Nashed Sally M, Morcos Rami Kamal A, Atif Muhammad, Shehryar Abdullah, Rehman Abdur, Kumari Reema, Khan Safiyyah M, Hassan Waleed, Zeb Muhammad Roshan, Zia Talha A, Jameel Syed
Department of Forensic Medicine and Toxicology, Faculty of Medicine, Ain Shams University, Cairo, EGY.
Department of General Surgery, Ain Shams University Specialized Hospital, Cairo, EGY.
Cureus. 2024 Oct 31;16(10):e72774. doi: 10.7759/cureus.72774. eCollection 2024 Oct.
This systematic review critically evaluates the comparative efficacy of novel and traditional antiemetic agents in preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderate or highly emetogenic chemotherapy (MEC/HEC). The findings suggest that novel agents, such as netupitant/palonosetron (NEPA), olanzapine, and transdermal granisetron (GTDS), offer comparable or superior efficacy to traditional antiemetic regimens, including standard options like aprepitant combined with 5-HT₃ receptor antagonists and corticosteroids. These novel agents demonstrate strong effectiveness in controlling both acute and delayed CINV and offer practical advantages, such as simplified dosing regimens and improved patient adherence, particularly in resource-limited settings. Additionally, traditional regimens incorporating aprepitant remain effective in preventing CINV. However, the review highlights the need for more direct comparisons between novel and traditional agents, as well as further studies evaluating novel therapies in real-world clinical settings. Future research should focus on larger, long-term trials to better establish the role of novel antiemetic agents and optimize CINV management strategies.
本系统评价批判性地评估了新型和传统止吐药物在预防接受中度或高度致吐性化疗（MEC/HEC）的患者化疗引起的恶心和呕吐（CINV）方面的比较疗效。研究结果表明，新型药物，如奈妥吡坦/帕洛诺司琼（NEPA）、奥氮平和透皮格拉司琼（GTDS），与传统止吐方案（包括阿瑞匹坦联合5-HT₃受体拮抗剂和皮质类固醇等标准方案）相比，具有相当或更好的疗效。这些新型药物在控制急性和迟发性CINV方面显示出强大的有效性，并具有实际优势，如简化给药方案和提高患者依从性，特别是在资源有限的环境中。此外，包含阿瑞匹坦的传统方案在预防CINV方面仍然有效。然而，该评价强调需要对新型和传统药物进行更多直接比较，以及在真实临床环境中评估新型疗法的进一步研究。未来的研究应侧重于更大规模的长期试验，以更好地确立新型止吐药物的作用并优化CINV管理策略。
