engleski

Novelties in antiemetic supportive therapy

Nausea and vomiting caused by antitumor drugs and procedures are the most commonly undesirable consequences of oncological treatment for the patients. Uncontrolled nausea and vomiting, undoubtedly are reducing the quality of life of a patient, also they could lead to the appearance of various complications such as dehydration, electrolyte imbalance, aspiration pneumonia, esophageal rupture, anorexia, malnutrition and worsening of the general condition. Clearly, all of these also significantly affects the patient’s compliance with the planned oncology therapy, leading to a possible, probable reduction in its effectiveness. It is estimated that 60-80% of patients treated with chemotherapy are suffering from nausea and vomiting to a certain extent, whereas in patients treated with high doses of cisplatin this percentage is as high as 90%. Therefore, the patient’s individual risk and emetogenic potential therapy should be determined before the therapy begins and on the basis of these two facts, the strategy for the prevention of acute and delayed nausea and vomiting. The use of prophylaxis according to the recommendations in the guidelines so far allows for the majority of (> 90%) patients receiving high emetogenic chemotherapy to successfully prevent nausea and vomiting and thus provide a civilized, quality oncological therapy in the planned form, which results in optimal treatment results. Despite the fact that guidelines for the prevention and treatment of nausea and vomiting induced by chemotherapy are widely available and based on evidence that well-conducted prophylaxis eff ectively improves control of nausea and vomiting in patients, the clinical use of the guidelines remains unacceptably low. Today’s gold standard for the prevention of high and medium emetogenic oncological therapies rests on a combination of selective inhibitors of P / neurokinin 1 (NK1) and 5-HT3 receptor inhibitors. The oral composition of the combination of said drugs, netupitant and palonosetron is an optimal formulation from the point of view of the medicine (single oral dosage), efficacy (potentially more effective than a combination of separate medications), and pharmacoeconomic aspects (the price is signifi cantly lower than the price of drugs currently on the HZZO Medicines List in said indication). The results of the clinical trials gave a clear confi rmation that the oral administration of the netupitant / palonosetron in combination with dexamethasone effectively prevents acute and delayed nausea and vomiting associated with high and moderate emetogenic chemotherapy. The safety profile of the fixed combination of the netupitant / palonosetron drug is favorable and is no different than expected for this drug group, and the frequency of side effects is rare and they are mostly of a mild nature.

antiemetic supportive therapy ; oncological treatment

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