Prevention of Nausea and Vomiting in Cancer Patients

Development of this book was supported by funding from Helsinn

Prevention of Nausea and Vomiting in Cancer Patients Matti Aapro Multidisciplinary Oncology Institute Clinique de Genolier Genolier Vaud, Switzerland Karin Jordan Clinic for Internal Medicine Department of Oncology/ Hematology Martin Luther University Hospital Halle-Wittenberg Halle, Germany Petra Feyer Department of Radio-oncology and Nuclear Medicine Vivantes Clinics Berlin-Neukölln Berlin, Germany

Published by Springer Healthcare Ltd, 236 Gray’s Inn Road, London, WC1X 8HB, UK. www.springerhealthcare.com © 2013 Springer Healthcare, a part of Springer Science+Business Media. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the copyright holder. British Library Cataloguing-in-Publication Data. A catalogue record for this book is available from the British Library. ISBN 978-1-908517-87-6 Although every effort has been made to ensure that drug doses and other information are presented accurately in this publication, the ultimate responsibility rests with the prescribing physician. Neither the publisher nor the authors can be held responsible for errors or for any consequences arising from the use of the information contained herein. Any product mentioned in this publication should be used in accordance with the prescribing information prepared by the manufacturers. No claims or endorsements are made for any drug or compound at present under clinical investigation. Project editor: Alla Zarifyan Designer: Joe Harvey Artworker: Sissan Mollerfors Production: Marina Maher

Contents Author biographies

vii

1 Introduction1 Antiemetic agents

1

History of antiemetic therapy 

2

References3

2 Pathophysiology and classification of chemotherapyinduced nausea and vomiting

5

Historical background

5

Mechanisms of chemotheraphy-induced nausea and vomiting

6

Neurotransmitters8 Classification of nausea and vomiting

13

References14

3 Risk factors associated with nausea and vomiting after chemotherapy15 Emetogenic potential of chemotherapy

15

Patient risk factors

17

References19

4 Risk factors associated with nausea and vomiting a fter radiotherapy Classification of radiotherapy-induced nausea and vomiting

21 21

References22

5 Antiemetic drugs Serotonin receptor antagonists 

23 23

Steroids 

27

Neurokinin-1 receptor antagonists

28

Dopamine receptor antagonists

29 v

vi • con t en t s

Olanzapine30 Cannabinoids31 Benzodiazepines 

31

Antihistamines 

31

Herbs as antiemetics

32

References32

6 Antiemetic prophylaxis of chemotherapy-induced nausea and vomiting  37 Prevention of acute nausea and emesis (within the first 24 hours of chemotherapy treatment)

39

Prevention of delayed nausea and emesis (days 2–5 after chemotherapy)

39

Therapy against anticipatory nausea and vomiting

40

Therapy in cases of insufficient antiemetic efficacy

41

Multiday chemotherapy

42

High-dose chemotherapy

42

References42

7 Antiemetic prophylaxis of radiotherapy-induced nausea and vomiting 45 Antiemetics and their efficacy for radiotherapy-induced nausea and vomiting 46 Guideline-based prophylaxis and treatment of radiotherapy-induced nausea and vomiting

50

References52

8 Summary of the approach to treatment of chemotherapyinduced nausea and vomiting 55 References57

9 Conclusions and future directions

59

Author biographies Matti Aapro, MD received his medical degree from the Faculty of Medicine, University of Geneva, Switzerland. He was subsequently a fellow at the Arizona Cancer Center in Tucson, USA, and later was the founding chair of the Medical and Radiation Therapy Department at the European Institute of Oncology in Milan, Italy. He is presently the dean of the Multidisciplinary Oncology Institute, Genolier, Switzerland. Dr Aapro serves as Executive Director of the International Society for Geriatric Oncology. He was a member of the Board of the European Organization for Research and Treatment of Cancer. Dr Aapro is a board member and a past-president of the Multinational Association for Supportive Care in Cancer (MASCC). Dr Aapro chaired the scientific and organizing committees of the International Union Against Cancer (UICC) World Cancer Congress (WCC) of 2008 and continues to serve UICC for the WCC in China in 2010. He is a member of the European Cancer Organisation/European Society of Medical Oncology (ECCO/ESMO) 2011 Scientific Committee. He coordinates the Sharing Progress in Cancer Care program of the European School of Oncology. Dr Aapro is the editor-in-chief of Critical Reviews in Oncology/Hematology, as well as the associate editor of Annals of Oncology, the associate editor for the geriatric section of The Oncologist and member of the editorial board of Journal of Clinical Oncology (breast section). He has authored more than 300 publications and his major interests are new drug development, breast cancer, cancer in the elderly, and supportive care. Karin Jordan, MD, PhD graduated from Martin Luther University of Halle-Wittenberg, Germany, after internships in the bone-marrow transplantation program at the University of California, San Diego, USA, and in general surgery at the University of Newcastle, UK. Following a number of posts at the University Hospital, Halle, and Bernward Hospital, Hildesheim, Germany, she was appointed as a specialist in internal vii

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medicine in 2007 and is now an associate professor of Medical Oncology and Supportive Care in the Department of Oncology/Haematology, University Hospital, Halle. She has been the vice executive director of the ethics committee at the University of Halle since 2009. Dr Jordan has served as a board member of the ESMO Consensus Panel 2008 on the treatment of testicular cancer, the Multinational Association of Supportive Care in Cancer MASCC/ESMO Antiemetic Guideline Consensus Panel 2009 in Perugia, Italy, and the German Cancer Society Consensus Panel on paravasation induced by cytotoxic agents. She holds the cochair of Supportive Care within the German Society of Medical Oncology and is the associate chair of the German Association of Supportive Care in Oncology, Rehabilitation and Social Medicine. She is a member of a number of national and international hematology and oncology societies. Dr Jordan has authored and coauthored more than 70 articles in national and international journals. Her principal area of interest is supportive care with a special focus on antiemetic treatment of chemotherapy-induced nausea and vomiting and side effects of new drugs. Further major interests are sarcoma and testicular cancer. Petra Feyer, MD, PhD studied medicine at the Universities of Sofia, Bulgaria and Leipzig, Germany. At the University of Leipzig she undertook a residency in the Department of Radiology before becoming consultant and then senior consultant in the Department of Radio-oncology. As well as undertaking fellowships at the Royal Marsden Hospital in London and Surrey and at the Western Infirmary, Glasgow, UK, she trained at the German Cancer Research Institute in Heidelberg. In 1994 she became an assistant professor at the Charité University Hospital in Berlin. She moved in 1999 to the University of Cologne, where she became the professor of Radiation Oncology. Since 2000 she has also been the director of the Clinic of Radiotherapy, Radio-oncology, and Nuclear Medicine at the Vivantes Clinics, Neukölln, Berlin and the professor of Radiation Oncology at the Charité University Medicine Berlin. Dr Feyer has served as a board member of the MASCC and was its secretary from 2006 to 2008. She is a faculty member of the ESMO, the

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president of the German Association of Supportive Care in Oncology, Rehabilitation and Social Medicine, the vice president of the Cancer Society of Berlin, and is a member of a number of national and international hematology and oncology societies. Dr Feyer has authored and coauthored more than 150 articles in national and international journals and books. Her principal areas of clinical interest are quality of life and supportive care in cancer patients, especially minimising side effects of radio and chemotherapy, optimising multimodal treatment strategies in oncology and palliative radio-oncological treatment modalities.