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In Memory of Ed Rubenstein

Edward Rubenstein2021    A long-time member, leader, and advocate for MASCC, Ed Rubenstein sadly passed away recently at the age of 63. As well as being instrumental in the development of MASCC’s mucositis and febrile neutropenia guidelines, Ed was also a warm and charismatic person who will be greatly missed by many. Many of our long-time members have shared their remembrances of Ed, his life and his work.

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MASCC/ESMO Antiemetic Guidelines Update

2016    The MASCC/ESMO Antiemetic Guidelines have been updated as of March, 2016. The guidelines are based on the Copenhagen Consensus Conference on Antiemetic Therapy, June 2015, and have been endorsed by both MASCC and ESMO. This set of evidence-based guidelines represents several important changes and first-time inclusions. This is the first time that recommendations about management of nausea and vomiting in advanced cancer have been included — as opposed to only nausea and vomiting induced by chemotherapy or radiotherapy — and in this respect, the new MASCC/ESMO guidelines differ from those of NCCN and ASCO. The new guidelines contain recommendations for two new NK1 receptor antagonists, rolapitant and netupitant, the latter given in combination with palonosetron (NEPA), and also discuss the use of olanzapine. The combination of an anthracycline with cyclophosphamide, previously considered of medium emetogenic risk (30-90% risk of vomiting) is now considered a high-risk combination (>90% risk of vomiting). However, this remains a special case, since recommendations for the delayed phase differ from those of other chemotherapies of highly emetogenic risk. In addition, carboplatin is now considered a special case with an indication for triple preventative therapy in the acute phase.

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fda-approves-single-dose-fosaprepitant

2016    In February, 2016, the US Food and Drug Administration approved a single-use injection of fosaprepitant dimeglumine (Emend®) to prevent delayed nausea and vomiting in adults receiving an initial or repeat course of moderately emetogenic chemotherapy. The drug was already approved for highly emetogenic chemotherapy. The approval was based in part on a phase III trial comparing a single IV infusion (150 mg) of fosaprepitant dimeglumine in combination with ondansetron and dexamethasone with a control regimen ondansetron and dexamethasone alone. 

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FDA Approves Rolapitant for Chemotherapy-Induced Nausea and Vomiting

2015    On September 2, 2015, the US Food and Drug Administration (FDA) approved rolapitant (Varubi™) for the prevention of chemotherapy-induced nausea and vomiting (CINV). Rolapitant, developed by Tesaro, Inc., is a selective and competitive neurokinin 1 (NK-1) receptor antagonist and is relatively long-acting with a half-life of about 7 days). The approval was based on three phase III clinical trials conducted by a research team that included MASCC members Bernardo Rapoport, Martin Chasen, Allen Poma, Lee Schwartzberg, and Rudolph Navari. These randomized, double-blind, controlled trials established the safety and efficacy of rolapitant. The drug was associated with a significant reduction in vomiting and use of rescue antiemetic drugs. Patients treated with rolapitant also reported both fewer episodes of nausea that interfered with their day-to-day life.

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