Print

Antiemetic Publications

The MASCC/ESMO Antiemetic Guidelines have been updated as of March, 2016. The revised guidelines are based on the Copenhagen Consensus Conference on Antiemetic Therapy, June 2015, and have been endorsed by both MASCC and ESMO. 

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.

A new slide set summarizing the consensus process and recommendations s freely available, provided no changes are made and that the MASCC and ESMO logos, as well as date of the information, are retained. You can access the slide set at the MASCC website. >> Download Slide Set

The full versions of the following papers from Supportive Care in Cancer (Vol. 27, Supplement 5, 2016), which reflect the conclusions of the 2015 Consensus Conference, are available to MASCC Members, courtesy of MASCC and Springer.  

2016 Updated MASCC/ESMO Consensus Recommendations: Prevention of Radiotherapy-Induced Nausea and Vomiting. Ruhlmann CH, Jahn F, Jordan K, Dennis K, Maranzano E, Molassiotis A, Roila FB, Feyer P. Support Care Cancer 2016 Sep 13 [Epub ahead of print]

2016 Updated MASCC/ESMO Consensus Recommendations: Controlling Nausea and Vomiting with Chemotherapy of Low or Minimal Emetic Potential. Olver I, Ruhlmann CH, Jahn F, Schwartzberg L, Rapoport B, Rittenberg CN, Clark-Snow R. Support Care Cancer. 2016 Aug 30. [Epub ahead of print]

2016 Updated MASCC/ESMO Consensus Recommendations: Prevention of Acute Chemotherapy-Induced Nausea and Vomiting in Children. Dupuis LL, Sung L, Molassiotis A, Orsey AD, Tissing W, van de Wetering M. Support Care Cancer. 2016 Aug 26. [Epub ahead of print]

2016 Updated MASCC/ESMO Consensus Recommendations: Management of Nausea and Vomiting in Advanced Cancer. Walsh D, Davis M, Ripamonti C, Bruera E, Davies A, Molassiotis A. Support Care Cancer. 2016 Aug 17. [Epub ahead of print]

2016 Updated MASCC/ESMO Consensus Recommendations: Prevention of Nausea and Vomiting Following Moderately Emetogenic Chemotherapy. Roila F, Warr D, Hesketh PJ, Gralla R, Herrstedt J, Jordan K, Aapro M, Ballatori E, Rapoport B. Support Care Cancer. 2016 Aug 11. [Epub ahead of print]

2016 updated MASCC/ESMO consensus recommendations: Anticipatory nausea and vomiting in children and adults receiving chemotherapy. Dupuis LL, Roscoe JA, Olver I, Aapro M, Molassiotis A. Support Care Cancer. 2016 Aug 10. [Epub ahead of print]

2016 Updated MASCC/ESMO Consensus Recommendations: Emetic Risk Classification and Evaluation of the Emetogenicity of Antineoplastic Agents. Jordan K, Chan A, Gralla RJ, Jahn F, Rapoport B, Warr D, Hesketh PJ. Support Care Cancer. 2016 Aug 8. [Epub ahead of print]

2016 Updated MASCC/ESMO Consensus Recommendations: Prevention of Nausea and Vomiting Following High Emetic Risk Chemotherapy. Herrstedt J, Roila F, Warr D, Celio L, Navari RM, Hesketh PJ, Chan A, Aapro MS. Support Care Cancer. 2016 Jul 22. [Epub ahead of print]

Erratum to: 2016 Updated MASCC/ESMO Consensus Recommendations: Prevention of Nausea and Vomiting Following Moderately Emetogenic Chemotherapy. Roila F, Warr D, Hesketh PJ, Gralla R, Herrstedt J, Jordan K, Aapro M, Ballatori E, Rapoport B.Support Care Cancer. 2016 Sep 14. [Epub ahead of print] No abstract available. 

This set of evidence-based guidelines represents several important changes and first-time inclusions.This is the first time that recommendations about management of nausea and vomiting in advanced cancer have been included — as opposed to only nausea and vomiting induced by chemotherapy or radiotherapy — and in this respect, the new MASCC/ESMO guidelines differ from those of NCCN and ASCO. The new guidelines contain recommendations for two new NK1 receptor antagonists, rolapitant and netupitant, the latter given in combination with palonosetron (NEPA), and also discuss the use of olanzapine. The combination of an anthracycline with cyclophosphamide, previously considered of medium emetogenic risk (30-90% risk of vomiting) is now considered a high-risk combination (>90% risk of vomiting). However, this remains a special case, since recommendations for the delayed phase differ from those of other chemotherapies of highly emetogenic risk. In addition, carboplatin is now considered a special case with an indication for triple preventative therapy in the acute phase.

Antiemetic Guidelines 2010 of the MASCC Antiemetic Study Group

The previous version of the Antiemetic Guidelines was based on the Consensus Guideline Meeting held in Perugia, Italy, June 2009. 

