NCCN临床实践指南_止吐(2019.V1)英文版

1、Version 1 2019 02 28 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Clinical Practice Guidelines in Oncology NCCN Guidelines Antiemesis Version 1 2019 February 28 2019 Continue NCCN org NCCN Guidelines for Patients available at www nccn org patients NCCN Guidelines Version 1 2019 Antiemesis Version 1 2019 02 28 19 2019 National Comprehensive Cancer N

2、etwork NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Guidelines Index Table of Contents Discussion David S Ettinger MD Chair The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Michael J Berger PharmD BCOP Vice Chair The Ohio State University Comprehensive Cancer Center James Cancer Hospital and Solove Research Institute Jonathan Aston PharmD BCOP Vanderbilt Ingram Cancer Center Sall

3、y Barbour PharmD BCOP CPP Duke Cancer Institute Jason Bergsbaken PharmD BCOP University of Wisconsin Carbone Cancer Center Debra Brandt DO Yale Cancer Center Smilow Cancer Hospital George E Brown RPh MS BCOP Case Comprehensive Cancer Center University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute Jennie R Crews MD Fred Hutchinson Cancer Research Center Seattle Cancer Care Alliance Eun Jeong Kim PharmD MS Stanford Cancer Institute Steve Kirkegaard PharmD Huntsman C

4、ancer Institute at the University of Utah Dwight D Kloth PharmD BCOP Fox Chase Cancer Center Kelsey Klute MD Fred 23 382 388 Nakashima K Murakami H Yokoyama K et al A phase II study of palonosetron aprepitant dexamethasone and olanzapine for the prevention of cisplatin based chemotherapy induced nausea and vomiting in patients with thoracic malignancy Jpn J Clin Oncol 2017 47 840 843 AE 6 The following references were removed from the footnotes and are now listed in the Discussion Yanai T Iwasa

5、S Hashimoto H et al A double blind randomized phase II dose finding study of olanzapine 10 mg or 5 mg for the prophylaxis of emesis induced by highly emetogenic cisplatin based chemotherapy Int J Clin Oncol 2018 23 382 388 Nakashima K Murakami H Yokoyama K et al A phase II study of palonosetron aprepitant dexamethasone and olanzapine for the prevention of cisplatin based chemotherapy induced nausea and vomiting in patients with thoracic malignancy Jpn J Clin Oncol 2017 47 840 843 Added the follo

6、wing statement to the end of footnote s If dexamethsone eliminated on subsequent days for delayed nausea and emesis prevention consider other alternative antiemetics eg olanzapine Footnote t is new Use of corticosteroid premedications should be avoided with cellular therapies and immune checkpoint inhibitors if at all possible See Pharmacologic Considerations for Antiemetic Prescribing AE B Modified footnote u Emerging data from smaller studies and clinical practice suggests a 5 mg dose may be c

7、onsidered especially for elderly or oversedated patients Modified footnote x No further 5 HT3 therapy required if palonsetron granisetron extended release injection or granisetron transdermal patch given on day 1 Printed by Maria Chen on 2 28 2019 9 28 15 PM For personal use only Not approved for distribution Copyright 2019 National Comprehensive Cancer Network Inc All Rights Reserved NCCN Guidelines Version 1 2019 Antiemesis Version 1 2019 02 28 19 2019 National Comprehensive Cancer Network NCC

8、N All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Guidelines Index Table of Contents Discussion UPDATES Updates in Version 1 2019 of the NCCN Guidelines for Antiemesis from Version 2 2018 include AE 8 Footnote z is new For some moderate to high emetic risk agents factors related to dosing schedule particularly continuous dosing for prolonged periods and clinical experience suggest routine premedicatio

9、n is not required An individualized approach is appropriate for whether to premedicate each dose or prescribe antiemetics as needed Added the following to Minimal to low emetic risk Acalabrutinib Binimetinib Dacomitinib Duvelisib Encorafenib Glasdegib Gilteritinib Ivosidenib Larotrectinib Lorlatinib Panobinostat Talazoparib tosylate AE 10 Modified Promethazine 25 mg supp PR every 6 h or 12 5 25 mg PO IV central line only every 4 6 h AE B 1 of 3 Added the following bullets under corticosteroids C

10、orticosteroid antiemetic premedication should be avoided for 3 5 days prior to and 90 days after CAR T cell therapies Antiemetic regimens used during lymphodepleting chemotherapy regimens should also use a corticosteroid sparing approach to antiemetic prophylaxis Corticosteroid antiemetic premedication should be avoided with immune checkpoint inhibitors when administered without cytotoxic chemotherapy When immune checkpoint inhibitors are administered concurrently with emetogenic chemotherapy in

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