de Las Penas, R., Blasco, A., De Castro, J., Escobar, Y., Garcia-Campelo, R., Gurpide, A., . . . Virizuela, J.A. (2016). SEOM Clinical Guideline update for the prevention of chemotherapy-induced nausea and vomiting (2016). Clinical and Translational Oncology, 18, 1237–1242.

PURPOSE: To provide an update of the previously published guideline of the SEOM, published to improve supportive care of patients with cancer

 

TYPES OF PATIENTS ADDRESSED: Patient undergoing chemotherapy of any emetogenicity

PROCESS OF DEVELOPMENT: Not mentioned; update for previous guidelines

 

DATABASES USED: Not mentioned  

 

INCLUSION CRITERIA: Not mentioned 

 

EXCLUSION CRITERIA: Not mentioned

PHASE OF CARE: Active antitumor treatment

 

APPLICATIONS: Elder care, palliative care

Highly emetogenic chemotherapy (HEC) prophylaxis consists of administering a triplet containing 5-HT₃ receptor antagonists (0.25 mg of palonosetron is the most efficacious) (level II evidence, recommendation B), NK₁ receptor antagnoist (125 mg apprepitant on day 1 and 80 mg on day 2, or fosaprepitant [150 mg IV] on day 1), and steroids (level I evidence, recommendation A). Netupitant plus palonosetron (NEPA) is efficacious in patients receiving HEC and moderately emetogenic chemotherapy (MEC) (level B evidence, recommendation A). For low emetogenic chemotherapy (LEC), a single antiemetic like dexamethasone, a dopamine receptor antagonist (metoclopramide), or a 5-HT₃ receptor antagonist (level II evidence, recommendation B) is recommended. Patients with multiple-day MEC or HEC should receive a 5-HT₃ receptor antagonist plus dexamethasone for acute nausea and vomiting, and dexamethasone for delayed nausea and vomiting (level II evidence, recommendation A). Patients receiving minimally emetic radiation therapy should receive a dopamine receptor antagonist or a 5-HT₃ receptor antagonist (level IV evidence, recommendation D). Steroids (dexamethasone) are administered PO/IV at various doses depending on the schedule used. Physicians should consider the prescription of a combination of the different antiemetic drugs considering the emetogenicity of the chemotherapy regimen, patient situation, and individual responses to treatment. Prophylactic antiemetic is as important as the postchemotherapy treatment.