Update on anti-emetics for chemotherapy-induced emesis
Article first published online: 26 JUL 2005
Internal Medicine Journal
Volume 35, Issue 8, pages 478–481, August 2005
How to Cite
Olver, I. N. (2005), Update on anti-emetics for chemotherapy-induced emesis. Internal Medicine Journal, 35: 478–481. doi: 10.1111/j.1445-5004.2005.00879.x
Potential conflicts of interest: The author has been involved in interactive studies with the major pharmaceutical companies but has no financial interest. He is a member of the Multinational Association for Supportive Care in Cancer, an independent profession organisation.
- Issue published online: 26 JUL 2005
- Article first published online: 26 JUL 2005
- Received 4 January 2005;accepted 28 March 2005.
- 5 hydroxytrptamine3 antagonist;
- neurokinin1 antagonist;
- acute emesis;
- delayed emesis
The need to control chemotherapy-induced emesis has stimulated research into anti-emetics. Emesis is not only unpleasant, but negatively impacts on global quality of life. The development of two new classes of drugs has been responsible for the major advances in anti-emesis. The 5 hydroxytryptamine3 (5HT3) antagonists in combination with dexamethasone significantly improved the control of acute post chemotherapy emesis, but delayed emesis which can last for several days was still problematic, yet its incidence was underestimated by clinicians. Both the control of acute and delayed emesis was improved when the neurokinin1 (NK1) receptor antagonists were added to 5HT3 antagonists and steroids. The complete control of delayed emesis was improved by 21% with little toxicity. The triple drug combination has become the standard of care for preventing the emesis associated with cytotoxic drugs of high emetic potential. (Intern Med J 2005; 35: 478−481)