2016 Updated MASCC/ESMO consensus recommendations

Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents

Karin Jordan, Alexandre Chan, Richard J. Gralla, Franziska Jahn, Bernardo Rapoport, David Warr, Paul J. Hesketh

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: Employing the same framework as in previous guideline updates, antineoplastic agents were classified into four emetic risk categories. The classification of the emetogenic level of new antineoplastic agents, especially for the oral drugs, represents an increasing challenge. Accurate reporting of emetogenicity of new antineoplastic agents in the absence of preventive antiemetic treatment is rarely available. Methods: A systematic search was conducted for drugs approved after 2009 until June 2015 using EMBASE and PubMed. The search term was “drug name.” The restrictions were language (English records only), date (2009 to 2015), and level of evidence (“clinical trial”). Results: From January 2009 to June 2015, 42 new antineoplastic agents were identified and a systematic search was conducted to identify relevant studies to help define emetic risk levels. The reported incidence of vomiting varied across studies for many agents, but there was adequate evidence to allow 41 of the 42 new antineoplastic agents to be classified according to emetogenic risk. No highly emetogenic agents were identified. Seven moderately emetogenic agents, 26 low emetogenic, agents and eight minimal emetogenic agents were identified and classified accordingly. The MASCC/ESMO update committee also recommended reclassification of the combination of an anthracycline and cyclophosphamide (AC) as highly emetogenic. Conclusion: Despite several limitations, we have attempted to provide a reasonable approximation of the emetic risk associated with new antineoplastic agents through a comprehensive search of the available literature. Hopefully by the next update, more precise information on emetic risk will have been collected during new agent development process.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalSupportive Care in Cancer
DOIs
StateAccepted/In press - Aug 8 2016

Fingerprint

Emetics
Antineoplastic Agents
Consensus
Pharmaceutical Preparations
Antiemetics
Anthracyclines
PubMed
Cyclophosphamide
Names
Vomiting
Language
Clinical Trials
Guidelines
Incidence

Keywords

  • Antineoplastic agents
  • Emetogenicity
  • Nausea
  • Risk classification
  • Vomiting

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology

Cite this

2016 Updated MASCC/ESMO consensus recommendations : Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents. / Jordan, Karin; Chan, Alexandre; Gralla, Richard J.; Jahn, Franziska; Rapoport, Bernardo; Warr, David; Hesketh, Paul J.

In: Supportive Care in Cancer, 08.08.2016, p. 1-5.

Research output: Contribution to journalArticle

Jordan, Karin ; Chan, Alexandre ; Gralla, Richard J. ; Jahn, Franziska ; Rapoport, Bernardo ; Warr, David ; Hesketh, Paul J. / 2016 Updated MASCC/ESMO consensus recommendations : Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents. In: Supportive Care in Cancer. 2016 ; pp. 1-5.
@article{46642ac127364247b60e1540c8f554aa,
title = "2016 Updated MASCC/ESMO consensus recommendations: Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents",
abstract = "Purpose: Employing the same framework as in previous guideline updates, antineoplastic agents were classified into four emetic risk categories. The classification of the emetogenic level of new antineoplastic agents, especially for the oral drugs, represents an increasing challenge. Accurate reporting of emetogenicity of new antineoplastic agents in the absence of preventive antiemetic treatment is rarely available. Methods: A systematic search was conducted for drugs approved after 2009 until June 2015 using EMBASE and PubMed. The search term was “drug name.” The restrictions were language (English records only), date (2009 to 2015), and level of evidence (“clinical trial”). Results: From January 2009 to June 2015, 42 new antineoplastic agents were identified and a systematic search was conducted to identify relevant studies to help define emetic risk levels. The reported incidence of vomiting varied across studies for many agents, but there was adequate evidence to allow 41 of the 42 new antineoplastic agents to be classified according to emetogenic risk. No highly emetogenic agents were identified. Seven moderately emetogenic agents, 26 low emetogenic, agents and eight minimal emetogenic agents were identified and classified accordingly. The MASCC/ESMO update committee also recommended reclassification of the combination of an anthracycline and cyclophosphamide (AC) as highly emetogenic. Conclusion: Despite several limitations, we have attempted to provide a reasonable approximation of the emetic risk associated with new antineoplastic agents through a comprehensive search of the available literature. Hopefully by the next update, more precise information on emetic risk will have been collected during new agent development process.",
keywords = "Antineoplastic agents, Emetogenicity, Nausea, Risk classification, Vomiting",
author = "Karin Jordan and Alexandre Chan and Gralla, {Richard J.} and Franziska Jahn and Bernardo Rapoport and David Warr and Hesketh, {Paul J.}",
year = "2016",
month = "8",
day = "8",
doi = "10.1007/s00520-016-3332-x",
language = "English (US)",
pages = "1--5",
journal = "Supportive Care in Cancer",
issn = "0941-4355",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - 2016 Updated MASCC/ESMO consensus recommendations

