2023 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following multiple-day chemotherapy, high-dose chemotherapy, and breakthrough nausea and vomiting
MASCC/ESMO · 2023 · Europe
Source and licence
- Authors
- Bernardo Leon Rapoport, Jørn Herrstedt, Rebecca Clark Snow et al.
- Title
- 2023 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following multiple-day chemotherapy, high-dose chemotherapy, and breakthrough nausea and vomiting
- Journal
- Supportive Care in Cancer, 2023
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC10725845
Licence statement of the original publication
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Recommendations
Verbatim, with grade of recommendation or strength of consensus where given.
Multiple-day cisplatin chemotherapy
- 5-HT3-RA + Dex + Apr + Olz(1) Dex + Apr + OlzUpdated level of evidence/grade of recommendation: I/A II/B for the number of days
Abstract
Purpose: This review is an update of the MASCC/ESMO 2015 recommendations for the prophylaxis of acute and delayed nausea and vomiting induced by multiple-day chemotherapy, high-dose chemotherapy, and breakthrough nausea and vomiting.
Methods: A systematic literature search was conducted using PubMed from June 1, 2015, through February 1, 2023.
Results: We identified 56 references (16 were duplications or invalid), leaving 40 manuscripts for this search. The panel classified level I evidence (three manuscripts) and level II evidence (14 manuscripts). High-dose chemotherapy and stem cell transplant were discussed in four of these manuscripts, and multiple-day chemotherapy treatment in 15. Some manuscripts covered both topics. Additionally, a search for breakthrough nausea and vomiting resulted in 12 “hits.” No new relevant studies were identified.
Conclusions: The recommendations for patients receiving high-dose chemotherapy with stem cell transplants and patients undergoing multiple-day cisplatin were updated. For patients receiving high-dose chemotherapy for stem cell transplant, a combination of a 5-HT3 receptor antagonist with dexamethasone and aprepitant is recommended. Olanzapine could be considered part of the antiemetic regimen. Patients receiving multiple-day cisplatin should receive a 5-HT3 receptor antagonist plus dexamethasone plus aprepitant plus olanzapine. For patients experiencing breakthrough nausea and vomiting, the available evidence suggests using a single dose of olanzapine daily for 3 days.
Contents of the original publication
The section headings of the original.
- Introduction
- Methods
- Results
- High-dose chemotherapy
- Recommendation for high-dose chemotherapy and stem cell transplantation
- Multiple-day chemotherapy
- Recommendation for multiple-day cisplatin chemotherapy
- Breakthrough nausea and vomiting
- Treatment of Breakthrough CINV
- Recommendation for Breakthrough CINV
- Conclusions
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