OFD 2025: Management of Chemotherapy Induced Nausea and Vomiting: Practical Implementation of the Current Guidelines in Oncology Practice

This practical review is designed for pharmacists with an interest in oncology who want a straightforward, usable approach to preventing and managing chemotherapy-induced nausea and vomiting (CINV). We will cover the different types—acute, delayed, anticipatory, breakthrough, and refractory—and look at how to assess risk based on both the chemotherapy regimen and patient factors. The focus is on multimodal prophylaxis tailored to emetogenic risk, with a plan for both acute and delayed phases. We’ll also review rescue strategies and ways to manage anticipatory symptoms as well as safety points to keep in mind (such as QT prolongation, drug interactions, SE) from certain antiemetics.

Focussing on outpatient care, we’ll discuss practical tips—like using standardized order sets, patient counseling sheets, clear home instructions, and triage pathways. Three short case studies will highlight common scenarios and decision points.

This presentation will encourage pharmacists to follow current guidelines while adapting them to real-world practice and individual patient needs. We will wrap up with three key takeaways: match prophylaxis to the regimen first, plan for delayed and breakthrough phases, and reassess/document response every cycle. References include the latest ASCO, NCCN, and MASCC/ESMO antiemetic guidelines.

Learning Objectives
By the end of the session participants will be able to:

1. Understand pathophysiology & risk factors for CINV
2. Classify chemotherapy by emetogenic risk
3. Apply guideline recommended prophylaxis and rescue therapy
4. Provide practical tips for outpatient implementation and patient education