significantly contribute to reduced
quality of life for these patients
and can best be prevented through
an adequate control of CINV in
previous treatment cycles in the
first place. 7
Use of risk factors in the
prophylaxis of CINV
Risk scores derived from validated
prediction models can potentially
be applied in clinical practice with
the goal of reducing the frequency
and severity of CINV events. 2
Current guidelines recommend a
combination of serotonin 5-HT3
RAs plus a corticosteroid such as
dexamethasone, and a NK1 RA to
prevent acute nausea and vomiting
30 | 2018 | hospitalpharmacyeurope.com
as a result of highly emetogenic
chemotherapy. 8–11 For patients
receiving moderately emetogenic
chemotherapy, the combination
of a 5-HT3 RA and corticosteroid
is used prior to chemotherapy,
with or without lorazepam.
Although dexamethasone, with
or without lorazepam (lorazepam
or alprazolam is recommended
in patients in whom high-level
anxiety is the main trigger for
chemotherapy-induced emesis),
is effective for emetogenic
regimens, 8,9 patients with CINV risk
factors may need adjustments to
guideline-based recommendations.
CINV risk profiles can also be used
to decrease the number and dose