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Delayed Nausea/Emesis

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Abstract

The symptoms of chemotherapy-induced nausea and vomiting cause significant physical and emotional distress. Some of the most troubling effects result from delayed symptoms, which occur greater than 24 hours following chemotherapy. Severe or prolonged nausea or vomiting can interfere with a patient’s ability to receive proper treatment and even cause patients to postpone or refuse potentially curative therapy. Providing adequate prophylaxis can prevent these symptoms, allowing chemotherapy to be better tolerated and given without dose modification. The antiemetic regimen which has shown the most promise in clinical trials is a 5-hydroxytryptamine (5-HT3) receptor antagonist combined with a neurokinin-1 receptor antagonist and dexamethasone. This chapter reviews the pathophysiology, diagnosis, and management of chemotherapy-induced nausea and vomiting, with special focus on delayed symptoms and the use of current clinical practice guidelines.

Keywords

  • National Comprehensive Cancer Network
  • National Comprehensive Cancer Network
  • Emetogenic Chemotherapy
  • Highly Emetogenic Chemotherapy
  • Moderately Emetogenic Chemotherapy

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References

  1. De Boer-Dennert M, de Wit R, Schmitz PI, et al. Patient perceptions of the side-effects of chemotherapy: the influence of 5-HT3 antagonists. Br J Cancer. 1997;76:1055–61.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  2. Jordan K, Sippel C, Schmoll HJ. Guidelines for antiemetic treatment of chemotherapy-induced nausea and vomiting: past, present, and future recommendations. Oncologist. 2007;12:1143–50.

    CAS  CrossRef  PubMed  Google Scholar 

  3. Wilcox PM, Fetting JH, Nettesheim KM, Abeloff MD. Anticipatory vomiting in women receiving cyclo-phosphamide, methotrexate and 5-fluorouracil (CMF) adjuvant chemotherapy for breast cancer. Cancer Treat Rep. 1982;66:1601–4.

    CAS  PubMed  Google Scholar 

  4. Janelsins MC, Tejani MA, Kamen C, Peoples AR, Mustian KM, Morrow GR. Current pharmacotherapy for chemotherapy-induced nausea and vomiting in cancer patients. Expert Opin Pharmacother. 2013;14(6):757–66.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  5. Hesketh PJ. Chemotherapy-induced nausea and vomiting. N Engl J Med. 2008;358:2482–94.

    CAS  CrossRef  PubMed  Google Scholar 

  6. Sun CC, Bodurka DC, Weaver CB, et al. Rankings and symptom assessments of side effects from chemotherapy: insights from experienced patients with ovarian cancer. Support Care Cancer. 2005;13:219–27.

    CrossRef  PubMed  Google Scholar 

  7. National Cancer Institute at the National Institute of Health. Nausea and vomiting PDQ. http://www.cancer.gov/cancertopics/pdq/supportivecare/nausea/HealthProfessional/. Last modified 12/10/2013.

  8. NCCN Clinical Practice Guidelines in Oncology: Antiemetics. 2012. Available from: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/pdf/antiemesis.pdf. Accessed 5 Nov 2012.

  9. Roila F, Donati D, Tamberi S, Margutti G. Delayed emesis: incidence, pattern, prognostic factors and optimal treatment. Support Care Cancer. 2002;10:88–95.

    CrossRef  PubMed  Google Scholar 

  10. Navari RM. Management of chemotherapy-induced nausea and vomiting. Focus on newer agents and new uses for older agents. Drugs. 2013;73:249–62.

    CAS  CrossRef  PubMed  Google Scholar 

  11. Bloechl-Daum B, Deuson RR, Mavros P, Hansen M, et al. Delayed nausea and vomiting continue to reduce patients' quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol. 2006;24:4472–8.

    CAS  CrossRef  PubMed  Google Scholar 

  12. Navari RM. Overview of the updated antiemetic guidelines for chemotherapy-induced nausea and vomiting. Commun Oncol. 2007;4 suppl 1:3–11.

    Google Scholar 

  13. Hornby PJ. Central neurocircuitry associated with emesis. Am J Med. 2001;111(8):106S–12.

    CrossRef  PubMed  Google Scholar 

  14. Feyer P, Jordan K. Update and new trends in antiemetic therapy: the continuing need for novel therapies. Ann Oncol. 2011;22:30–8.

    CAS  CrossRef  PubMed  Google Scholar 

  15. Miller AD, Leslie RA. The area postrema and vomiting. Front Neuroendocrinol. 1994;15(4):301–20.

    CAS  CrossRef  PubMed  Google Scholar 

  16. Pisters KM, Kris MG. Treatment-related nausea and vomiting. In: Berger A, Portenoy RK, Weissman DE, editors. Principles and practice of supportive oncology. Philadelphia: Lippincott-Raven Publishers; 1998. p. 165–99.

    Google Scholar 

  17. Bayo J, Fonseca PJ, Hernando S, Servitja S, Calvo A, et al. Chemotherapy-induced nausea and vomiting: pathophysiology and therapeutic principles. Clin Transl Oncol. 2012;14:413–22.

    CAS  CrossRef  PubMed  Google Scholar 

  18. Steinhoff MS, von Mentzer B, Geppetti P, Pothoulakis C, Bunnett NW. Tachykinins and their receptors: contributions to physiological control and the mechanisms of disease. Physiol Rev. 2014;94(1):265–301.

