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MASCC Antiemetics Study Group

Leadership

Chair: Matti Aapro, MD (maapro@genolier.net) - Switzerland
Vice-Chair: Bernardo Rapoport, MD (brapoport@icon.co.za) - South Africa
Vice-Chair: Rita Wickham PhD, RN, AOCN (rita_wickham@yahoo.com) - USA

Mission and Goals

The Antiemetic Study Group was originally established as a subcommittee of MASCC to address the control of nausea and vomiting induced by chemotherapy and radiotherapy. At the 1995 MASCC Annual Meeting in Luxembourg, the group organized a consensus conference on the use of antiemetics. To identify the most important topics on which consensus should be measured and developed, the group constructed a questionnaire and circulated it to experts. The results, published in Supportive Care in Cancer, identified eight major issues that served as the basis for the conference (Ballatori et al, Support Care Cancer 1997; 5: 269-273). The Consensus Conference was held in Perugia, Italy, 28-29 April 1997, and results were published in the ESMO journal, Annals of Oncology (Ann Oncol.1998; 9: 811-819).

In the following years, the Study Group has worked in two directions. First, because various guideline recommendations for antiemetic prophylaxis (from, for example, the ASCO, ESMO, MASCC, NCON, and ASHP) differed, a unified consensus conference was held in New York. 19-20 April 2001. The final document of the conference was presented during the ASCO-MASCC Joint Session held in San Francisco, 14 May, 2001. 

Second, the members of the Study Group have always been most concerned about the moderate transfer of knowledge from clinical trials to clinical practice. The Study Group thus planned an international drug utilization study to study antiemetic prescriptions and effectiveness with respect to delayed emesis induced by chemotherapy. Despite optimal prophylaxis, this remains one of the unsolved problems of antiemetic therapy.

Guidelines Guidelines & Assessment Tools

Latest Updates

New 2016 MASCC/ESMO Antiemetic Guidelines and Slide Set
The MASCC/ESMO Antiemetic Guidelines have been updated as of March, 2016, and a slide set summarizing the consensus process and recommendations is now available. The guidelines are based on the Copenhagen Consensus Conference on Antiemetic Therapy, June 2015, and have been endorsed by both MASCC and ESMO. This set of evidence-based guidelines represents several important changes and first-time inclusions. >> Read More

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Recent News

US FDA Approves Single-Dose Fosaprepitant for CINV
In February, 2016, the US Food and Drug Administration approved a single-use injection of fosaprepitant dimeglumine (Emend®) to prevent delayed nausea and vomiting in adults receiving an initial or repeat course of moderately emetogenic chemotherapy. The drug was already approved for highly emetogenic chemotherapy. The approval was based in part on a phase III trial comparing a single IV infusion (150 mg) of fosaprepitant dimeglumine in combination with ondansetron and dexamethasone with a control regimen ondansetron and dexamethasone alone. Read More

FDA Approves Rolapitant for Chemotherapy-Induced Nausea and Vomiting
On September 2, 2015, the US Food and Drug Administration (FDA) approved rolapitant (Varubi™) for the prevention of chemotherapy-induced nausea and vomiting (CINV). Rolapitant, developed by Tesaro, Inc., is a selective and competitive neurokinin 1 (NK-1) receptor antagonist. Rolapitant, neither an inducer nor inhibitor of the metabolic enzyme CYP3A4, is less likely to interact with other drugs, especially chemotherapy metabolized by CYP3A4. The approval was based on phase III clinical trials headed by Bernrdo Rapoport and Lee Schwartzberg.  >> Read More

FDA and EU Commission Approval for Netupitant/Palonosetron (Akynzeo)
In October, 2014, the FDA approved Akynzeo for control of nausea and vomiting in patients undergoing chemotherapy. Akynzeo, developed by Helsinn Healthcare S.A., is a fixed combination capsule that combines the two drugs, netupitant and palonosetron. The effectiveness of Akynzeo was established in three studies headed by Paul Hesketh, Richard Gralla, and Matti Aapro. >> Read More

2017 Workshop

2017 Annual Meeting Workshop, June 22, Washington, DC

How Adherence to Guidelines Increases the Cost-Effectiveness of Supportive Care Interventions
The need to increase the cost-effectiveness of medical treatments is recognized around the globe. One way to increase cost-effectiveness is by following evidence-based guidelines that consider cost containment. This workshop is intended to provide evidence for the need to adhere to such guidelines, both to improve outcomes and to ensure that available resources are used in the most appropriate manner. We will review current guidelines from this perspective and note possible negative consequences of non-adherence. We will also highlight the importance of a multidisciplinary approach to cancer treatment and supportive care.

This workshop will be offered jointly by the following MASCC Study Groups: Antiemetics; Neutropenia, Infection, and Myelosuppression; Oral Care;  Psychosocial. 
Workshop Chair: Bernardo Rapoport

Issues in Controlling Nausea Associated with Cancer Chemotherapy.MASCC/ISOO Annual Meeting, Athens, 2011  >> Read More

Publications

MASCC and ESMO Consensus Guidelines for the Prevention of Chemotherapy and Radiotherapy-Induced Nausea and Vomiting: ESMO Clinical Practice Guidelines. F. Roila, A. Molassiotis, J. Herrstedt, M. Aapro, R. J. Gralla, E. Bruera, et al. On behalf of the participants of the MASCC/ESMO Consensus Conference Copenhagen 2015. Ann Oncol. 2016; 27(suppl 5):v119-v133, 2016.

Guideline update for MASCC and ESMO in the prevention of chemotherapy and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference.  F. Roila, J. Herrstedt, M. Aapro, R.J. Gralla, et al. , Annals of Oncology 21 (Supplement 5): v232 - v243, 2010

Member Publications Resource on Nausea and Vomiting (CINV)

MASCC Endorsed Guideline Partnerships

Guideline for the Prevention and Treatment of Anticipatory Nausea and Vomiting Due to Chemotherapy in Pediatric Cancer Patients
The Pediatric Oncology Group of Ontario (POGO) has published "Guideline for the Prevention and Treatment of Anticipatory Nausea and Vomiting due to Chemotherapy in Pediatric Cancer Patients” (April 2014). This evidence-based guideline contains recommendations for optimizing control of anticipatory nausea and vomiting  in children from 1 month to 18 years of age who are receiving chemotherapy. Recommendations for both pharmacological and nonpharmacological interventions are included.  >> Read the Guideline  *Disclaimer* The evidence used in formulating this guideline was rated as "low level" by the authors and much of it was derived from evidence in the adult population, rather than a pediatric population. While the conclusions have face validity, the strength of the recommendations is limited by a dearth of high-quality data. There remains a need for more studies in the pediatric population.

Acute AINV Guideline for Pediatric Cancer Patients
The Pediatric Oncology Group of Ontario (POGO) has published “Guideline for the Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients” (April 2014). The purpose of this guideline is to provide healthcare providers with an approach to the prevention of acute antineoplastic-induced nausea and vomiting (AINV) in children. The scope is limited to the prevention of AINV in the acute phase (within 24 hours of antineoplastic administration).  >> Quick Review Summary


Please contact the Study Group Chairs above with your questions.
MASCC Study Group Coordinator, Anne Young