3
Treatment
Low-Emetic-Risk Antineoplastic Agents
➤ Adult patients treated with low-emetic-risk antineoplastic agents
should be offered a single dose of a 5-HT
3
receptor antagonist or a
single 8-mg dose of dexamethasone before antineoplastic treatment
(Moderate Recommendation; IC-L).
Minimal Emetic Risk Antineoplastic Agents
➤ Adult patients treated with minimal emetic risk antineoplastic agents
should not be offered routine antiemetic prophylaxis (Moderate
Recommendation; IC-L).
Antineoplastic Combinations
➤ Adult patients treated with antineoplastic combinations should be
offered antiemetics appropriate for the component antineoplastic
agent of greatest emetic risk (Moderate Recommendation; IC-I).
Adjunctive Drugs
➤ Lorazepam is a useful adjunct to antiemetic drugs, but is
not recommended as a single-agent antiemetic (Moderate
Recommendation; IC-L).
Cannabinoids
➤ Evidence remains insufficient for a recommendation regarding
medical marijuana for the prevention of nausea and vomiting in
patients with cancer receiving chemotherapy or radiation therapy.
Evidence is also insufficient for a recommendation regarding the use
of medical marijuana in place of the tested and US Food and Drug
Administration-approved cannabinoids dronabinol and nabilone for
the treatment of nausea and vomiting caused by chemotherapy or
radiation therapy.
Complementary and Alternative Therapies
➤ Evidence remains insufficient for a recommendation for or against the
use of ginger, acupuncture/acupressure, and other complementary
or alternative therapies for the prevention of nausea and vomiting in
patients with cancer.
High-Dose Chemotherapy With Stem-Cell or Bone Marrow
Transplantation
➤ Adult patients treated with high-dose chemotherapy and stem-
cell or bone marrow transplantation should be offered a three-
drug combination of an NK
1
receptor antagonist, a 5-HT
3
receptor
antagonist, and dexamethasone (Strong Recommendation; EB-H).
