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Antiemetics: ASCO guideline update

Purpose: To update the guideline to include new anticancer agents, antiemetics, and antiemetic regimens and to provide recommendations on the use of dexamethasone as a prophylactic antiemetic in patients receiving checkpoint inhibitors (CPIs). Methods: ASCO convened an Expert Panel and updated the s...

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Main Authors: Hesketh, Paul (Author) , Kris, Mark G. (Author) , Basch, Ethan (Author) , Bohlke, Kari (Author) , Barbour, Sally Y. (Author) , Clark-Snow, Rebecca Anne (Author) , Danso, Michael A. (Author) , Dennis, Kristopher (Author) , Dupuis, L. Lee (Author) , Dusetzina, Stacie B. (Author) , Eng, Cathy (Author) , Feyer, Petra C. (Author) , Jordan, Karin (Author) , Noonan, Kimberly (Author) , Sparacio, Dee (Author) , Lyman, Gary H. (Author)
Format: Article (Journal)
Language:English
Published: July 13, 2020
In: Journal of clinical oncology
Year: 2020, Volume: 38, Issue: 24, Pages: 2782-2797
ISSN:1527-7755
DOI:10.1200/JCO.20.01296
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1200/JCO.20.01296
Verlag, lizenzpflichtig, Volltext: https://ascopubs.org/doi/10.1200/JCO.20.01296
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Author Notes:Paul J. Hesketh, Mark G. Kris, Ethan Basch, Kari Bohlke, Sally Y. Barbour, Rebecca Anne Clark-Snow, Michael A. Danso, Kristopher Dennis, L. Lee Dupuis, Stacie B. Dusetzina, Cathy Eng, Petra C. Feyer, Karin Jordan, Kimberly Noonan, Dee Sparacio, and Gary H. Lyman
Description
Summary:Purpose: To update the guideline to include new anticancer agents, antiemetics, and antiemetic regimens and to provide recommendations on the use of dexamethasone as a prophylactic antiemetic in patients receiving checkpoint inhibitors (CPIs). Methods: ASCO convened an Expert Panel and updated the systematic review to include randomized controlled trials (RCTs) and meta-analyses of RCTs published between June 1, 2016, and January 24, 2020. To address the dexamethasone and CPI question, we conducted a systematic review of RCTs that evaluated the addition of a CPI to chemotherapy. Results: The systematic reviews included 3 publications from the updated search and 10 publications on CPIs. Two phase III trials in adult patients with non-small-cell lung cancers evaluating a platinum-based doublet with or without the programmed death 1 (PD-1) inhibitor pembrolizumab recommended that all patients receive dexamethasone as a component of the prophylactic antiemetic regimen. In both studies, superior outcomes were noted in the PD-1 inhibitor-containing arms. Other important findings address olanzapine in adults and fosaprepitant in pediatric patients. Recommendations: Recommendations for adults are unchanged with the exception of the option of adding olanzapine in the setting of hematopoietic stem cell transplantation. Dosing information now includes the option of a 5-mg dose of olanzapine in adults and intravenous formulations of aprepitant and netupitant-palonosetron. The option of fosaprepitant is added to pediatric recommendations. There is no clinical evidence to warrant omission of dexamethasone from guideline-compliant prophylactic antiemetic regimens when CPIs are administered to adults in combination with chemotherapy. CPIs administered alone or in combination with another CPI do not require the routine use of a prophylactic antiemetic. Additional information is available at www.asco.org/supportive-care-guidelines.
Item Description:Gesehen am 29.10.2020
Physical Description:Online Resource
ISSN:1527-7755
DOI:10.1200/JCO.20.01296

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