Practical insight into the current management of chemotherapy induce nausea and vomiting: An indian survey

Abstract

Nausea and vomiting are two of the most severe and distressing consequences of cytotoxic chemotherapies. The present survey was conducted to highlight current practice pattern, factors that contribute to failure and to determine current challenges and unmet need in the management of chemotherapy Induce Nausea and vomiting (CINV). The present study was a questionnaire based survey conducted among oncologist/ hematologist and consisted of sample of 16 questions. 328 oncologist were included in the analysismajority (57%) being medical oncologist. CINV leading to dose reduction, delay or discontinuation was seen in 28% of the practioners with more than 10% in their usual practice. Breakthrough nausea and vomiting was the most common type of CINV experienced by patient on chemotherapy. Controlling CINV in delayed phase was the greatest perceived challenge by 62% respondents. In both Highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC) setting, serotonin receptor antagonists (5HT3 RA) was the most preferred drug in both acute and delayed phase. NCCN was the most preferred guideline in 69% respondents. Ninty for percent of the respondent believed that there is a need for better drug in the management of CINV and the new drug should have superior efficacy, better control of delayed phase and single dose administration before chemotherapy. Survey highlights the need for better contorl of delayed phase of CINV and the need for drug with better efficacy in delayed phase with single dose administration.: The survey highlights unmet need and poor control in the management of delayed phase of nausea and vomiting. Also, majority of the oncologist felt the need for a new drug in the management of CINV.