{"entity":{"id":"antiemetic-therapy","kind":"technology","name":"Antiemetics for chemotherapy-induced nausea and vomiting","aka":[],"tldr":"The drugs that stopped chemotherapy from meaning days of vomiting: 5-HT3 blockers (ondansetron, palonosetron), NK1 blockers (aprepitant), dexamethasone and olanzapine, given by the emetic risk of each regimen.","summary":"Before 1991, cisplatin caused vomiting in nearly all patients; ondansetron (1991), granisetron, palonosetron (2003, long-acting), aprepitant (2003, NK1 antagonist), fosaprepitant, netupitant-palonosetron (2014), rolapitant and olanzapine (Navari, NEJM 2016) built the modern regimen. Guidelines (MASCC/ESMO, ASCO, NCCN) classify regimens as high (cisplatin, AC), moderate, low or minimal emetic risk and prescribe three- or four-drug prophylaxis for high risk (NK1 + 5-HT3 + dexamethasone ± olanzapine). Breakthrough, anticipatory and radiation-induced nausea have separate algorithms. CINV remains under-treated in ~30% of patients, particularly delayed nausea; dexamethasone-sparing and lower-dose olanzapine (5 mg) are recent refinements.","status":"standard-of-care","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Chemotherapy-induced_nausea_and_vomiting","links":[{"label":"MASCC/ESMO antiemetic guideline","url":"https://mascc.org/resources/antiemetic-guidelines/"},{"label":"Olanzapine (NEJM 2016)","url":"https://doi.org/10.1056/NEJMoa1515725"}],"tags":["gap-fill","supportive"],"related":[],"cancers":[],"sections":["supportive-care"],"technologies":["cytotoxic-chemotherapy","integrative-oncology","epro-symptom-monitoring"],"targets":[],"drugs":["cisplatin","carboplatin","doxorubicin","rolapitant"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-navari-n-engl-j-med"],"journals":[],"dependsOn":[],"notes":[],"principle":"Prophylaxis matched to emetogenic risk of the regimen and patient risk factors, blocking serotonin (acute), substance P/NK1 (delayed), and dopamine/multiple receptors (olanzapine), with corticosteroid.","strengths":["Complete response in ~70-80% even with cisplatin","Generic, oral, inexpensive options","Consensus guidelines from three bodies"],"limitations":["Delayed and anticipatory nausea still common","Guideline non-adherence (under- and over-prescribing)","Olanzapine sedation; dexamethasone and immunotherapy interactions"],"since":1991},"route":"/technologies/antiemetic-therapy/","neighbours":{"section":[{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"acupuncture-nausea","kind":"technology","name":"Acupuncture and acupressure for chemotherapy nausea","route":"/technologies/acupuncture-nausea/"},{"id":"cachexia-appetite-pharmacotherapy","kind":"technology","name":"Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine","route":"/technologies/cachexia-appetite-pharmacotherapy/"},{"id":"cannabinoids-nausea","kind":"technology","name":"Cannabinoids for chemotherapy nausea (dronabinol, nabilone, medical cannabis)","route":"/technologies/cannabinoids-nausea/"},{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"epro-symptom-monitoring","kind":"technology","name":"Electronic patient-reported outcome (ePRO) symptom monitoring","route":"/technologies/epro-symptom-monitoring/"},{"id":"integrative-oncology","kind":"technology","name":"Evidence-based integrative oncology","route":"/technologies/integrative-oncology/"},{"id":"ginger-nausea","kind":"technology","name":"Ginger for chemotherapy nausea","route":"/technologies/ginger-nausea/"}],"drug":[{"id":"aprepitant","kind":"drug","name":"Aprepitant (and fosaprepitant)","route":"/drugs/aprepitant/"},{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"dexamethasone","kind":"drug","name":"Dexamethasone","route":"/drugs/dexamethasone/"},{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"granisetron","kind":"drug","name":"Granisetron","route":"/drugs/granisetron/"},{"id":"netupitant-palonosetron","kind":"drug","name":"Netupitant