November 3, 2011 — For the first time in 5 years, the American Society of Clinical Oncology (ASCO) has updated its clinical practice guideline on the use of antiemetic medications to prevent vomiting and nausea resulting from treatment with chemotherapy and/or radiation.
The updated guideline includes recommendations on the use of antiemetics with chemotherapy drugs that are classified as high, moderate, minimal, and low risk for causing vomiting and nausea.
The updated guideline, published in the November 1 issue of the Journal of Clinical Oncology, is based on a systematic review of 37 relevant clinical trials in the medical literature.
More than half of all cancer patients experience nausea or vomiting during treatment, which can cause dehydration and other problems, according to the guideline.
"Over the past 2 decades, major strides have been made in recognizing the scope of this problem. There have been improvements in stratifying the risk of side effects according to the type of drug treatment used. This guideline update reflects progress in refining antiemetic approaches and minimizing these side effects," said panel cochair and lead author Ethan Basch, MD, from Memorial Sloan-Kettering Cancer Center in New York City, in a press statement.
The guideline details the risk for nausea and vomiting associated with specific chemotherapy and radiation therapy regimens, and recommends antiemetic regimens for each.
One of the highlights is the reclassification of combined anthracycline and cyclophosphamide regimens as highly emetic. Each drug alone is classified as having a moderate risk but, on the basis of new data, this combination, which is widely used in breast cancer and non-Hodgkin's lymphoma, is now considered high-risk. Patients who receive this combination or any highly emetic agents should receive a combination of a 5-HT3-receptor antagonist, dexamethasone, and a neurokinin 1–receptor antagonist, according to the new guideline.
Other highlights from the include:
"In general, we have more effective and better tolerated antiemetic agents today, and we have also learned how to use the available agents in more effective ways," said panel cochair Gary Lyman, MD, MPH, professor of medicine at Duke University and the Duke Cancer Institute in Durham, North Carolina.
A number of the guideline authors have disclosed financial ties with industry.
J Clin Oncol. 2011;29:4189-4198. Full text
The updated guideline includes recommendations on the use of antiemetics with chemotherapy drugs that are classified as high, moderate, minimal, and low risk for causing vomiting and nausea.
The updated guideline, published in the November 1 issue of the Journal of Clinical Oncology, is based on a systematic review of 37 relevant clinical trials in the medical literature.
More than half of all cancer patients experience nausea or vomiting during treatment, which can cause dehydration and other problems, according to the guideline.
"Over the past 2 decades, major strides have been made in recognizing the scope of this problem. There have been improvements in stratifying the risk of side effects according to the type of drug treatment used. This guideline update reflects progress in refining antiemetic approaches and minimizing these side effects," said panel cochair and lead author Ethan Basch, MD, from Memorial Sloan-Kettering Cancer Center in New York City, in a press statement.
The guideline details the risk for nausea and vomiting associated with specific chemotherapy and radiation therapy regimens, and recommends antiemetic regimens for each.
One of the highlights is the reclassification of combined anthracycline and cyclophosphamide regimens as highly emetic. Each drug alone is classified as having a moderate risk but, on the basis of new data, this combination, which is widely used in breast cancer and non-Hodgkin's lymphoma, is now considered high-risk. Patients who receive this combination or any highly emetic agents should receive a combination of a 5-HT3-receptor antagonist, dexamethasone, and a neurokinin 1–receptor antagonist, according to the new guideline.
Other highlights from the include:
- the classification of fosaprepitant, a single-day intravenous formulation, as being equivalent to aprepitant
- the recommendation for the preferential use of palonosetron combined with dexamethasone for regimens of moderate emetic risk
- the recommendation that patients undergoing treatment with low-risk agents be offered dexamethasone before the first dose of chemotherapy
- the recommendation that patients undergoing high emetic risk radiation therapy receive a 5-HT3-receptor antagonist before each fraction and for 24 hours after treatment, and can receive a 5-day course of dexamethasone during fractions 1 to 5.
"In general, we have more effective and better tolerated antiemetic agents today, and we have also learned how to use the available agents in more effective ways," said panel cochair Gary Lyman, MD, MPH, professor of medicine at Duke University and the Duke Cancer Institute in Durham, North Carolina.
A number of the guideline authors have disclosed financial ties with industry.
J Clin Oncol. 2011;29:4189-4198. Full text
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου