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2023 updated MASCC/ESMO consensus recommendations: controlling nausea and vomiting with chemotherapy of low or minimal emetic potential

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Abstract

Purpose

Review the literature to update the MASCC guidelines from 2016 for controlling nausea and vomiting with systemic cancer treatment of low and minimal emetic potential.

Methods

A working group performed a systematic literature review using Medline, Embase, and Scopus databases between June 2015 and January 2023 of the management of antiemetic prophylaxis for anticancer therapy of low or minimal emetic potential. A consensus committee reviewed recommendations and required a consensus of 67% or greater and a change in outcome of at least 10%.

Results

Of 293 papers identified, 15 had information about managing systemic cancer treatment regimens of low or minimal emetic potential and/or compliance with previous management recommendations. No new evidence was reported that would change the current MASCC recommendations. No antiemetic prophylaxis is recommended for minimal emetic potential therapy, and single agents recommended for low emetic potential chemotherapy for acute emesis, but no prophylaxis is recommended for delayed emesis. Commonly, rescue medication includes antiemetics prescribed for the next higher level of emesis.

Conclusion

There is insufficient data to change the current guidelines. Future studies should seek to more accurately determine the risk of emesis with LEC beyond the emetogenicity of the chemotherapy to include patient-related risk assessment.

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Data Availability

All data supporting the findings of this study are available within the paper and its publicly available references.

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Author information

Authors and Affiliations

  1. Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South, 5000, Australia

    Ian Olver

  2. Oncology Supportive Care Consultant, Overland Park, KS, 66212, USA

    Rebecca Clark-Snow

  3. Department of Oncology, Odense University Hospital, Odense, Denmark

    Christina H. Ruhlmann

  4. Pharmacy Department, School of Pharmacy and Nutrition, Clínica Universidad de Navarra, Universidad de Navarra, Madrid HeadquartersMadrid, Spain

    Maria-Angeles Garcia-del-Barrio

  5. Reno College of Medicine, University of Nevada, Reno, NV, USA

    Lee Schwartzberg

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

    Bernardo Leon Rapoport

  7. Department of Immunology, Faculty of Health Sciences, University of Pretoria, Corner Doctor Savage Road and Bophelo Road, Pretoria, 0002, South Africa

    Bernardo Leon Rapoport

  8. Department of Hematology and Oncology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany

    Franziska Jahn

Authors
  1. Ian Olver
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  2. Rebecca Clark-Snow
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  3. Christina H. Ruhlmann
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  4. Maria-Angeles Garcia-del-Barrio
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  5. Lee Schwartzberg
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  6. Bernardo Leon Rapoport
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  7. Franziska Jahn
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Contributions

The initial draft was written by IO and all authors revised it critically for its intellectual content.

All authors reached agreement on the recommendations, are accountable for the accuracy and integrity of the work, and have approved the version to be published.

Corresponding author

Correspondence to Ian Olver.

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Conflict of interest

Schwartzberg COI: Consultant, Helsinn, GlaxoSmithKline, Pfizer.

The other authors have no relevant financial or non-financial interests to declare.

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Olver, I., Clark-Snow, R., Ruhlmann, C.H. et al. 2023 updated MASCC/ESMO consensus recommendations: controlling nausea and vomiting with chemotherapy of low or minimal emetic potential. Support Care Cancer 32, 37 (2024). https://doi.org/10.1007/s00520-023-08223-2

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