New treatments on the horizon for chemoradiotherapy-induced nausea and vomiting

Abstract

Antiemetic prophylaxis for patients receiving concomitant chemoradiotherapy has, for many years, been an orphan research area. The distinction between acute and delayed nausea and vomiting does not apply to fractionated radiotherapy, and prophylaxis should be considered to cover the entire course of treatment and not only the acute and delayed chemotherapy-induced nausea and vomiting. The best prophylaxis in women receiving fractionated radiotherapy and concomitant weekly cisplatin is a combination of the neurokinin receptor antagonist fosaprepitant with palonosetron and dexamethasone. Even with this three-drug combination nausea is a significant problem and the effect of multi-receptor targeting antiemetics such as olanzapine and amisulpride should be explored in this setting.

Harnessing the power of traditional Chinese medicine monomers and compound prescriptions to boost cancer immunotherapy

“…Chinese herbal therapy typically takes advantage of natural substances that are less toxic and have fewer side effects compared to chemoradiotherapy drugs ( 11 ). Chemoradiotherapy can cause side effects such as nausea, vomiting, hair loss, and fatigue, whereas Chinese herbal therapy is generally well-tolerated and can improve quality of life ( 12 , 13 ). Chinese herbal therapy is tailored to the individual patient’s needs and can be adjusted based on their response to treatment.…”

“…Chemoradiotherapy can weaken the immune system, making the patient more vulnerable to infections and other complications ( 14 , 15 ). Overall, while there is still much to learn about the potential of TCM for the treatment of tumor, research to date suggests that it may have a role to play in improving outcomes for cancer patients ( 12 , 15 ).…”

Antiemetic prophylaxis for chemoradiotherapy-induced nausea and vomiting in locally advanced head and neck squamous cell carcinoma: a prospective phase II trial

“…A cross-sectional study demonstrated that one third of patients experiencing RINV would like additional treatment [ 5 ]. Nevertheless, evidence for the guideline recommendations is scarce, and little is known about the combination and optimal duration of antiemetic agents [ 6 ]. In the chemoradiotherapy setting, RINV can be exacerbated by concomitant chemotherapy to higher levels, which has been confirmed by prior studies, though the pathophysiological mechanism is not well understood [ 7 – 9 ].…”