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Chemotherapy-induced nausea and vomiting (CINV) is a common side-effect of many cancer treatments. Nausea and vomiting are two of the most feared cancer treatment-related side effects for cancer patients and their families.
Anticipatory nausea and vomiting is experienced by approximately 20–30% of people undergoing chemotherapy. [20] Chemotherapy-induced nausea and vomiting resulting from treatment with highly emetogenic cytotoxic drugs can be prevented or effectively treated in 70 to 80% of affected people. [4] [16]
The neurotransmitters implicated in the control of nausea and vomiting include acetylcholine, dopamine, histamine (H1 receptor), substance P (NK-1 receptor), and serotonin (5-HT3 receptor). There are also opioid receptors present, which may be involved in the mechanism by which opiates cause nausea and vomiting.
The discovery of neurokinin 1 (NK 1) receptor antagonists was a turning point in the prevention of nausea and vomiting associated with cancer chemotherapy. [4] An example of a drug in this class is aprepitant. Chemotherapy-induced emesis appears to consist of acute and delayed phases.
5-HT 3 antagonists are most effective in the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV), especially that caused by highly emetogenic drugs such as cisplatin; when used for this purpose, they may be given alone or, more frequently, with a glucocorticoid, usually dexamethasone.
Palonosetron, sold under the brand name Aloxi, is a medication used for the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV). [2] [4] [5] It is a 5-HT 3 antagonist. [2] [4] [5] Palonosetron is administered intravenously, [6] or as a single oral capsule. [7] It has a longer duration of action than other 5-HT 3 antagonists.