Antiemetics: American Society of Clinical Oncology clinical practice guideline update Review uri icon


MeSH Major

  • Antiemetics
  • Antineoplastic Agents
  • Nausea
  • Radiotherapy
  • Vomiting


  • Combined anthracycline and cyclophosphamide regimens were reclassified as highly emetic. Patients who receive this combination or any highly emetic agents should receive a 5-HT(3) receptor antagonist, dexamethasone, and a neurokinin 1 (NK(1)) receptor antagonist. A large trial validated the equivalency of fosaprepitant, a single-day intravenous formulation, with aprepitant; either therapy is appropriate. Preferential use of palonosetron is recommended for moderate emetic risk regimens, combined with dexamethasone. For low-risk agents, patients can be offered dexamethasone before the first dose of chemotherapy. Patients undergoing high emetic risk radiation therapy should receive a 5-HT(3) receptor antagonist before each fraction and for 24 hours after treatment and may receive a 5-day course of dexamethasone during fractions 1 to 5. The Update Committee noted the importance of continued symptom monitoring throughout therapy. Clinicians underestimate the incidence of nausea, which is not as well controlled as emesis.

publication date

  • November 2011



  • Review



  • eng

PubMed Central ID

  • PMC4876353

Digital Object Identifier (DOI)

  • 10.1200/JCO.2010.34.4614

PubMed ID

  • 21947834

Additional Document Info

start page

  • 4189

end page

  • 98


  • 29


  • 31