ASCO NCCN
Acute phase:
5-HT 3 RA + NK 1 RA + Dex + olanzapine Acute phase:
• Option A:
5-HT 3 RA + NK 1 RA + Dex
• Option B:
5-HT 3 RA + NK 1 RA + Dex +
olanzapine
• Option C:
olanzapine + palonosetron + Dex
Delayed phase (non-AC HEC):
Dex + olanzapine
(if APR is used on day 1, it is to be
used again in the delayed phase) Delayed phase
• Option A:
Dex + (if APR used in day 1, APR)
• Option B:
Olanzapine + Dex + APR (if APR was
used on day 1)
• Option C:
Olanzapine
Delayed phase (AC regimes):
Olanzapine
(if APR is used on day 1, it is to be
used again in the delayed phase)
Acute phase:
5-HT 3 RA + Dex
Carboplatin-treated patients
(AUC ≥ 4mg/ml/min)
5-HT 3 RA + NK 1 RA + Dex
Delayed phase:
Patients treated with
cyclophosphamide, doxorubicin,
oxaliplatin, and other moderate-
emetic-risk antineoplastic agents
known to cause delayed nausea and
vomiting may be offered Dex
Acute phase:
• Option A:
5-HT 3 RA + Dex
• Option B:
5-HT 3 RA + NK 1 RA + Dex
• Option C:
olanzapine + palonosetron + Dex
Delayed phase:
• Option A:
Dex or 5-HT 3 RA
• Option B:
APR (if APR was used on day 1)
+/- Dex
An NK 1 RA should be added to
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