RA), netupitant, has been combined with palonosetron in a single oral tablet for treating the effects of moderately emetogenic chemotherapy (MEC) and highly emetogenic chemotherapy (HEC). Rolapitant, another NK1RA, unlike aprepitant, has a long half-life and does not block CYP-3A4 and therefore has fewer drug interactions. Olanzapine reduces nausea more effectively than aprepitant in patients who are receiving HEC and is a better rescue antiemetic than is metoclopramide. Ginger lacks efficacy as an antiemetic agent for CINV. Although there was some evidence in a pilot study of gabapentin as an antiemetic, it was no better in reducing CINV than was placebo. Compliance to guidelines in multiple settings ranges from 50%-60% but is improved by computerized order entry of antiemetics and recommendations displayed with chemotherapy.

 

Click on the PDF icon at the top of this introduction to read the full article.

 

Issue
The Journal of Community and Supportive Oncology - 14(1)
Issue
The Journal of Community and Supportive Oncology - 14(1)
Page Number
11-20
Page Number
11-20
Publications
Publications
Topics
Article Type
Display Headline
New therapies for antiemetic prophylaxis for chemotherapy
Display Headline
New therapies for antiemetic prophylaxis for chemotherapy
Legacy Keywords
antiemetic prophylaxis, chemotherapy-related nausea and vomiting, CINV, neurokinin-1 receptor antagonist, NK1RA, netupitant, palonosetron, moderately emetogenic chemotherapy, MEC, highly emetogenic chemotherapy, HEC, rolapitant, aprepitant, CYP-3A4, olanzapine, rescue antiemetic, metoclopramide, ginger, gabapentin
Legacy Keywords
antiemetic prophylaxis, chemotherapy-related nausea and vomiting, CINV, neurokinin-1 receptor antagonist, NK1RA, netupitant, palonosetron, moderately emetogenic chemotherapy, MEC, highly emetogenic chemotherapy, HEC, rolapitant, aprepitant, CYP-3A4, olanzapine, rescue antiemetic, metoclopramide, ginger, gabapentin
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JCSO 2016;4(1):11-20
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