Controversies exist regarding the classification of the emetogenic potential of chemotherapeutic agents such as
taxanes,
gemcitabine and
irinotecan and the
antiemetic prophylaxis for acute
emesis to be administered. Instead, no prophylaxis for delayed
emesis has been suggested. A prospective, observational study was carried out in 103 Italian oncological centers to evaluate the prescriptions of
antiemetics and the incidence of
nausea and
vomiting in patients submitted to these
chemotherapy agents. Two hundred and nine patients treated with
taxanes, 300 with
gemcitabine and 93 with
irinotecan were evaluated. For the prophylaxis of acute
emesis a
5-HT3 antagonist alone or in combination with a
corticosteroid was administered to 86.6% of patients receiving
taxanes, to 59.3% of those receiving
gemcitabine and to 96.8% of those submitted to
irinotecan. 20% to 40% of patients received
antiemetic prophylaxis for delayed
emesis. In
taxane-treated patients the incidence of acute
vomiting and
nausea was 6.2% and 27.3%, respectively, while in
gemcitabine- and
irinotecan-treated patients it was 6.0/33.4% and 17.9/58.9%, respectively. In conclusion, the study showed that almost all patients received prophylaxis for acute
emesis and that there is overprescription of
5-HT3 antagonists. The incidence of acute
emesis is low; therefore, randomized clinical trials are necessary to verify the utility of prophylaxis and to find the best
antiemetic treatment.