The Clinical Problem of Chemotherapy-Induced Nausea and Vomiting.
نویسنده
چکیده
Over the past 2 decades, substantial advances have been made in the management of chemotherapy-induced nausea and vomiting (CINV). This is primarily because of a deeper understanding of the molecular and physiologic pathways critical to CINV. The discovery of the 5-hydroxytryptamine type 3 (5-HT3) receptor and the subsequent development of 5-HT3 receptor antagonists (RAs) in the early 1990s represent significant progress in the treatment of the acute phase of CINV, with early studies showing improved outcomes when standard antiemetic therapy with dexamethasone was combined with the 5-HT3 RAs granisetron[1] or ondansetron.[2] Also, the discovery of the role of neurokinin-1 receptor antagonists (NK1 RAs) in the pathogenesis of the delayed phase of CINV have led to significant developments in the management of the emetogenic complication of anticancer treatment. Building on the benefits demonstrated with dual therapy using a corticosteroid plus a 5-HT3 RA, large phase III studies in the early 2000s showed further benefit from triplet regimens comprising the NK1 RA aprepitant given with dexamethasone plus the 5-HT3 RA ondansetron.[3,4] In their thorough review in this issue of ONCOLOGY, Drs. Nasir and Schwartzberg describe the evolution and optimization of treatment regimens for CINV, highlighting treatment-related, patient-related, and protocol-related factors that influence their effectiveness.[5]
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عنوان ژورنال:
- Oncology
دوره 30 8 شماره
صفحات -
تاریخ انتشار 2016