Update on antiemetics of chemotherapy

During the past 20 years, nausea and vomiting of the patients who received chemotherapy has been controlled successfully. It is based on many clinical and basic research. The goal of new anti-emetic therapy is to prevent nausea and vomiting completely. Food and drug administration (FDA) has approved aprepitant (neurokinin-1 NK1 receptor antagonist) on March 2003 for prevention of acute and delayed chemotherapy induced nausea and vomiting (CINV) when highly emetogeneic agents are given. The American Society of Clinical Oncology (ASCO) and the Multinational Association of Supportive Care in Cancer (MASCC) have updated guideline recently. The three-drug combination of a 5-hydroxytryptamine-3 (5-HT3) serotonin receptor antagonist, dexamethasone, and aprepitant is recommended for prevention of acute emesis, and it has better response than traditional use of two drug combination. Besides, the 5-HT3 serotonin receptor antagonist is instituted by the two-drug combination of dexamethasone and aprepitant when we choose them for the prevention of delayed emesis of chemotherapy. Not all relevant questions regarding emesis in cancer have been resolved. More research for the prevention of emesis and the development of new agents with better antiemetic effects are encouraged.