RECENT UPDATES IN THE MANAGEMENT OF CHEMOTHERAPY INDUCED NAUSEA AND VOMITING

Abstract

The leading factor that has an impact on cancer patients' quality of life and their adherence to treatment is chemotherapy induced nausea and vomiting (CINV). Better understanding of the physiology of CINV and the identification of risk factors can be beneficial in improving the treatment outcomes. A number of antiemetic agents are currently available including 5-hydroxytryptamine receptor antagonists (5HT₃RAs), neurokinin receptor antagonists (NK₁RAs), dopamine receptor antagonists, benzodiazepines and cannabinoids. These agents can be used in the effective management of CINV according to the various antiemetic guidelines like NCCN (National Comprehensive Cancer Network) guidelines, ASCO (American Society of Clinical Oncology) guidelines and MASCC (Multinational Association of Supportive Care in Cancer) guidelines. Even though CINV can be prevented to a great extent with these agents, some patients still experience nausea and vomiting. In order to attain the ultimate goal of complete control of CINV, more effective therapies are greatly needed. This review focuses on the pathophysiological aspects of CINV, antiemetic agents, current guidelines for management of CINV, their comparative evaluation and recent trends in management of CINV.