T2 - Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents

AU - Jordan, Karin

AU - Chan, Alexandre

AU - Gralla, Richard J.

AU - Jahn, Franziska

AU - Rapoport, Bernardo

AU - Warr, David

AU - Hesketh, Paul J.

PY - 2016/8/8

Y1 - 2016/8/8

N2 - Purpose: Employing the same framework as in previous guideline updates, antineoplastic agents were classified into four emetic risk categories. The classification of the emetogenic level of new antineoplastic agents, especially for the oral drugs, represents an increasing challenge. Accurate reporting of emetogenicity of new antineoplastic agents in the absence of preventive antiemetic treatment is rarely available. Methods: A systematic search was conducted for drugs approved after 2009 until June 2015 using EMBASE and PubMed. The search term was “drug name.” The restrictions were language (English records only), date (2009 to 2015), and level of evidence (“clinical trial”). Results: From January 2009 to June 2015, 42 new antineoplastic agents were identified and a systematic search was conducted to identify relevant studies to help define emetic risk levels. The reported incidence of vomiting varied across studies for many agents, but there was adequate evidence to allow 41 of the 42 new antineoplastic agents to be classified according to emetogenic risk. No highly emetogenic agents were identified. Seven moderately emetogenic agents, 26 low emetogenic, agents and eight minimal emetogenic agents were identified and classified accordingly. The MASCC/ESMO update committee also recommended reclassification of the combination of an anthracycline and cyclophosphamide (AC) as highly emetogenic. Conclusion: Despite several limitations, we have attempted to provide a reasonable approximation of the emetic risk associated with new antineoplastic agents through a comprehensive search of the available literature. Hopefully by the next update, more precise information on emetic risk will have been collected during new agent development process.

AB - Purpose: Employing the same framework as in previous guideline updates, antineoplastic agents were classified into four emetic risk categories. The classification of the emetogenic level of new antineoplastic agents, especially for the oral drugs, represents an increasing challenge. Accurate reporting of emetogenicity of new antineoplastic agents in the absence of preventive antiemetic treatment is rarely available. Methods: A systematic search was conducted for drugs approved after 2009 until June 2015 using EMBASE and PubMed. The search term was “drug name.” The restrictions were language (English records only), date (2009 to 2015), and level of evidence (“clinical trial”). Results: From January 2009 to June 2015, 42 new antineoplastic agents were identified and a systematic search was conducted to identify relevant studies to help define emetic risk levels. The reported incidence of vomiting varied across studies for many agents, but there was adequate evidence to allow 41 of the 42 new antineoplastic agents to be classified according to emetogenic risk. No highly emetogenic agents were identified. Seven moderately emetogenic agents, 26 low emetogenic, agents and eight minimal emetogenic agents were identified and classified accordingly. The MASCC/ESMO update committee also recommended reclassification of the combination of an anthracycline and cyclophosphamide (AC) as highly emetogenic. Conclusion: Despite several limitations, we have attempted to provide a reasonable approximation of the emetic risk associated with new antineoplastic agents through a comprehensive search of the available literature. Hopefully by the next update, more precise information on emetic risk will have been collected during new agent development process.

KW - Antineoplastic agents

KW - Emetogenicity

KW - Nausea

KW - Risk classification

KW - Vomiting

UR - http://www.scopus.com/inward/record.url?scp=84981274490&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84981274490&partnerID=8YFLogxK

U2 - 10.1007/s00520-016-3332-x

DO - 10.1007/s00520-016-3332-x

M3 - Article

SP - 1

EP - 5

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

ER -