© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
Some chemotherapy is more likely to cause nausea and vomiting than other chemotherapy. The table (Table 1) below lists the likelihood that a certain intravenous (IV; given in a vein) chemotherapy will cause nausea and vomiting.
Table 1. The Risk of Nausea and Vomiting From Intravenous Chemotherapy
|
Nearly Always Causes Nausea and Vomiting |
Usually Causes Nausea and Vomiting |
Sometimes Causes Nausea and Vomiting |
Rarely Causes Nausea and Vomiting |
| Carmustine (Becenum, BiCNU, Carmubris) | Azacitadine (Mylosar, Vidaza) | Bortezomib (Velcade) | Bevacizumab (Avastin) |
| Cisplatin (Platinol) | Alemtuzumab (Campath) | Cabazitaxel (Jevtana) | Bleomycin (Blenoxane) |
| Cyclophosphamide (Cytoxan, Clafen, Neosar) at higher doses | Bendamustine (Treanda) | Catumaxumab (Removab) | Busulfan (Busulfex, Mitosan, Myleran) |
| Dacarbazine (DTIC-Dome) | Carboplatin (Paraplat, Paraplatin) | Cytarabine at lower doses | Cetuximab (Erbitux) |
| Dactinomycin (Cosmegen, Lyovac Cosmegen) | Clofarabine (Clofarex, Clolar) | Docetaxel (Taxotere) | 2-Chlorodeoxyadenosine (cladribine, Leustatin) |
| Daunorubicin (Cerubidine, Rubidomycin) when combined with cyclophosphamide | Cyclophosphamide at lower doses | Doxorubicin HCL liposome injection (Doxil, Dox-SL, Evacet, LipoDox) | Fludarabine (Fludara) |
| Doxorubicin (Adriamycin) when combined with cyclophosphamide | Cytarabine (Cytosar-U, Tarabine PFS) at higher doses | Etoposide (Etopophus, Toposar, VePesid) | Pralatrexate (Folotyn) |
| Epirubicin (Ellence) when combined with cyclophosphamide | Daunorubicin | Fluorouracil (5-FU, Adrucil, Efudex, Fluoroplex) | Rituximab (Rituxan) |
| Idarubicin (Idamycin) when combined with cyclophosphamide | Doxorubicin | Gemcitabine (Gemzar) | Vinblastine (Velban, Velsar) |
| Mechlorethamine (Mustargen) | Epirubicin | Ixabepilone (Ixempra) | Vincristine (Vincasar PFS, Oncovin) |
| Streptozotocin (Zanosar) | Idarubicin | Methotrexate (multiple brand names) | Vinorelbine (Navelbine, Alocrest) |
| Ifosfamide (Cyfos, Ifex, Ifosfamidum) | Mitomycin (Mitozytrex, Mutamycin) | ||
| Irinotecan (Camptosar) | Mitoxantrone (Novantrone) | ||
| Oxaliplatin (Eloxatin) | Paclitaxel (Taxol, Abraxane) | ||
| Panitumumab (Vectibix) | |||
| Pemetrexed (Alimta) | |||
| Temsirolimus (Torisel) | |||
| Topotecan (Hycamtin, Brakiva) | |||
| Trastuzumab (Herceptin) |
The recommended treatments for preventing nausea and vomiting are listed in Table 2.
Table 2. Recommendations for Preventing Vomiting Caused by Chemotherapy
|
Likelihood of Chemotherapy to Cause Nausea and Vomiting |
Nearly Always Causes Nausea and Vomiting (High Risk) |
Usually Causes Nausea and Vomiting (Moderate Risk) |
Sometimes Causes Nausea and Vomiting (Low Risk) |
Rarely Causes Nausea and Vomiting (Minimal Risk) |
| Recommended Treatment |
A three-drug combination of the following: 1. Aprepitant (Emend) on days 2 and 3 or fosaprepitant on day 1 2. Dolasetron (Anzemet; oral [by mouth] form only), granisetron (Kytril, Sancuso), ondansetron (Zofran), palonosetron (Aloxi), tropisetron (Navoban), or ramosetron (Nasea) 3. Dexamethasone (multiple brand names) on days 2 through 4 |
A two-drug combination of the following: 1. Palonosetron (this is the preferred treatment, but granisetron or ondansetron may also be used) 2.Dexamethasone on days 2 and 3 |
Dexamethasone | No treatment required unless the patient has previously experienced vomiting with this treatment. |