HPE Managing CINV pocket guide 2019 | Page 32

is to predict CINV risk according to cycle of chemotherapy using repeated measures in addition to baseline data. 2 An easy-to- use online tool (www.cinvrisk. org) based on this model helps oncologists to calculate the risk, in real-time, of developing Grade 2 or higher CINV events for cancer patients with specific risk factors. The online tool also suggests specific antiemetic regimens to improve CINV control. 2 These useful tools will certainly be refined in the future as additional evidence on approaches to CINV is gathered. Conclusions CINV can profoundly affect cancer patients by reducing their quality of life and thus decreasing adherence to treatment, with potential negative effects on survival and health care costs. Better antiemetic agents (either targeting early or delayed symptoms), together with patient education initiatives and support programmes, can reduce the negative impact of these side effects without sacrificing the efficacy of anticancer therapies. The development and validation of tools with good predictive accuracy and high generalisability for the different types of malignancies will ultimately contribute to improved, personalised, emetic therapy strategies in the oncology setting. 32 | 2019 | hospitalpharmacyeurope.com References 1 Rapoport BL. Delayed chemotherapy-induced nausea and vomiting: pathogenesis, incidence, and current management. Front Pharmacol 2017;8:19. 2 Dranitsaris G et al. The development of a prediction tool to identify cancer patients at high risk for chemotherapy-induced nausea and vomiting. Ann Oncol 2017;28(6):1260-7. 3 Janelsins MC et al. Current pharmacotherapy for chemotherapy-induced nausea and vomiting in cancer patients. Expert Opin Pharmacother 2013;14(6):757–66. 4 Sommariva S et al. Impact of chemotherapy- induced nausea and vomiting on health-related quality of life and resource utilization: A systematic review. Crit Rev Oncol Hematol 2016;99:13–36. 5 Warr D. Prognostic factors for chemotherapy induced nausea and vomiting. Eur J Pharmacol 2014;722:192–6. 6 Petrella T et al. Identifying patients at high risk for nausea and vomiting after chemotherapy: The development of a practical validated prediction tool. II. Delayed nausea and vomiting. J Support Oncol 2009;7(4):W9–15. 7 Molassiotis A et al. Anticipatory nausea, risk factors, and its impact on chemotherapy- induced nausea and vomiting: results from the Pan European Emesis Registry Study. J Pain Symptom Manage 2016;51(6):987–93. 8 Roila F et al. 2016 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients. Ann Oncol 2016;27(Suppl 5):v119–v133. 9 Hesketh PJ et al. Antiemetics: American Society of Clinical Oncology focused guideline update. J Clin Oncol 2017;35:3240–61. 10 NCCN Clinical Practice Guidelines in Oncology; Version 1.0 2019. www.nccn.org. 11 Basch E et al. Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2011;29:4189–98. 12 Clemons M et al. Risk model-guided antiemetic prophylaxis vs physician’s choice in patients receiving chemotherapy for early-stage breast cancer: A randomized clinical trial. JAMA Oncol 2016;2(2):225–31. 13 Dranitsaris G et al. Identifying patients at high risk for nausea and vomiting after chemotherapy: The development of a practical prediction tool. J Support Oncol 2009;7:W1-8.