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.

This Consensus Conference, a successful collaboration between MASCC and ESMO, was the first time that patient advocates were included in the consensus panel.

A new slide set summarizing the consensus process and recommendations has been produced and is freely available, provided no changes are made and that the MASCC and ESMO logos, as well as date of the information, are retained. See Antiemetics Guidelines.

For questions, please contact Matti Aapro, Chair, MASCC Antiemetic Study Group, or Alex Molassiotis, Past Chair, MASCC Antiemetic Study Group.

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