Antiemetic Strategies in Oncology Care
Summary
Effective management of chemotherapy-induced nausea and vomiting (CINV) is central to optimising patient comfort, adherence and overall treatment outcomes in oncology. Contemporary antiemetic regimens combine agents that target multiple pathways involved in emesis, including 5-hydroxytryptamine type 3 (5-HT₃) receptors, neurokinin 1 (NK₁) receptors and corticosteroid-sensitive inflammatory cascades. Stratification of patients by emetogenic risk—ranging from minimal to highly emetogenic chemotherapy—guides the choice and timing of prophylactic therapy. Acute CINV (within 24 hours of treatment) is principally controlled by 5-HT₃ receptor antagonists in conjunction with dexamethasone, whereas delayed CINV (24–120 hours post-treatment) often requires the addition of NK₁ receptor antagonists or novel agents such as olanzapine. Personalised approaches now incorporate patient-related risk factors—age, sex, history of motion sickness or prior CINV—and evolving insights into intracellular signalling to refine antiemetic protocols. Ongoing research focuses on minimising corticosteroid exposure, improving long-acting single-dose formulations and exploring receptor-independent pathways to enhance control of both nausea and vomiting across diverse patient populations.
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Antiemetic Strategies in Oncology Care publication trend
The graph below shows the total number of articles in antiemetic strategies in oncology care across all publications each year (not limited to Nature Index journals).
Technical terms
Emetogenic risk: Classification of chemotherapy agents by their likelihood to induce nausea and vomiting.
5-HT₃ receptor antagonist: A drug class that blocks serotonin type 3 receptors in the gut and brainstem to prevent acute emesis.
Neurokinin 1 (NK₁) receptor antagonist: A therapy that inhibits substance P binding at NK₁ receptors, particularly effective against delayed CINV.
Acute CINV: Nausea and vomiting occurring within the first 24 hours after chemotherapy administration.
Delayed CINV: Nausea and vomiting manifesting between 24 and 120 hours following chemotherapy.
References
- Clinical research of Olanzapine for prevention of chemotherapy-induced nausea and vomiting. Journal of Experimental & Clinical Cancer Research (2009).
- Patient-Related Risk Factors for Chemotherapy-Induced Nausea and Vomiting: A Systematic Review. Frontiers in Pharmacology (2020).
- Mechanisms of Nausea and Vomiting: Current Knowledge and Recent Advances in Intracellular Emetic Signaling Systems. International Journal of Molecular Sciences (2021).
- Prevention of chemotherapy-induced nausea: the role of neurokinin-1 (NK1) receptor antagonists. Supportive Care in Cancer (2017).
- Impact of dexamethasone-sparing regimens on delayed nausea caused by moderately or highly emetogenic chemotherapy: a meta-analysis of randomised evidence. BMC Cancer (2019).
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