and palonosetron","route":"/drugs/netupitant-palonosetron/"},{"id":"ondansetron","kind":"drug","name":"Ondansetron","route":"/drugs/ondansetron/"},{"id":"palonosetron","kind":"drug","name":"Palonosetron","route":"/drugs/palonosetron/"},{"id":"rolapitant","kind":"drug","name":"Rolapitant","route":"/drugs/rolapitant/"}],"paper":[{"id":"paper-navari-n-engl-j-med","kind":"paper","name":"Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting","route":"/key-papers/paper-navari-n-engl-j-med/"}],"term":[{"id":"nutrition-impact-symptoms","kind":"term","name":"Nutrition impact symptoms","route":"/terms/nutrition-impact-symptoms/"}],"trial":[{"id":"nct04973605","kind":"trial","name":"A Phase 1b/2 Study of Sonrotoclax (BGB-11417) as Monotherapy and in Various Combinations With Dexamethasone Plus Carfilzomib, Dexamethasone Plus Darat","route":"/trials/nct04973605/"},{"id":"nct05455320","kind":"trial","name":"A Study Comparing Talquetamab in Combination With Daratumumab or in Combination With Daratumumab and Pomalidomide Versus Daratumumab in Combination Wi","route":"/trials/nct05455320/"},{"id":"nct06208150","kind":"trial","name":"A Study Comparing Talquetamab Plus Pomalidomide, Talquetamab Plus Teclistamab, and Elotuzumab, Pomalidomide, and Dexamethasone or Pomalidomide, Bortez","route":"/trials/nct06208150/"},{"id":"nct05572515","kind":"trial","name":"A Study Comparing Teclistamab Monotherapy Versus Pomalidomide, Bortezomib, Dexamethasone (PVd) or Carfilzomib, Dexamethasone (Kd) in Participants With","route":"/trials/nct05572515/"},{"id":"nct03539744","kind":"trial","name":"A Study Designed to Evaluate the Safety and Efficacy of Venetoclax Plus Dexamethasone (VenDex) Compared With Pomalidomide Plus Dexamethasone (PomDex) ","route":"/trials/nct03539744/"},{"id":"nct06679101","kind":"trial","name":"A Study of Belantamab Mafodotin Administered in Combination With Lenalidomide and Dexamethasone (BRd) Versus Daratumumab, Lenalidomide, and Dexamethas","route":"/trials/nct06679101/"},{"id":"nct03314181","kind":"trial","name":"A Study of Combination Therapy With Venetoclax, Daratumumab and Dexamethasone (With and Without Bortezomib) in Participants With Relapsed or Refractor","route":"/trials/nct03314181/"},{"id":"nct04442022","kind":"trial","name":"A Study of Rituximab-Gemcitabine-Dexamethasone-Platinum (R-GDP) With or Without Selinexor in Patients With Relapsed/Refractory Diffuse Large B-cell Ly","route":"/trials/nct04442022/"},{"id":"nct04414475","kind":"trial","name":"A Study of Selinexor (Seli) + Low-dose Dexamethasone (LDD) in Penta-refractory Multiple Myeloma (MM), Seli and Bortezomib + LDD in Triple-class Refrac","route":"/trials/nct04414475/"},{"id":"nct05552222","kind":"trial","name":"A Study of Teclistamab in Combination With Daratumumab and Lenalidomide (Tec-DR) and Talquetamab in Combination With Daratumumab and Lenalidomide (Tal","route":"/trials/nct05552222/"},{"id":"nct07742215","kind":"trial","name":"A Study of the Efficacy and Safety of BCD-248 in Combination With Daratumumab in Patients With Relapsed or Refractory Multiple Myeloma (AMMADINA)","route":"/trials/nct07742215/"},{"id":"nct07095452","kind":"trial","name":"A Study to Assess A Change in Disease Activity and Adverse Events of Intravenous Etentamig and Daratumumab (Etentamig+D) Compared to Daratumumab, Lena","route":"/trials/nct07095452/"},{"id":"nct05552976","kind":"trial","name":"A Study to Evaluate Mezigdomide in Combination With Carfilzomib and Dexamethasone (MeziKD) Versus Carfilzomib and Dexamethasone (Kd) in Participants W","route":"/trials/nct05552976/"},{"id":"nct05519085","kind":"trial","name":"A Study to Evaluate Mezigdomide, Bortezomib and Dexamethasone (MEZIVd) Versus Pomalidomide, Bortezomib and