Which anticancer drug is most emetogenic?

Table 2

Which chemo agent has the highest emetogenic potential?

Available pediatric experience confirms the source guideline’s ranking of cisplatin ≥ 50 mg/m2 and cyclophosphamide > 1.5 g/m2 as highly emetogenic antineoplastic agents when given as single agents.

Is etoposide highly emetogenic?

Highly and moderately emetogenic agents require antiemetic prophylaxis for chemotherapy-induced nausea and vomiting. Intravenous etoposide is listed as having low emetic potential. However, oral etoposide is categorized as having moderate emetogenicity.

What antiemetics are approved for chemotherapy patients?

Currently, there are four 5-HT3 antagonists available in the US market—dolasetron, granisetron, ondansetron, and palonosetron. Studies with these agents show relatively similar rates of success in the prevention of CINV in patients receiving cisplatin-based chemotherapy regimens.

What is the best antiemetic for chemotherapy?

Low emetogenic chemotherapy Within the first 24 hours, all guidelines recommend dexamethasone as the antiemetic of choice, while dopamine receptor antagonist or 5-HT3 receptor antagonist have been recommended as alternatives to dexamethasone by MASCC/ESMO and NCCN guidelines.

How long does Emend stay in your system?

This effect can last for up to 28 days after your last dose of this medication. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking aprepitant and for at least 1 month after your treatment ends.

Which chemotherapy agent has the lowest emetogenic potential?

Drugs considered to have low emetogenic risk (10%-30%) include the taxanes, etoposide, and biologics such as trastuzumab (Herceptin) and cetuximab (Erbitux). Some antineoplastic agents such as the vinca alkaloids as a class or bevacizumab (Avastin) are associated with minimal risk of emesis without prophylaxis (< 10%).

Is oxaliplatin highly emetogenic?

Although oxaliplatin is considered a moderately emetogenic agent in most chemotherapy classification systems, some patients experience more significant CINV with this agent.

Why is etoposide called VP 16?

Etoposide was first synthesized in 1966 and U.S. Food and Drug Administration approval was granted in 1983. The nickname VP-16 likely comes from a compounding of the last name of one of the chemists who performed early work on the drug (von Wartburg) and podophyllotoxin.

Which antiemetic is best in chemotherapy?

What is highly emetogenic chemotherapy?

Regimens that are linked to a high incidence (90% or higher) of nausea and vomiting are referred to as “highly emetogenic chemotherapy”, and those causing a moderate incidence (30–90%) of nausea and vomiting are referred to as “moderately emetogenic chemotherapy”.

Can you take Emend every day?

Emend is not for long-term use. You will most likely need only 1 to 3 doses. The first dose is usually given 30 to 60 minutes before treatment with chemotherapy. Follow your doctor’s dosing instructions very carefully.

Who are the people who use antiemetics for cancer?

Adults and children who receive antineoplastic agents and adults who undergo radiation therapy for cancer. Medical and radiation oncologists, oncology nurses, nurse practitioners, physician assistants, oncology pharmacists, and patients with cancer.

When to use an active antiemetic treatment regimen?

All patients should receive the most active antiemetic regimen appropriate for the antineoplastic agents being administered. Clinicians should use such regimens with initial antineoplastic treatment rather than assessing the patient’s emetic response with less-effective antiemetic treatment.

Which is the best antiemetics for pediatric patients?

Pediatric patients treated with moderate-emetic-risk antineoplastic agents should be offered a 2-drug combination of a 5-HT 3 receptor antagonist and dexamethasone (Type: evidence based, benefits outweigh harms; Evidence quality: intermediate; Strength of recommendation: strong).

When to use antiemetics for breakthrough nausea and vomiting?

For patients with breakthrough nausea or vomiting, clinicians should re-evaluate emetic risk, disease status, concurrent illnesses, and medications; and ascertain that the best regimen is being administered for the emetic risk (Type: informal consensus, benefits outweigh harms; Evidence quality: low; Strength of recommendation: moderate).