2012 EDUCATIONAL BOOK - American Society of Clinical Oncology

INCIDENCE AND PREVALENCE OF CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING
subjective, it is also much more difficult to identify animal
models that reliably display nausea and that can be quantified
to a sufficient degree to screen new antinausea agents
before clinical testing. It is certainly true that nausea and
vomiting are correlated and that agents that are effective
against one of these phenomena are likely to have some
effect against the other. However, it must also be recognized
that neurotransmitter pathways that control vomiting and
nausea are probably not identical and that these differences
may provide guidance to develop new agents specifically
effective against chemotherapy-induced nausea. It is of
interest that several agents suggested to have significant
activity against chemotherapy-induced nausea (such as
corticosteroids, 15 megestrol acetate, 16 cannabinoids, 17 and
olanzapine 18 ) are not agents that have been highly effective
Author’s Disclosures of Potential Conflicts of Interest
Author
Employment or
Leadership
Positions
Consultant or
Advisory Role
Steven M. Grunberg A.P. Pharma;
Archimedes;
Helsinn; Merck;
Tesaro
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against chemotherapy-induced vomiting but rather agents
suggested to have activity against cancer anorexia and
cachexia. Perhaps the common ground between nausea and
anorexia will be more promising in leading to increased
understanding of this phenomenon than the common ground
between nausea and vomiting.
Although advances in antiemetic care have been based on
identification of relevant neurotransmitter/neurotransmitter
receptor pathways and on carefully conducted clinical
trials, 19 it is still necessary to understand the extent of the
problem and the nature of the problem before the problem
can be fully addressed. Issues of communication and reporting
as well as continued efforts to more accurately define
and address the specific problem of nausea will therefore be
critical to further advances in this field.
Stock
Ownership Honoraria
Merck Merck
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