Dataset Information

Antiemetics: American Society of Clinical Oncology clinical practice guideline update.

ABSTRACT:

Purpose

To update the American Society of Clinical Oncology (ASCO) guideline for antiemetics in oncology.

Methods

A systematic review of the medical literature was completed to inform this update. MEDLINE, the Cochrane Collaboration Library, and meeting materials from ASCO and the Multinational Association for Supportive Care in Cancer were all searched. Primary outcomes of interest were complete response and rates of any vomiting or nausea.

Results

Thirty-seven trials met prespecified inclusion and exclusion criteria for this systematic review. Two systematic reviews from the Cochrane Collaboration were identified; one surveyed the pediatric literature. The other compared the relative efficacy of the 5-hydroxytryptamine-3 (5-HT(3)) receptor antagonists.

Recommendations

Combined anthracycline and cyclophosphamide regimens were reclassified as highly emetic. Patients who receive this combination or any highly emetic agents should receive a 5-HT(3) receptor antagonist, dexamethasone, and a neurokinin 1 (NK(1)) receptor antagonist. A large trial validated the equivalency of fosaprepitant, a single-day intravenous formulation, with aprepitant; either therapy is appropriate. Preferential use of palonosetron is recommended for moderate emetic risk regimens, combined with dexamethasone. For low-risk agents, patients can be offered dexamethasone before the first dose of chemotherapy. Patients undergoing high emetic risk radiation therapy should receive a 5-HT(3) receptor antagonist before each fraction and for 24 hours after treatment and may receive a 5-day course of dexamethasone during fractions 1 to 5. The Update Committee noted the importance of continued symptom monitoring throughout therapy. Clinicians underestimate the incidence of nausea, which is not as well controlled as emesis.

SUBMITTER: Basch E

PROVIDER: S-EPMC4876353 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Antiemetics: American Society of Clinical Oncology clinical practice guideline update.

Basch Ethan E Prestrud Ann Alexis AA Hesketh Paul J PJ Kris Mark G MG Feyer Petra C PC Somerfield Mark R MR Chesney Maurice M Clark-Snow Rebecca Anne RA Flaherty Anne Marie AM Freundlich Barbara B Morrow Gary G Rao Kamakshi V KV Schwartz Rowena N RN Lyman Gary H GH

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20110926 31

<h4>Purpose</h4>To update the American Society of Clinical Oncology (ASCO) guideline for antiemetics in oncology.<h4>Methods</h4>A systematic review of the medical literature was completed to inform this update. MEDLINE, the Cochrane Collaboration Library, and meeting materials from ASCO and the Multinational Association for Supportive Care in Cancer were all searched. Primary outcomes of interest were complete response and rates of any vomiting or nausea.<h4>Results</h4>Thirty-seven trials met ...[more]

PMID: 21947834

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Dataset Information

Antiemetics: American Society of Clinical Oncology clinical practice guideline update.

Purpose

Methods

Results

Recommendations

Publications

Antiemetics: American Society of Clinical Oncology clinical practice guideline update.

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