Loading
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.
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.
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.
Aprepitant (Emend) was the first of a new class of anti-sickness drugs. Taken with a 5-HT3 blocker and dexamethasone, it prevents the delayed nausea and vomiting that follow strongly emetogenic chemotherapy such as cisplatin.
Dexamethasone is a long-acting glucocorticoid steroid that kills lymphoid cancer cells directly, which is why it sits in nearly every myeloma regimen and in childhood leukaemia and lymphoma protocols. It is also the standard drug for preventing chemotherapy sickness and for brain swelling and spinal cord compression; high blood sugar, insomnia, muscle wasting and infection follow prolonged use.
Granisetron is an anti-sickness medicine for chemotherapy given as a tablet, an injection, a week-long skin patch (Sancuso) or a slow-release injection that lasts several days (Sustol).
Akynzeo combines two anti-sickness drugs in one capsule or infusion taken once before chemotherapy, so a single dose plus dexamethasone protects against both immediate and delayed vomiting.
Ondansetron (Zofran) was the drug that made cisplatin-type chemotherapy bearable. It blocks the serotonin signal that triggers vomiting and is now a cheap generic tablet, dissolving wafer or injection used across cancer care.
Palonosetron (Aloxi) is a long-acting anti-sickness injection given once before chemotherapy; a single dose covers both the first day and the delayed nausea that follows.
Rolapitant (Varubi) is a long-lasting anti-sickness tablet taken once before chemotherapy, alongside a 5-HT3 blocker and dexamethasone, to prevent nausea and vomiting in the days after treatment.
Query for this technology: (TITLE:"Antiemetics for chemotherapy-induced nausea and vomiting" OR ABSTRACT:"Antiemetics for chemotherapy-induced nausea and vomiting") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Antiemetics for chemotherapy-induced nausea and vomiting, not a curated reading list.
Shares Electronic patient-reported outcome (ePRO) symptom monitoring, Evidence-based integrative oncology and the tag supportive.
Shares Cachexia pharmacotherapy: GDF-15 blockade, anamorelin, olanzapine and the tag supportive.
Shares Evidence-based integrative oncology and the tag supportive.
Shares Doxorubicin and the tag supportive.
Shares Electronic patient-reported outcome (ePRO) symptom monitoring and the tag supportive.
Shares Cytotoxic chemotherapy and the tag supportive.
Shares Cytotoxic chemotherapy and the tag supportive.
Shares Cytotoxic chemotherapy and the tag supportive.