Cancer Supportive Care > Chemotherapy Induced Nausea & Vomiting
Chemotherapy induced nausea & vomiting (CINV) occurs in approximately 70% of all cancer patients receiving chemotherapy. It is a considerable concern for patients and is one of the major side effects of cancer therapy. The effects of CINV can be more distressing to a patient than future concerns of life expectancy, sometimes resulting in the patient choosing to discontinue potentially curative therapy.
There are a number of approved agents in use, and commonly prescribed drugs include 5HT3-antagonists such as ondansetron, granisetron and palonosetron. These are usually used in combination with the steroid dexamethasone. In addition the NK-1 inhibitor aprepitant can be added to this regimen to improve outcomes further.
Despite the improvements in treating CINV there remain a number of clear unmet needs. The treatment regimens currently used are relatively effective at stopping a patient vomiting but much less so at stopping nausea and are less effective in delayed CINV.
What is CINV?
There are three types of nausea & vomiting associated with chemotherapy:
• Acute – occurs on the day of treatment and lasts up to 24 hours;
• Delayed – occurs up to five days following chemotherapy;
• Anticipatory – the conditioned response of a patient who has previously suffered from CINV and is about to receive further chemotherapy.
The most important risk factor is the potential of the particular chemotherapy being used to induce nausea & vomiting (emetogenic potential). Treatment is classified into mildly emetogenic (e.g. fluorouracil, etoposide, low dose methotrexate, vinca alkaloids); moderately emetogenic (e.g. doxorubicin, low dose cyclophosphamide, mitoxantrone, high dose methotrexate); and highly emetogenic (e.g. cisplatin, dacarbazine, high dose cyclophosphamide).
Related Product Information
Acacia Pharma will develop APD403 for the prevention and treatment of early and delayed CINV. An intravenous formulation has already been developed for acute CINV. Non-injectable presentations will be developed for use by patients outside the hospital environment in delayed CINV. The drug in APD403 is the same well known marketed dopamine D2-antagonist used in APD421.