For patients treated with low or minimally emetogenic
chemotherapy there is little evidence from clinical trials supporting the choice of a given
antiemetic therapy or of any treatment at all. The panel recognized the necessity of considering the introduction into clinical practice of new agents in these categories, particularly oral
cytotoxic agents and targeted
biological agents and also the possibility of over-treatment with
antiemetics. There was consensus among panel members regarding the recommended treatment for patients receiving
chemotherapy agents with low and minimal
emetic risk. Patients without a history of
nausea and
vomiting for whom minimally
emetic risk
chemotherapy is prescribed should not routinely receive
antiemetic prophylaxis. A single agent such as a low-dose
corticosteroid is suggested for patients receiving agents of low
emetic risk. If
nausea and
vomiting occurs during subsequent cycles of
chemotherapy, prophylaxis with a single agent such as a substituted
benzamide, a
corticosteroid, or a
phenothiazine should be administered. Only patients with persistent
nausea and
vomiting despite treatment with these recommended agents should receive a
5-HT3 receptor antagonist in the following cycles.