ASCO Updates Guidelines on Medicines to Control Nausea and Vomiting

Save as Favorite
Sign in to receive recommendations (Learn more)

The American Society of Clinical Oncology (ASCO) has updated its guidelines on medicines to control nausea and vomiting in people being treated for cancer.

The update was published online on July 31, 2017 by the Journal of Clinical Oncology. Read the abstract of “Antiemetics: American Society of Clinical Oncology Clinical Practice Guideline Update.”

ASCO is a national organization of oncologists and other cancer care providers. ASCO guidelines give doctors recommendations for treatments and testing that are supported by much credible research and experience.

An emetic is a medicine or other substance that causes vomiting, so doctors call medicines that manage nausea and vomiting antiemetics.

Nausea and vomiting are common side effects of many breast cancer treatments, including chemotherapy, radiation therapy, hormonal therapy, and targeted therapy medicines.

The updated guidelines include recommendations on new antiemetic medicines.

To create the update, a panel of experts reviewed 41 studies that were published from November 2009 to June 2016.

The update says:

  • Adults treated with Platinol (chemical name: cisplatin) and other anticancer medicines with a high risk of causing nausea and vomiting should be offered a combination of four medicines:
    • a neurokinin 1 receptor antagonist; Emend (chemical name: aprepitant) is one example
    • a serotonin (5-HT3) receptor antagonist; Zofran (chemical name: ondansetron) is one example
    • Decadron (chemical name: dexamethasone)
    • Zyprexa (chemical name: olanzapine)
  • Adults treated with an anthracycline combined with Cytoxan (chemical name: cyclophosphamide) should be offered a combination of four medicines:
    • a neurokinin 1 receptor antagonist; Emend is one example
    • a serotonin (5-HT3) receptor antagonist; Zofran is one example
    • Decadron
    • Zyprexa
  • Adriamycin (chemical name: doxorubicin), daunorubicin, mitoxantrone, Ellence (chemical name: epirubicin), and Doxil (chemical name: doxorubicin) are anthracyclines.

  • Adults treated with carboplatin (brand name: Paraplatin) should be offered a combination of three medicines:
    • a neurokinin 1 receptor antagonist; Emend is one example
    • a serotonin (5-HT3) receptor antagonist; Zofran is one example
    • Decadron
  • Adults treated with anticancer medicines other than carboplatin with a moderate risk of causing nausea and vomiting should be offered a combination of two medicines:
    • a neurokinin 1 receptor antagonist; Emend is one example
    • Decadron
  • Adults treated with Cytoxan, Adriamycin, Doxil, Eloxatin (chemical name: oxaliplatin), and other anticancer medicines with a moderate risk of causing nausea and vomiting that are known to cause delayed nausea and vomiting may be offered Decadron.
  • Adults treated with anticancer medicines with a low risk of causing nausea and vomiting should be offered a single dose of Zofran or other serotonin (5-HT3) receptor antagonist or a single 8 mg dose of Decadron before anticancer treatment.
  • Ativan (chemical name: lorazepam) can offer benefits when given with antiemetic medicines, but shouldn’t be used by itself to control nausea and vomiting.
  • Adults treated with high-dose chemotherapy and stem cell or bone marrow transplant should be offered a combination of three medicines:
    • a neurokinin 1 receptor antagonist; Emend is one example
    • a serotonin (5-HT3) receptor antagonist; Zofran is one example
    • Decadron
  • Adults who have nausea or vomiting despite taking preventive medicines, but who have not taken Zyprexa, should be offered Zyprexa along with their current antiemetic medicines.
  • Adults who have nausea or vomiting despite taking preventive medicines and who have taken Zyprexa may be offered a different class of antiemetic medicine along with their current regimen.
  • Adults treated with radiation therapy with a high risk of causing nausea and vomiting should be offered a combination of two medicines:
    • a serotonin (5-HT3) receptor antagonist; Zofran is one example
    • Decadron

For more information, visit the Breastcancer.org pages on Nausea and Vomiting in our Treatment Side Effects section.


Was this article helpful? Yes / No


Springappeal17 miniad 1
Back to Top