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01-01-2024 | Dexamethasone | Special Section

2023 updated MASCC/ESMO Consensus recommendations: Prevention of nausea and vomiting following moderately emetic risk antineoplastic agents

Authors: Florian Scotté, Lee Schwartzberg, Hirotoshi Iihara, Matti Aapro, Richard Gralla, Paul J. Hesketh, Karin Jordan, Ronald Chow, Jørn Herrstedt

Published in: Supportive Care in Cancer | Issue 1/2024

Abstract

Purpose

Review the literature to update the MASCC guidelines from 2015 for controlling nausea and vomiting with systemic cancer treatment of moderate emetic potential.

Methods

A systematic literature review was completed using Medline, Embase, and Scopus databases. The literature search was done from June 2015 to January 2023 of the management of antiemetic prophylaxis for anticancer therapy of moderate emetic potential.

Results

Of 342 papers identified, 19 were relevant to update recommendations about managing antiemetic prophylaxis for systemic cancer treatment regimens of moderate emetic potential. Important practice changing updates include the use of emetic prophylaxis based on a triple combination of neurokinin (NK)₁ receptor antagonist, 5-HT₃ receptor antagonist, and steroids for patients undergoing carboplatin (AUC ≥ 5) and women < 50 years of age receiving oxaliplatin-based treatment. A double combination of 5-HT₃ receptor antagonist and steroids remains the recommended prophylaxis for other MEC. Based on the data in the literature, it is recommended that the administration of steroids should be limited to day 1 in moderately emetogenic chemotherapy regimens, due to the demonstration of non-inferiority between the different regimens.

More data is needed on the emetogenicity of new agents at moderate emetogenic risk. Of particular interest would be antiemetic studies with the agents sacituzumab-govitecan and trastuzumab-deruxtecan. Experience to date with these agents indicate an emetogenic potential comparable to carboplatin > AUC 5. Future studies should systematically include patient-related risk assessment in order to define the risk of emesis with MEC beyond the emetogenicity of the chemotherapy and improve the guidelines for new drugs.

Conclusion

This antiemetic MASCC-ESMO guideline update includes new recommendations considering individual risk factors and the optimization of supportive anti-emetic treatments.

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Title: 2023 updated MASCC/ESMO Consensus recommendations: Prevention of nausea and vomiting following moderately emetic risk antineoplastic agents
Authors: Florian Scotté
Lee Schwartzberg
Hirotoshi Iihara
Matti Aapro
Richard Gralla
Paul J. Hesketh
Karin Jordan
Ronald Chow
Jørn Herrstedt
Publication date: 01-01-2024
Publisher: Springer Berlin Heidelberg
Keywords: Dexamethasone
Nausea
Vomiting
Cytostatic Therapy
Olanzapine
Published in: Supportive Care in Cancer / Issue 1/2024
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-023-08222-3

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