Antiemetic therapy

Summary Chemotherapy-induced nausea and vomiting (CINV) remains one of the most distressing adverse effects of antineoplastic therapy despite major advances in antiemetic management. The introduction of serotonin (5-HT3) and neurokinin‑1 (NK1) receptor antagonists has significantly improved control rates, although underutilization of guideline-based prophylaxis persists. Current recommendations emphasize tailoring therapy to the emetogenic potential of agents, with olanzapine now incorporated for improved delayed-phase control. Challenges remain in breakthrough and delayed CINV, steroid-sparing regimens, and individualized risk-adapted prophylaxis. Optimizing adherence to ASCO, NCCN, and MASCC/ESMO guidelines and patient education are key to enhancing outcomes and quality of life during chemotherapy.