52 PART TWO | CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING Abstract Background: Delayed chemotherapy-induced nausea and vomiting (CINV) remains an important adverse effect of moderately emetogenic chemotherapy not containing anthracyclines and cyclophosphamide (non-AC MEC). In this review, we summarize current literature to update recommendations for delayed CINV prophylaxis after non-AC MEC. Methods: We conducted a systematic search in PubMed, and conference proceedings from ASCO, ESMO, and MASCC. Included randomized controlled trials (RCTs) aimed to prospectively evaluate the efficacy of two or more antiemetic strategies in the prevention of delayed CINV after the administration of non-AC MEC. At least one of the following endpoints was used: complete response, complete control, no nausea, no vomiting, and/or no use of rescue medication. Results: Our search provided 247 publications. Ninemet the predefined criteria. Included RCTs reported outcomes on palonosetron, aprepitant, casopitant, netupitant/palonosetron (NEPA), olanzapine, and megesterol acetate. Conclusions: Superiority of palonosetron over first- generation 5HT3 receptor antagonists for the prevention of acute and delayed CINV after non-AC MEC has not been proven. The addition of a Neurokinin-1 (NK1) receptor antagonist to first-generation 5-HT3 receptor antagonists does not significantly improve the incidence of delayedCINV after non-ACMEC. The efficacy of a single-day regimen dexamethasone with palonosetron is non-inferior to multiday dexamethasone. NEPA, olanzapine, and megesterol acetate show highly effective CR rates. Key words: antiemetics, delayed CINV, moderately emetogenic chemotherapy
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