CINV

 Q: 32 years old female on active chemotherapy is recovering in ICU. Oncology service wants to restart her chemotherapy cycle with Cisplatin. Patient request anti-emetic prior to her chemotherapy agent. A chemotherapy agent can be anticipated for the risk of its emetic properties (risk of inducing vomiting)?

A) True

B) False

Answer: A

Fortunately, a chemotherapy agent can be fairly accurately predicted for its risk of causing chemotherapy-induced-nausea-vomiting (CINV). This helps a clinician to prescribe prophylaxis for chemotherapy. Broadly, they are divided into four categories. 

• Highly emetic – >90% risk of emesis 
• Moderately emetic – 30 to 90% risk of emesis
• Low emetogenicity – 10 to 30% risk of emesis 
• Minimally emetic – < 10% risk of emesis

Many centers follow proper CINV protocol in this regard. 

#oncology

References:

1. Roila F, Hesketh PJ, Herrstedt J, Antiemetic Subcommitte of the Multinational Association of Supportive Care in Cancer. Prevention of chemotherapy- and radiotherapy-induced emesis: results of the 2004 Perugia International Antiemetic Consensus Conference. Ann Oncol 2006; 17:20. 

2. Roila F, Molassiotis A, Herrstedt J, et al. 2016 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients. Ann Oncol 2016; 27:v119. 

3.  Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO Guideline Update. J Clin Oncol 2020; 38:2782.