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Clinical and Translational Oncology

, Volume 14, Issue 6, pp 413–422 | Cite as

Chemotherapy-induced nausea and vomiting: pathophysiology and therapeutic principles

  • Juan BayoEmail author
  • Paula J. Fonseca
  • Susana Hernando
  • Sonia Servitja
  • Aitana Calvo
  • Sandra Falagan
  • Estefanía García
  • Iria González
  • María José de Miguel
  • Quionia Pérez
  • Ana Milena
  • Antonio Ruiz
  • Agustí Barnadas
Educational Series New Trends in Clinical Oncology

Abstract

Chemotherapy-induced nausea and vomiting (CINV) is a major determinant of quality of life in cancer patients. In addition, the perceptions that oncology professionals have about CINV quite often do not coincide with reality. Antineoplastic agents and their combinations can be categorised according to their emetogenic level, and this categorisation is helpful for classifying the severity of CINV and treating it. All CINV treatment guidelines emphasise the need to administer prophylaxis to patients who receive highly or moderately emetogenic chemotherapy. With the introduction of NK1 receptor antagonists, the control of acute and delayed CINV after highly or moderately emetogenic chemotherapy schedules has improved in the great majority of patients. NK1 receptor antagonists have been demonstrated to improve the control of CINV in all risk subgroups of patients.

Keywords

Acute emesis Antiemetics Delayed emesis Highly emetogenic chemotherapy Risk factors Moderately emetogenic chemotherapy 

