Focusing on a topic that affects all tumor types, Lee S Schwartzberg, MD, FACP, medical oncologist and hematologist from West Cancer Center at the University of Tennessee, spoke on the latest advances in the management and prevention of chemotherapy-induced nausea and vomiting (CINV). Starting with a history lesson Dr. Schwartzberg showed us how far we’ve come: “If we start back 40 years ago with the development of cisplatin, that was simply a drug that was impossible to give outside of the hospital, 100% of people threw up continuously with it…and we wandered in the desert for a long time.”
That was, Dr. Schwartzberg told, until 1991 with the development of the first 5-HT3 receptor antagonist. With the addition of NK-1 receptor antagonists, the use of corticosteroids, and the use of other agents CINV is now regularly managed, but still presents with unique challenges. Even with “optimal” supportive care, up to 60% of patients can still experiencing some grade of CINV. Guiding the audience through the latest breakthroughs, Schwartzberg detailed the results of trials involving the use of NEPA, subcutaneous polymer-based granisetron, and the antipsychotic agent olanzapine. While we’ve come far, we still have areas of continued need, including investigations into novel agents such as cannabinoids and alternative chemotherapy regimens.
Schwartzberg left us with a reminder: “The goal is prophylaxis in your patients, not to treat them after they have breakthrough CINV. Your time to take care of them is before chemotherapy.”