In reviewing the latest trials of antiemetic usage to prevent cytotoxic chemotherapy induced emesis, gaps in the literature suggest directions for future research and identify methodological approaches to be used in future investigations. The usage of molecular techniques and the identification of new receptors may allow new antiemetics to be developed and identification of the genes coding for antiemetic receptors may be used to select the appropriate antiemetics for individuals. Given the success achieved in controlling post chemotherapy vomiting, future studies should focus upon the control of nausea, and measure the impact of antiemetic control on quality of life as well as evaluating the pharmacoeconomics of these agents. Accounting for the interaction of antiemetics with cytotoxics becomes more important in trial design with the increasing complexity of antiemetic regimens. More information is needed on the emetic potential of the various combination chemotherapy regimens, multiple day chemotherapy and chemotherapy over multiple cycles. The emetic potential of prolonged administration of oral chemotherapy and newer biologicals and targeted therapies needs to be recorded. Further studies are required in specialized areas such as with high dose chemotherapy, for radiation induced emesis and in pediatrics.
Keywords: Antiemetics, methodology, guidelines, prognostic factors, quality of life, health economics
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