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, L. H. Einhorn, E. Ballatori, et al. On behalf of the ESMO/MASCC Guidelines Working Group. Ann Oncol. 2010;21(suppl 5):v232-43.

The following papers in this edition of Supportive Care in Cancer represent a detailed summary of the deliberations from the consensus guideline meeting which took place in Perugia, Italy in June 2009. Please refer to the PowerPoint guideline presentation for the most recent, and updated version of the MASCC/ESMO Antiemetic Guideline on the Antiemetic Guidelines web page.

Antiemetic therapy for multiple-day chemotherapy and additional topics consisting of rescue antiemetics and high-dose chemotherapy with stem cell transplant: review and consensus statement  - Lawrence H. Einhorn, Steven M. Grunberg, Bernardo Rapoport, Cynthia Rittenberg and Petra Feyer

Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009  - Petra Christine Feyer, Ernesto Maranzano, Alexander Molassiotis, Fausto Roila and Rebecca A. Clark-Snow, et al.

Acute emesis: moderately emetogenic chemotherapy - Jørn Herrstedt, Bernardo Rapoport, David Warr, Fausto Roila and Emilio Bria, et al.

Consensus recommendations for the prevention of vomiting and nausea following high-emetic-risk chemotherapy - Mark G. Kris, Maurizio Tonato, Emilio Bria, Enzo Ballatori and Birgitte Espersen, et al.

Guidelines for the control of nausea and vomiting with chemotherapy of low or minimal emetic potential  - Ian Olver, Rebecca A. Clark-Snow, Enzo Ballatori, Birgitte T. Espersen and Emilio Bria, et al.

Antiemetics in children receiving chemotherapy. MASCC/ESMO guideline update 2009 - Karin Jordan, Fausto Roila, Alexander Molassiotis, Ernesto Maranzano and Rebecca A. Clark-Snow, et al.

Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity—state of the art  - Steven M. Grunberg, David Warr, Richard J. Gralla, Bernardo L. Rapoport and Paul J. Hesketh, et al.

Antiemetic research: future directions - Ian Olver, Alexander Molassiotis, Matti Aapro, Jørn Herrstedt and Steven Grunberg, et al.

Delayed emesis: moderately emetogenic chemotherapy (single-day chemotherapy regimens only) - Fausto Roila, David Warr, Matti Aapro, Rebecca A. Clark-Snow and Larry Einhorn, et al.

Meeting Highlight* Prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: Guideline update and results of the Perugia consensus conference
- Fausto Roila, Jorn Herrstedt, Richard J. Gralla and Maurizio Tonato

2004 Perugia Consensus Guideline Process and Review Articles

Original Article
 The 2004 Perugia Antiemetic Consensus Guideline process: methods, procedures, and participants  pp. 77 - 79
Richard J. Gralla, Fausto Roila, Maurizio Tonato

Review Article
 Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity - an update  pp. 80 - 84
Steven M. Grunberg, David Osoba, Paul J. Hesketh, et al. 

Review Article
 Consensus proposals for the prevention of acute and delayed vomiting and nausea following high-emetic-risk chemotherapy  pp. 85 - 96
Mark G. Kris, Paul J. Hesketh, Jorn Herrstedt, et al. 

Review Article
 Acute emesis: moderately emetogenic chemotherapy  pp. 97 - 103
Jørn Herrstedt, Jim M. Koeller, Fausto Roila, et al. 

Review Article
 Delayed emesis: moderately emetogenic chemotherapy  pp. 104 - 108
Fausto Roila, David Warr, Rebecca A. Clark-Snow, et al. 

Review Article
 Emesis induced by low or minimal emetic risk chemotherapy  pp. 109 - 111
Maurizio Tonato, Rebecca A. Clark-Snow, David Osoba, et al. 

Review Article
 Antiemetic therapy for multiple-day chemotherapy and high-dose chemotherapy with stem cell transplant: review and consensus statement  pp. 112 - 116
Lawrence H. Einhorn, Bernardo Rapoport, Jim Koeller, et al. 

Review Article
 Anticipatory nausea and vomiting  pp. 117 - 121
Matti S. Aapro, Alexander Molassiotis, Ian Olver 

Review Article
 Radiotherapy-induced nausea and vomiting (RINV): antiemetic guidelines  pp. 122 - 128
Petra Ch. Feyer, Ernesto Maranzano, Alexander Molassiotis, et al. 

Review Article
 Antiemetics in children receiving chemotherapy  pp. 129 - 131
Fausto Roila, Petra Feyer, Ernesto Maranzano, et al. 

 REVIEW - Prevention of chemotherapy - and radiotherapy-induced emesis: results of the 2004 Perugia International Antiemetic Consensus Conference
Antiemetic Subcommittee MASCC
Annals of Oncology 17:20-28, 2006  doi:10.1093/annonc/mdj078