antiemetic prophylaxis to cover
the entire risk period, both acute
and delayed, thus also reducing
the incidence of anticipatory,
breakthrough and refractory
CINV.
Categories of emetogenicity
A useful framework for classifying
the emetic potential of cancer
chemotherapy agents was
developed in 1997 by Hesketh and
colleagues. 9 This was modified
in 2004 at an expert consensus
congress, 10 and it usefully divides
chemotherapy agents into
four levels, depending on their
emetogenicity: high, moderate,
low, and minimal (see Table 3).
This framework has become
an accepted standard for defining
emetogenicity with internationally
recognised bodies such as the
American Society of Clinical
Oncology, the Multinational
Association of Supportive Cancer
Care (MASCC), ESMO and NCCN
being among those that use it as
the basis for the development of
antiemetic guidelines. 11–13
Conclusions
Nausea and vomiting associated
with chemotherapy is multifaceted
and multifactorial. Understanding
the complexity of these factors and
the underlying pathophysiology
will better enable healthcare
professionals to provide
appropriate interventions to
reduce symptoms.
12 | 2018 | hospitalpharmacyeurope.com
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