The treatment landscape for chemotherapy-induced nausea and vomiting (CINV) will likely include the increased use of newer agents, such as rolapitant, as well as the use of olanzapine (an oral antipsychotic) for breakthrough and refractory nausea, states Eric Roeland, MD. In addition, new indications will be explored, such as the use of antiemetics in multi-day chemotherapy regimens, particularly with hematologic malignancies. The guidelines do not offer clear direction on how to appropriately prevent CINV in these patients, he adds.
Patient risk factors likely will increasingly be considered. Certain subgroups of patients are at an increased likelihood of experiencing CINV and may benefit from additional upfront therapies, explains Roeland. Another area of interest, he notes, is exploring whether subcutaneous administration offers advantages compared with the intravenous route.
There are a number of clinical trials exploring the use of olanzapine for the prevention of CINV, states Charles L. Loprinzi, MD. Data have shown that the use of olanzapine substantially reduces nausea, he adds.