Searching for perfection: further progress in management of chemotherapy-induced nausea and vomiting—introduction

Excerpt

Emesis is an evolutionary reflex designed to protect the body from ingested toxins. Many treatments, including chemotherapeutic agents, to varying degrees, are also felt to be toxins by the body and can elicit an immediate or delayed reaction involving nausea and vomiting. Chemotherapy-induced nausea and vomiting (CINV) is a common side effect of many anticancer therapies and significantly reduces patient quality of life [1]. CINV can also lead to treatment interruption, dose reduction, and early discontinuation, which compromise the effectiveness of these therapies and negatively impacts long-term patient outcomes. Significant gains in the prevention and management of CINV have emerged over the last two decades. Without antiemetic prophylaxis, more than 90% of patients receiving highly emetogenic chemotherapy (HEC) are at risk for emesis [2, 3]. In contrast, a recent meta-analysis of clinical trials investigating modern-day antiemetic therapy in patients receiving HEC showed rates of vomiting and significant nausea ranging from approximately 10 to 40% [4]. The achievements in CINV prophylaxis are reflected in a worldwide online survey conducted by the American Society of Clinical Oncology (ASCO) in 2014, in which antiemetic therapy was voted one of the “Top 5 Advances in Modern Oncology” [5]. …