Patients experiencing delayed CINV may suffer in silence1,2
More than half of patients undergoing emetogenic chemotherapy experience delayed chemotherapy-induced nausea and vomiting (CINV), despite 97% receiving a 5-hydroxytryptamine-3 (serotonin) receptor antagonist (5-HT3 RA) and 78% receiving a corticosteroid.1
Oncologists and nurses commonly underestimate the incidence of delayed CINV1
- Delayed CINV symptoms occur outside the clinic and often go unreported1-3
- Patients have ranked nausea and vomiting associated with chemotherapy among the worst possible health states4
- Despite significant improvements in managing the condition and the availability of a range of antiemetics, there remains a clear unmet need to reduce the incidence of delayed CINV2
Factors that increase CINV risk5,6
a A standard drink is 1.5 ounces (oz) of 80-proof spirits (hard liquor), 12 oz of beer, or 5 oz of wine.
5-HT3, 5-hydroxytryptamine-3 (serotonin); GI, gastrointestinal; NK-1, neurokinin 1.
Use of combination therapeutics provides greater efficacy and prevention of delayed CINV symptoms5
- Combination antiemetic therapy is considered more effective than single-agent antiemetic therapy due to the various neuronal pathways targeted by different agents and differentiation in efficacy for distinct phases of CINV5,9
- As a common pathway has not been identified, a single agent cannot be expected to provide protection from the different phases of CINV5
- Emetogenic chemotherapy triggers receptors in both the peripheral and central nervous systems5,8,10
- Following chemotherapy administration, the delayed phase of CINV (25-120 h) is driven by the release of the neurotransmitter
- Substance P is highly concentrated in the emetic centers of the brain and binds to the NK-1 receptor, stimulating induction of vomiting pathways10,11