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01.03.2009 | Review Article

Pharmacological Management of Chemotherapy-Induced Nausea and Vomiting

Focus on Recent Developments

verfasst von: Dr Rudolph M. Navari

Erschienen in: Drugs | Ausgabe 5/2009

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Abstract

Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life. The emetogenicity of the chemotherapeutic agents, repeated chemotherapy cycles and patient risk factors significantly influence CINV. Serotonin 5-HT₃ receptor antagonists plus dexamethasone have significantly improved the control of acute CINV, but delayed CINV remains a significant clinical problem.

Two new agents, palonosetron and aprepitant, have recently been approved for the prevention of both acute and delayed CINV. Palonosetron is a second-generation 5-HT₃ receptor antagonist with a longer half-life and a higher binding affinity than first-generation 5-HT₃ receptor antagonists. Aprepitant is the first agent available in the new drug class of neurokinin-1 (NK-1) receptor antagonists. Casopitant is another NK-1 receptor antagonist, which is under review by the US FDA after recent completion of phase III clinical trials.

The introduction of these new agents has generated revised antiemetic guidelines for the prevention of CINV. Future studies may consider the use of palonosetron, aprepitant and casopitant with other antiemetic agents (e.g. olanzapine, gabapentin, cannabinoids) in moderately and highly emetogenic chemotherapy, as well as in the clinical settings of multiple-day chemotherapy and bone marrow transplantation.

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Titel: Pharmacological Management of Chemotherapy-Induced Nausea and Vomiting
Focus on Recent Developments
verfasst von: Dr Rudolph M. Navari
Publikationsdatum: 01.03.2009
Verlag: Springer International Publishing
Erschienen in: Drugs / Ausgabe 5/2009
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI: https://doi.org/10.2165/00003495-200969050-00002

Springer Medizin

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