Integrating nutrition, physical exercise, psychosocial support and antiemetic drugs into CINV management: The road to success

Crit Rev Oncol Hematol. 2024 Sep:201:104444. doi: 10.1016/j.critrevonc.2024.104444. Epub 2024 Jul 13.

Abstract

Over the years, advancements in antiemetic drugs have improved chemotherapy-induced nausea and vomiting (CINV) control. However, despite the antiemetics therapies, in a relevant number of adult patients (∼30 %), CINV is still persistent, leading to several complications, such as electrolyte imbalances, anorexia, and treatment discontinuation. Supportive care interventions have gained credibility in cancer care, helping to improve patients' psycho-physical condition, quality of life, and managing symptoms, including CINV. Physical exercise and tailored nutritional counseling have demonstrated benefits in reducing the severity of nausea and vomiting. Psychological intervention has been postulated as a key approach in controlling anticipatory nausea/vomiting, as well as acupuncture/acupressure has been shown to decrease nausea and vomiting after chemotherapy treatments. In the current review, we aim to provide a clinical update on current prophylactic and delayed antiemetic guidelines for CINV and an overview of the non-pharmacological interventions tested for alleviating CINV in patients with cancer.

Keywords: CINV; Pharmacological approach; Quality of life; Supportive care.

Publication types

  • Review

MeSH terms

  • Antiemetics* / therapeutic use
  • Antineoplastic Agents* / adverse effects
  • Antineoplastic Agents* / therapeutic use
  • Exercise*
  • Humans
  • Nausea* / chemically induced
  • Nausea* / prevention & control
  • Nausea* / therapy
  • Neoplasms* / drug therapy
  • Neoplasms* / psychology
  • Psychosocial Support Systems
  • Quality of Life
  • Vomiting* / chemically induced
  • Vomiting* / drug therapy
  • Vomiting* / prevention & control

Substances

  • Antiemetics
  • Antineoplastic Agents