Chemotherapy-induced Nausea and Vomiting

Nausea and vomiting are commonly observed and feared side effects of chemotherapy. Understanding of the physiological mechanisms of chemotherapy-induced nausea and vomiting (CINV) has led to the development of several classes of anti-emetic, including substance P antagonists, serotonin antagonists, and dopamine antagonists. The newest of these agents include aprepitant and palonosetron, which are very effective in treating emesis in highly emotegenic chemotherapies. Several organizations, including the Multinational Association of Supportive Care in Cancer (MASCC), the National Comprehensive Cancer Network (NCCN), and the American Society of Clinical Oncology (ASCO), have developed guidelines for classification and treatment of CINV. The aim of this article is to summarize current gold standards of anti-emetics and treatment guidelines, as well as introducing innovations such as approaches to breakthrough and refractory nausea and vomiting, alternative therapies, and transdermal delivery systems.