State of the art of antiemetic therapy

Despite relevant progress achieved in the last 30 years for the prevention of chemotherapy-induced emesis, nausea and vomiting continue to be among the most distressing adverse events induced by chemotherapy. Emesis is a complex phenomenon, and the precise mechanism by which chemotherapy induces nausea and vomiting is not well known. Many neurotransmitters are involved, and several antiemetic drugs are available. Complete control of vomiting could be achieved in about 70-90% of patients with a better combination of antiemetic drugs. Recently, international guidelines to prevent chemotherapy-induced nausea and vomiting have been updated, and it is very important to know these recommendations and to use them correctly in our clinical practice. However, several aspects of antiemetic therapy will be clarified in the coming years: the improvement of nausea control, the prophylaxis of emesis induced by oral therapies, and the prevention of emesis induced by chemoradiation therapy.