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2016 Updated MASCC/ESMO Consensus Recommendations: Controlling nausea and vomiting with chemotherapy of low or minimal emetic potential

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Abstract

Purpose

The purpose of this review is to update the MASCC (Multinational Association of Supportive Care in Cancer) guidelines for controlling nausea and vomiting with chemotherapy of low or minimal emetic potential.

Methods

The antiemetic study group of MASCC met in Copenhagen in 2015 to review the MASCC antiemetic guidelines. A subgroup performed a systematic literature review on antiemetics for low emetogenic chemotherapy (LEC) and chemotherapy of minimal emetic potential and the chair presented the update recommendation to the whole group for discussion. They then voted with an aim of achieving 67 % or greater consensus.

Results

For patients receiving low emetogenic chemotherapy, a single antiemetic such as dexamethasone, a 5HT3 receptor antagonist, or a dopamine receptor antagonist may be considered for prophylaxis of acute emesis. For patients receiving chemotherapy of minimal emetogenicity, no antiemetic should be routinely administered. If patients vomit, they should be treated as for chemotherapy of low emetic potential. No antiemetic should be administered for prevention of delayed nausea and vomiting induced by low or minimally emetogenic chemotherapy.

Conclusions

More research is needed to determine the incidence of emesis, particularly delayed emesis, in the LEC group. Prospective studies are required to evaluate antiemetic strategies. The risk of emesis within LEC may be more accurately determined by adding the patient risk factors for emesis to those of the chemotherapy drugs. Improved strategies for promoting adherence to guidelines are required.

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Authors and Affiliations

  1. Sansom Institute for Health Research, University of South Australia, P5-06e Playford Building, City East Campus, GPO Box 2471, Adelaide, SA, 5001, Australia

    Ian Olver

  2. Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark

    Christina H. Ruhlmann

  3. Department of Hematology and Oncology, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Germany

    Franziska Jahn

  4. West Cancer Center, University of Tennessee Health Science Center, Memphis, TN, USA

    Lee Schwartzberg

  5. The Medical Oncology Centre of Rosebank, 129 Oxford Road, Saxonwold, Johannesburg, 2196, South Africa

    Bernardo Rapoport

  6. Rittenberg Oncology Consulting, 500 Rue St. Ann, Suite 223, Metairie, LA, 70005, USA

    Cynthia N. Rittenberg

  7. The University of Kansas Cancer Center, 2330 Shawnee Mission Parkway, Westwood, KS, 66205, USA

    Rebecca Clark-Snow

Authors
  1. Ian Olver
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  2. Christina H. Ruhlmann
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  3. Franziska Jahn
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  4. Lee Schwartzberg
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  5. Bernardo Rapoport
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  6. Cynthia N. Rittenberg
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  7. Rebecca Clark-Snow
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Corresponding author

Correspondence to Ian Olver.

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Conflicts of interest

The authors received remuneration, research funding, and consultancies as follows:

I Olver: Tesaro; C Ruhlmann: Swedish Orphan Biovitrum; F Jahn: MSD, Merck, Helsinn, Tesaro; L Schwartzberg: Eisai, Merck, Helsinn, Tesaro; B Rapoport: Merck, Helsinn, MSD Tesaro; C Rittenberg: none; R Clark-Snow: none.

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Olver, I., Ruhlmann, C.H., Jahn, F. et al. 2016 Updated MASCC/ESMO Consensus Recommendations: Controlling nausea and vomiting with chemotherapy of low or minimal emetic potential. Support Care Cancer 25, 297–301 (2017). https://doi.org/10.1007/s00520-016-3391-z

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  • DOI: https://doi.org/10.1007/s00520-016-3391-z

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