Tuesday, 11 April 2017

2016 Updated MASCC/ESMO consensus recommendations: Management of nausea and vomiting in advanced cancer

Supportive Care in Cancer, 2017, 25(1) 333-340
Walsh D.; Davis M.; Ripamonti C.; Bruera E.; Davies A.; Molassiotis A.

The aim of this paper was to develop a set of evidence-based guidelines for the management of different syndromes related to nausea and vomiting in advanced cancer.  The authors found that the level of evidence in most studies is low, but conclude that the drug of choice is metoclopramide, with alternative options including haloperidol, levomepromazine, or olanzapine. For bowel obstruction, the recommendation is to use octreotide given alongside an antiemetic (haloperidol) and where octreotide is not an option to use an anticholinergic antisecretory agent. For opioid-induced nausea and vomiting, no recommendation could be made. 

Fulltext available in  Supportive Care in Cancer