table 1
Selective recommendations of key guidelines
MASCC/ESMO
Cisplatin-treated and AC-treated
patients Three-drug combination:
5-HT3 RA plus NK1 RA plus Dex
Moderately emetogenic
chemotherapy 5-HT3 RA plus Dex Carboplatin-
treated patients
5-HT3 RA plus NK1 RA plus Dex
Low emetogenic chemotherapy Single dose antiemetic, such as Dex,
5-HT3 RA or dopamine RA
Minimally emetogenic
chemotherapy No routine prophylaxis
recommends dexamethasone
or prochlorperazine or
metoclopramide or 5-HT3 RA.
Some of the principles of
an optimal CINV management
include:
1 The goal is prevention
2 Risk period for emesis for HEC
and MEC is considered to be at
least four days (but patients can
18 | 2018 | hospitalpharmacyeurope.com
experience nausea and vomiting
beyond that time)
3 Oral and IV 5-HT3 RAs are
considered to be equally effective
4 Antiemetic prophylaxis is
based on emetic risk of the
chemotherapy
5 Antiemetic prophylaxis should
be used when the CINV risk is
greater than 10%