Dexamethasone (PVd) in Participants With Re","route":"/trials/nct05519085/"},{"id":"nct07284758","kind":"trial","name":"A Study to Evaluate the Efficacy of Cemsidomide + Dexamethasone in Participants With Relapsed/Refractory Multiple Myeloma","route":"/trials/nct07284758/"},{"id":"nct05704049","kind":"trial","name":"A Study to Investigate Subcutaneous Isatuximab in Combination With Carfilzomib and Dexamethasone in Adult Participants With Relapsed and/or Refractory","route":"/trials/nct05704049/"},{"id":"nct05623020","kind":"trial","name":"A Study to Learn About the Effects of the Combination of Elranatamab, Daratumumab and Lenalidomide Compared With Daratumumab, Bortezomib, Lenalidomide","route":"/trials/nct05623020/"},{"id":"nct05020236","kind":"trial","name":"A Study to Learn About the Study Medicine Elranatamab Alone and With Daratumumab in People With Multiple Myeloma Who Have Received Other Treatments","route":"/trials/nct05020236/"},{"id":"nct05730036","kind":"trial","name":"A Trial to Learn How Well Linvoseltamab Works Compared to the Combination of Elotuzumab, Pomalidomide and Dexamethasone for Adult Participants With Re","route":"/trials/nct05730036/"},{"id":"nct06956170","kind":"trial","name":"All Japanese Population: Belantamab Mafodotin Plus Pomalidomide and Dexamethasone (Pd) Versus Bortezomib Plus Pd in Relapsed/Refractory Multiple Myelo","route":"/trials/nct06956170/"},{"id":"nct06868654","kind":"trial","name":"China Subpopulation: Evaluation of Efficacy and Safety of Belantamab Mafodotin, Bortezomib and Dexamethasone Versus Daratumumab, Bortezomib and Dexame","route":"/trials/nct06868654/"},{"id":"nct04270409","kind":"trial","name":"Isatuximab in Combination With Lenalidomide and Dexamethasone in High-risk Smoldering Multiple Myeloma","route":"/trials/nct04270409/"},{"id":"nct06868667","kind":"trial","name":"Japan Expansion Cohort: Evaluation of Efficacy and Safety of Belantamab Mafodotin, Bortezomib and Dexamethasone Versus Daratumumab, Bortezomib and Dex","route":"/trials/nct06868667/"},{"id":"olanzapine-appetite-tmh","kind":"trial","name":"Low-dose olanzapine for cancer anorexia (Tata Memorial)","route":"/trials/olanzapine-appetite-tmh/"},{"id":"nct06152575","kind":"trial","name":"MagnetisMM-32: A Study to Learn About the Study Medicine Called Elranatamab in People With Multiple Myeloma (MM) That Has Come Back After Taking Other","route":"/trials/nct06152575/"},{"id":"nct04975997","kind":"trial","name":"Open-label Study Comparing Iberdomide, Daratumumab and Dexamethasone (IberDd) Versus Daratumumab, Bortezomib, and Dexamethasone (DVd) in Participants ","route":"/trials/nct04975997/"},{"id":"nct05663866","kind":"trial","name":"Premedication to Reduce Amivantamab Associated Infusion Related Reactions","route":"/trials/nct05663866/"},{"id":"nct02899052","kind":"trial","name":"Study of Venetoclax in Combination With Carfilzomib and Dexamethasone in Participants With Relapsed or Refractory Multiple Myeloma (MM)","route":"/trials/nct02899052/"},{"id":"nct06904235","kind":"trial","name":"Study With IV NEPA (Fosnetupitant/Palonosetron) for the Prevention of Chemotherapy-induced Nausea and Vomiting in Paediatric Cancer Patients Undergoing Highly Emetogenic Chemotherapy (HEC)","route":"/trials/nct06904235/"},{"id":"nct07150104","kind":"trial","name":"Sub-study of Belantamab Mafodotin (GSK2857916) as Monotherapy and in Combination With Nirogacestat, Pomalidomide, and Dexamethasone in Participants Wi","route":"/trials/nct07150104/"},{"id":"nct07150091","kind":"trial","name":"Sub-study of Belantamab Mafodotin (GSK2857916) in Combination With Nirogacestat, Lenalidomide, and Dexamethasone in Participants With RRMM","route":"/trials/nct07150091/"}],"company":[{"id":"acacia-pharma","kind":"company","name":"Acacia Pharma","route":"/companies/acacia-pharma/"}]}}