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References

  1. 1.
    Watcha MF, White PF (1992) Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 77:162–184Google Scholar
  2. 2.
    Sanger GJ, Andrews PL (2006) Treatment of nausea and vomiting: gaps in our knowledge. Auton Neurosci 129:3–16PubMedCrossRefGoogle Scholar
  3. 3.
    Ingle RJ, Burish TG, Wallston KA (1984) Conditionability of cancer chemotherapy patients. Oncol Nurs Forum 11:97–102PubMedGoogle Scholar
  4. 4.
    Higgins GA, Kilpatrick GJ, Bunce KT et al (1989) 5-HT3 receptor antagonists injected into the area postrema inhibit cisplatin-induced emesis in the ferret. Br J Pharmacol 97:247–255PubMedGoogle Scholar
  5. 5.
    Horn CC, Ciucci M, Chaudhury A (2007) Brain Fos expression during 48 h after cisplatin treatment: neural pathways for acute and delayed visceral sickness. Auton Neurosci 132:44–51PubMedCrossRefGoogle Scholar
  6. 6.
    Strominger NL, Knox AP, Carpenter DO (1994) The connectivity of the area postrema in the ferret. Brain Res Bull 33:33–47PubMedCrossRefGoogle Scholar
  7. 7.
    Zagon A, Totterdell S, Jones RS (1994) Direct projections from the ventrolateral medulla oblongata to the limbic forebrain: anterograde and retrograde tract-tracing studies in the rat. J Comp Neurol 340:445–468PubMedCrossRefGoogle Scholar
  8. 8.
    Hornby PJ (2001) Central neurocircuitry associated with emesis. Am J Med 111[Suppl 8A]:106S–112SPubMedCrossRefGoogle Scholar
  9. 9.
    Miller AD, Grelot S (1997) Neural control of respiratory muscle activation during vomiting. In: Miller AD, Bianchi AL, Bishop BP (eds) Neural control of the respiratory muscles. CRC Press, Boca Raton, FL, pp 239–248Google Scholar
  10. 10.
    Friedman LS, Isselbacher KJ (1998) Nausea, vomiting, and indigestion. In: Fauci AS, Brownwald E, Isselbacher KJ et al (eds) Harrison’s principles of internal medicine, 14th edn. Mc Graw-Hill, New York, pp 230–231Google Scholar
  11. 11.
    Gralla R (2001) Management of nausea and vomiting. Cancer management: a multidisciplinary approach, 5th edn. Available from: http://www.cancernetwork.com/handbook/Nausea.htm Google Scholar
  12. 12.
    Roila F, Boschetti E, Tonato M et al (1991) Predictive factors of delayed emesis in cisplatin-treated patients and antiemetic activity and tolerability of metoclopramide or dexamethasone. A randomized single-blind study. Am J Clin Oncol 14:238–242Google Scholar
  13. 13.
    Jacobsen PB, Redd WH (1988) The development and management of chemotherapy-related anticipatory nausea and vomiting. Cancer Invest 6:329–336PubMedCrossRefGoogle Scholar
  14. 14.
    Moher D, Arthur AZ, Pater JL (1984) Anticipatory nau sea and/or vomiting. Cancer Treat Rev 11:257–264PubMedCrossRefGoogle Scholar
  15. 15.
    Hesketh PJ, Grunberg SM, Gralla RJ et al (2003) The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin-the Aprepitant Protocol 052 Study Group. J Clin Oncol 21:4112–4119PubMedCrossRefGoogle Scholar
  16. 16.
    Poli-Bigelli S, Rodrigues-Pereira J, Carides AD et al (2003) Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America. Cancer 97:3090–3098PubMedCrossRefGoogle Scholar
  17. 17.
    Perwitasari DA, Gelderblom H, Atthobari J et al (2011) Anti-emetic drugs in oncology: pharmacology and individualization by pharmacogenetics. Int J Clin Pharm 33:33–43PubMedCrossRefGoogle Scholar
  18. 18.
    Kris MG, Gralla RJ, Clark RA et al (1985) Incidence, course, and severity of delayed nausea and vomiting following the administration of high-dose cisplatin. J Clin Oncol 3:1379–1384PubMedGoogle Scholar
  19. 19.
    Ettinger DS, Armstrong DK (2011) NCCN Clinical Practice Guidelines in Oncology. http://www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf. Accessed: 8 August 2011Google Scholar
  20. 20.
    Basch E, Prestrud AA, Hesketh PJ et al (2011) Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 29:4189–4198PubMedCrossRefGoogle Scholar
  21. 21.
    Roila F, Herrstedt J, Aapro M et al (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol 21[Suppl 5]:v232–243PubMedCrossRefGoogle Scholar
  22. 22.
    Garcia Gomez J, Perez Lopez ME, Garcia Mata J et al (2010) SEOM clinical guidelines for the treatment of antiemetic prophylaxis in cancer patients receiving chemotherapy. Clin Transl Oncol 12:770–774PubMedCrossRefGoogle Scholar
  23. 23.
    NCI (2010) Common Terminology Criteria for Adverse Events (CTCAE) v4.0. http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf. Accessed: 14 June 2010Google Scholar
  24. 24.
    Hesketh PJ, Kris MG, Grunberg SM et al (1997) Proposal for classifying the acute emetogenicity of cancer chemotherapy. J Clin Oncol 15:103–109PubMedGoogle Scholar
  25. 25.
    Pollera CF, Giannarelli D (1989) Prognostic factors influencing cisplatin-induced emesis. Definition and validation of a predictive logistic model. Cancer 64:1117–1122Google Scholar
  26. 26.
    Fraunholz I, Grau K, Weiss C et al (2011) Patient- and treatment-related risk factors for nausea and emesis during concurrent chemoradiotherapy. Strahlenther Onkol 187:1–6PubMedCrossRefGoogle Scholar
  27. 27.
    Hesketh PJ, Aapro M, Street JC et al (2010) Evaluation of risk factors predictive of nausea and vomiting with current standard-of-care antiemetic treatment: analysis of two phase III trials of aprepitant in patients receiving cisplatin-based chemotherapy. Support Care Cancer 18:1171–1177PubMedCrossRefGoogle Scholar
  28. 28.
    Warr DG, Street JC, Carides AD (2011) Evaluation of risk factors predictive of nausea and vomiting with current standard-of-care antiemetic treatment: analysis of phase 3 trial of aprepitant in patients receiving adriamycin-cyclophosphamide-based chemotherapy. Support Care Cancer 19: 807–813PubMedCrossRefGoogle Scholar
  29. 29.
    Osoba D, Zee B, Warr D et al (1997) Effect of postchemotherapy nausea and vomiting on health-related quality of life. The Quality of Life and Symptom Control Committees of the National Cancer Institute of Canada Clinical Trials Group. Support Care Cancer 5:307–313PubMedCrossRefGoogle Scholar
  30. 30.
    Grunberg SM, Deuson RR, Mavros P et al (2004) Incidence of chemotherapy-induced nausea and emesis after modern antiemetics. Cancer 100:2261–2268PubMedCrossRefGoogle Scholar
  31. 31.
    Majem M, Moreno ME, Calvo N et al (2011) Perception of healthcare providers versus patient reported incidence of chemotherapy-induced nausea and vomiting after the addition of NK-1 receptor antagonists. Support Care Cancer 19:1983–1990PubMedCrossRefGoogle Scholar
  32. 32.
    Grunberg SM, Osoba D, Hesketh PJ et al (2005) Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity: an update. Support Care Cancer 13:80–84PubMedCrossRefGoogle Scholar
  33. 33.
    Zaglama NE, Rosenblum SL, Sartiano GP et al (1986) Single, high-dose intravenous dexamethasone as an antiemetic in cancer chemotherapy. Oncology 43:27–32PubMedCrossRefGoogle Scholar
  34. 34.
    Chiara S, Campora E, Lionetto R et al (1987) Methylprednisolone for the control of CMF-induced emesis. Am J Clin Oncol 10:264–267PubMedCrossRefGoogle Scholar
  35. 35.
    Aapro MS (1991) Present role of corticosteroids as antiemetics. Recent Results Cancer Res 121:91–100PubMedCrossRefGoogle Scholar
  36. 36.
    Ioannidis JP, Hesketh PJ, Lau J (2000) Contribution of dexamethasone to control of chemotherapy-induced nausea and vomiting: a meta-analysis of randomized evidence. J Clin Oncol 18:3409–3422PubMedGoogle Scholar
  37. 37.
    Billio A, Morello E, Clarke MJ (2010) Serotonin receptor antagonists for highly emetogenic chemotherapy in adults. Cochrane Database Syst Rev CD006272Google Scholar
  38. 38.
    Wong EH, Clark R, Leung E et al (1995) The interaction of RS 25259-197, a potent and selective antagonist, with 5-HT3 receptors, in vitro. Br J Pharmacol 114:851–859PubMedGoogle Scholar
  39. 39.
    Stoltz R, Cyong JC, Shah A et al (2004) Pharmacokinetic and safety evaluation of palonosetron, a 5-hydroxytryptamine-3 receptor antagonist, in U.S. and Japanese healthy subjects. J Clin Pharmacol 44:520–531PubMedCrossRefGoogle Scholar
  40. 40.
    Gralla R, Lichinitser M, Van Der Vegt S et al (2003) Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Ann Oncol 14:1570–1577PubMedCrossRefGoogle Scholar
  41. 41.
    Saito M, Aogi K, Sekine I et al (2009) Palonosetron plus dexamethasone versus granisetron plus dexamethasone for prevention of nausea and vomiting during chemotherapy: a double-blind, double-dummy, randomised, comparative phase III trial. Lancet Oncol 10:115–124PubMedCrossRefGoogle Scholar
  42. 42.
    Grunberg S, Chua D, Maru A et al (2011) Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with cisplatin therapy: randomized, double-blind study protocol—EASE. J Clin Oncol 29:1495–1501PubMedCrossRefGoogle Scholar
  43. 43.
    Cubeddu LX (2009) Iatrogenic QT abnormalities and fatal arrhythmias: mechanisms and clinical significance. Curr Cardiol Rev 5:166–176PubMedCrossRefGoogle Scholar
  44. 44.
    Hofman M, Morrow GR, Roscoe JA et al (2004) Cancer patients’ expectations of experiencing treatment-related side effects: a University of Rochester Cancer Center-Community Clinical Oncology Program study of 938 patients from community practices. Cancer 101:851–857PubMedCrossRefGoogle Scholar
  45. 45.
    Warr DG, Hesketh PJ, Gralla RJ et al (2005) Efficacy and tolerability of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients with breast cancer after moderately emetogenic chemotherapy. J Clin Oncol 23:2822–2830PubMedCrossRefGoogle Scholar
  46. 46.
    Rapoport BL, Jordan K, Boice JA et al (2010) Aprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with a broad range of moderately emetogenic chemotherapies and tumor types: a randomized, double-blind study. Support Care Cancer 18:423–431PubMedCrossRefGoogle Scholar
  47. 47.
    Grunberg S, Clark-Snow RA, Koeller J (2010) Chemotherapy-induced nausea and vomiting: contemporary approaches to optimal management: Proceedings from a symposium at the 2008 Multinational Association of Supportive Care in Cancer (MASCC) Annual Meeting. Support Care Cancer (in press)Google Scholar
  48. 48.
    Olver I, Molassiotis A, Aapro M et al (2011) Antiemetic research: future directions. Support Care Cancer 19[Suppl 1]:S49–55PubMedCrossRefGoogle Scholar

