Supportive Care in Cancer

, Volume 13, Issue 2, pp 97–103 | Cite as

Acute emesis: moderately emetogenic chemotherapy

  • Jørn HerrstedtEmail author
  • Jim M. Koeller
  • Fausto Roila
  • Paul J. Hesketh
  • David Warr
  • Cynthia Rittenberg
  • Mario Dicato
Review Article


This paper is a review of the recommendations for the prophylaxis of acute emesis induced by moderately emetogenic chemotherapy as concluded at the Perugia Consensus Conference, which took place at the end of March 2004. The review focuses on new studies appearing since the last consensus conference in 1997. The following issues are addressed: dose and schedule of antiemetics, different groups of antiemetics such as corticosteroids, serotonin (5-HT3)-receptor antagonists, dopamine D2 receptor antagonists, and neurokinin (NK1) receptor antagonists. Antiemetic prophylaxis in patients receiving multiple cycles of moderately emetogenic chemotherapy is also reviewed. Consensus statements are given, including optimal dose and schedule of 5-HT3-receptor antagonists and of dexamethasone. The new 5-HT3-receptor antagonist, palonosetron, is a reasonable alternative to the well-established agents of this class—ondansetron, granisetron, tropisetron and dolasetron. It is concluded that the best prophylaxis in patients receiving moderately emetogenic chemotherapy is still the combination of one of the 5-HT3-receptor antagonists and dexamethasone. The results of studies adding a NK1-receptor antagonist to this combination are awaited and might change future recommendations.


Serotonin antagonists Dexamethasone Anthracycline Cyclophosphamide Chemotherapy 


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Jørn Herrstedt
    • 1
    Email author
  • Jim M. Koeller
    • 2
  • Fausto Roila
    • 3
  • Paul J. Hesketh
    • 4
  • David Warr
    • 5
  • Cynthia Rittenberg
    • 6
  • Mario Dicato
    • 7
  1. 1.Department of Oncology 54 B1Copenhagen University HospitalHerlevDenmark
  2. 2.University of Texas Health Science Center at San AntonioSan AntonioUSA
  3. 3.Policlinico HospitalPerugiaItaly
  4. 4.Caritas St. Elizabeth’s Medical Center of BostonBostonUSA
  5. 5.Princess Margaret HospitalUniversity of TorontoCanada
  6. 6.Rittenberg Oncology ConsultingMetairieUSA
  7. 7.Luxembourg Medical CenterLuxembourg

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