Antiemetic therapy

The emetogenic potential of cancer chemotherapeutic agents varies according to the agent employed. Among the highly emetogenic agents, cisplatin has been the most studied. As for emesis induced by cisplatin, an optimal antiemetic schedule is effective in 70-90% of cases of acute emesis, in 60% of cases of delayed emesis, whereas acute emesis induced by moderately emetogenic agents can be prevented in over 90% of cases. The major risk factor in delayed emesis is the vomiting experienced during the previous chemotherapy cycles. Special situations are represented by high-dose chemotherapy and radiation therapy. Drugs and scheduling for emesis prevention in children are empirically derived from the regimens employed for adults, although some differences in the pharmacokinetics and in toxicity profiles have been reported.