Copyright information

© FESEO 2012

Authors and Affiliations

  • Juan Bayo
    • 1
    Email author
  • Paula J. Fonseca
    • 2
  • Susana Hernando
    • 3
  • Sonia Servitja
    • 4
  • Aitana Calvo
    • 5
  • Sandra Falagan
    • 3
  • Estefanía García
    • 6
  • Iria González
    • 4
  • María José de Miguel
    • 7
  • Quionia Pérez
    • 2
  • Ana Milena
    • 8
  • Antonio Ruiz
    • 1
  • Agustí Barnadas
    • 9
  1. 1.Servicio de Oncología MédicaHospital Juan Ramón JiménezHuelvaSpain
  2. 2.Hospital Universitario Central de AsturiasOviedo, AsturiasSpain
  3. 3.Fundación Hospital de AlcorcónAlcorcón, MadridSpain
  4. 4.Hospital del MarBarcelonaSpain
  5. 5.Hospital de la PrincesaMadridSpain
  6. 6.Corporació Sanitària i Universitària Parc TaulíSabadell, BarcelonaSpain
  7. 7.Hospital Universitario Virgen del RocíoSevillaSpain
  8. 8.Hospital Universitario A CoruñaA CoruñaSpain
  9. 9.Hospital de la Santa Creu i Sant PauBarcelonaSpain

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