Chemotherapy-induced nausea and vomiting in an oncologist's practice. How can nausea and vomiting be prevented? Review article
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Published:
Jul 30, 2025
Keywords:
adverse events, chemotherapy-induced nausea and vomiting, CINV
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Abstract
Chemotherapy-induced nausea and vomiting (CINV) affects 70–80% of patients and significantly reduces quality of life and complicates treatment. Prevention is more effective than treatment – once symptoms develop, they are more difficult to control and can cause anticipatory nausea. The most important drug classes used for prophylaxis are: 5-HT3-RA s (e.g., ondansetron, palonosetron), NK1-RA s (aprepitant, netupitant), dexamethasone, and olanzapine. Modern regimens (e.g., NEPA, palonosetron) are more effective in preventing delayed and long-term CINV.
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1.
Jagiełło-Gruszfeld A. Chemotherapy-induced nausea and vomiting in an oncologist’s practice. How can nausea and vomiting be prevented?. OncoReview [Internet]. 2025Jul.30 [cited 2026Jun.10];15(2(58):36-0. Available from: https://www.journalsmededu.pl/index.php/OncoReview/article/view/3452
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PERSONALIZED ONCOLOGY
Copyright: ? Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
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16. Celio L, Bonizzoni E, Zattarin E et al. Impact of dexamethasone-sparing regimens on delayed nausea caused by moderately or highly emetogenic chemotherapy: a meta-analysis of randomised evidence. BMC Cancer. 2019; 19: 1268. https://doi.org/10.1186/s12885-019-6454-y.
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3. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN Guidelines®). Antiemesis.
4. Herrstedt J, Clark-Snow R, Ruhlmann CH et al. 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. ESMO Open. 2024; 9(2): 102195. http://doi.org/10.1016/j.esmoop.2023.102195.
5. Herrstedt J, Celio L, Hesketh P et al. 2023 updated MASCC /ESMO consensus recommendations: prevention of nausea and vomiting following high-emetic-risk antineoplastic agents. Support Care Cancer. 2024; 32: 47. https://doi.org/10.1007/s00520-023-08221-4.
6. bbLavanya D, Prasanna V, Firdous A et al. A systemic review on chemotherapy induced nausea and vomiting- risk and clinical management with alternative therapies. Cancer Treat Res Commun. 2025; 44: 100938. http://doi.org/10.1016/j.ctarc.2025.100938.
7. Pan H, Yurong H, Bifang H. Application of buried beans at auricular points in gastrointestinal reactions in patients undergoing cancer chemotherapy. J Tradit Chin Med. 2014; 42(2): 114-5.
8. Jordan K, de Azambuja E, García Del Barrio MÁ et al. Going beyond the 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. Eur J Cancer. 2025; 222: 115451. http://doi.org/10.1016/j.ejca.2025.115451.
9. Navari RM, Tyler T, Inui N et al. Individual patient data meta-analysis of NEPA versus aprepitant-based antiemetic regimens for preventing chemotherapy- induced nausea and vomiting. Future Oncol. 2025; 21(21): 2823-33. http://doi.org/10.1080/14796694.2025.2542108.
10. Nguyen TD, Bordeau BM, Balthasar JP. Mechanisms of ADC toxicity and strategies to increase ADC tolerability. Cancers (Basel). 2023; 15(3): 713. http://doi.org/10.3390/cancers15030713.
11. Farhat J, Sakai H, Tsurutani J. Management of nausea and vomiting induced by antibody–drug conjugates. Breast Cancer. 2025; 8(2): 278-85. http://doi.org/10.1007/s12282-025-01670-1.
12. Park YH, Bianchini G, Cortés J et al. Nausea and vomiting in an evolving anticancer treatment landscape: long-delayed and emetogenic antibod-drug conjugates. Future Oncol. 2025; 21(10): 1261-72. http://doi.org/10.1080/14796694.2025.2479417.
13. Chow R, Yin LB, Baqri W et al. Prevalence and predictors of long-delayed (> 120 h) chemotherapy-induced nausea and vomiting(CINV) – a systematic review and individual patient data meta-analysis. Support Care Cancer. 2023; 31(8): 505. http://doi.org/ 10.1007/s00520-023-07978-y.
14. Zelek L, Navari R, Aapro M et al. Single-dose NEPA versus an aprepitant regimen for prevention of chemotherapy-induced nausea and vomiting in patients receiving moderately emetogenic chemotherapy. Cancer Med. 2023; 12(15): 15769-76. http://doi.org/10.1002/cam4.6121.
15. Radhakrishnan V, Venkatakrishnan K, Perumal Kalaiyarasi J et al. Dexamethasone-free antiemetic prophylaxis for highly emetogenicchemotherapy: a double-blind, phase III randomized controlled trial (CINV POD study). JCO Glob Oncol. 2024; 10: e2300301. https://doi.org/10.1200/GO.23.00301.
16. Celio L, Bonizzoni E, Zattarin E et al. Impact of dexamethasone-sparing regimens on delayed nausea caused by moderately or highly emetogenic chemotherapy: a meta-analysis of randomised evidence. BMC Cancer. 2019; 19: 1268. https://doi.org/10.1186/s12885-019-6454-y.
17. Ottaiano A, Santorsola M, Capuozzo M et al. Balancing immunotherapy and corticosteroids in cancer treatment: dilemma or paradox? Oncologist. 2025; 30(3): oyaf045. http://doi.org/10.1093/oncolo/oyaf045.