70–80% of cancer patients
experience chemotherapy-related
emesis, if no antiemetic prohylaxis
is administered. However, more
than 90% of patients receiving HEC
suffer from vomiting when they
do not receive effective antiemetic
prophylaxis. Prophylaxis of nausea
and vomiting in the first cycle
has been shown to be the most
important step to prevent further
episodes of CINV in repetitive
cycles of chemotherapy. 10
Prophylactic treatment
with antiemetics given before
emetogenic chemotherapy
regimens can reduce acute
vomiting in up to 70% of patients.
Effective antiemetic prophylaxis is
of utmost importance. Adherence
34 | 2018 | hospitalpharmacyeurope.com
to antiemetic guidelines reduces
the incidence of CINV after HEC
and MEC. Key updates of the
ASCO guidelines for prevention
of CINV include the addition of
olanzapine to antiemetic regimens
for adults receiving HEC or who
experience breakthrough nausea
and vomiting; a recommendation
to administer dexamethasone
on day 1 only for adults who
receive anthracycline and
cyclophosphamide chemotherapy;
and the addition of a NK1 RA for
adults who receive carboplatin
area under the curve ≥4mg/ml/min
or high-dose chemotherapy. 8
The 2018 NCCN guidelines 6 also
have key updates, which include:
• For combination HEC +