    Google Scholar 

  19. Saito R, Takano Y, Kamiya HO. Roles of substance P and NK(1) receptor in the brainstem in the development of emesis. J Pharmacol Sci. 2003;91:87–94.

    CAS  CrossRef  PubMed  Google Scholar 

  20. Hesketh PJ, Van Belle S, Aapro M, Tattersall FD, Naylor RJ, Hargreaves R, Carides AD, Evans JK, Horgan KJ. Differential involvement of neurotransmitters through the time course of cisplatin-induced emesis as revealed by therapy with specific receptor antagonists. Eur J Cancer. 2003;39:1074–80.

    CAS  CrossRef  PubMed  Google Scholar 

  21. Blackshaw LA, Brookes SJ, Grundy D, Schemann M. Sensory transmission in the gastrointestinal tract. Neurogastroenterol Motil. 2007;19:1–19.

    CAS  CrossRef  PubMed  Google Scholar 

  22. Farber L, Haus U, Spath M, Drechsler S. Physiology and pathophysiology of the 5-HT3 receptor. Scand J Rheum Suppl. 2004;119:2–8.

    CAS  CrossRef  Google Scholar 

  23. Cunningham D, Morgan RJ, Mills PR, et al. Functional and structural changes of the human proximal small intestine after cytotoxic therapy. J Clin Pathol. 1985;38:265–70.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  24. Fredrikson M, Hursti T, Furst CJ, et al. Nausea in cancer chemotherapy is inversely related to urinary cortisol excretion. Br J Cancer. 1992;65:779–80.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  25. Fredrikson M, Hursti TJ, Steineck G, et al. Delayed chemotherapy induced nausea is augmented by high levels of endogenous noradrenaline. Br J Cancer. 1994;70:642–5.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  26. Kris MG, Gralla RJ, Clark RA, et al. Incidence, course, and severity of delayed nausea and vomiting following the administration of high-dose cisplatin. J Clin Oncol. 1985;3:1379–84.

    CAS  PubMed  Google Scholar 

  27. Gralla RJ, Itri LM, Pisko SE, et al. Antiemetic efficacy of high-dose metoclopramide: randomized trials with placebo and prochlorperazine in patients with chemotherapy-induced nausea and vomiting. N Engl J Med. 1981;305:905–9.

    CAS  CrossRef  PubMed  Google Scholar 

  28. Martin M. The severity and pattern of emesis following different cytotoxic agents. Oncology. 1996;53 Suppl 1:26–31.

    CrossRef  PubMed  Google Scholar 

  29. Grunberg SM, Deuson RR, Mavros P, Geling O, Hansen M, Cruciani G, Daniele B, De Pouvourville G, Rubenstein EB, Daugaard G. Incidence of chemotherapy-induced nausea and emesis after modern antiemetics: perception versus reality. Cancer. 2004;100:2261–8.

    CrossRef  PubMed  Google Scholar 

  30. Cohen L, De Moor CA, Eisenberg P, et al. Chemotherapy-induced nausea and vomiting: incidence and impact on patient quality of life at community oncology settings. Support Care Cancer. 2007;15(5):497–503.

    CrossRef  PubMed  Google Scholar 

  31. Hesketh PJ, Aapro M, Street JC, et al. Evaluation of risk factors predictive of nausea and vomiting with current standard-of-care antiemetic treatment: analysis of two phase III trials of aprepitant in patients receiving cisplatin-based chemotherapy. Support Care Cancer. 2010;18:1171–7.

    CrossRef  PubMed  Google Scholar 

  32. Roila F, Warr D, Aapro M, Clark-Snow RA, Einhorn L, Gralla RJ, Herrstedt J, Saito M, Tonato M. Delayed emesis: moderately emetogenic chemotherapy (single-day chemotherapy regimens only). Support Care Cancer. 2011;19 Suppl 1:57–62.

    CrossRef  Google Scholar 

  33. Roila F, Herrstedt J, Aapro M, et al. Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol. 2010;21(5):v232–43.

    CrossRef  PubMed  Google Scholar 

  34. Italian Group for Antiemetic Research. Cisplatin-induced delayed emesis: pattern and prognostic factors during three subsequent cycles. Ann Oncol. 1994;5:585–9.

    Google Scholar 

  35. Fraunholz I, Grau K, Weiss C, et al. Patient and treatment-related risk factors for nausea and emesis during concurrent chemoradiotherapy. Strahlenther Onkol. 2011;187:1–6.

    CrossRef  PubMed  Google Scholar 

  36. Grunberg SM. Antiemetic activity of corticosteroids in patients receiving cancer chemotherapy: dosing, efficacy, and tolerability analysis. Ann Oncol. 2007;18:233–40.

    CAS  CrossRef  PubMed  Google Scholar 

  37. Hickok JT, Roscoe JA, Morrow GR, et al. 5-Hydroxytryptamine-receptor antagonists versus prochlorperazine for control of delayed nausea caused by doxorubicin: a URCC CCOP randomised controlled trial. Lancet Oncol. 2005;6:765–72.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  38. Hesketh PJ, Kris MG, Grunberg SM, et al. Proposal for classifying the acute emetogenicity of cancer chemotherapy. J Clin Oncol. 1997;15:103–9.

    CAS  PubMed  Google Scholar 

  39. Basch E, Prestrud AA, Hesketh PJ, et al. Antiemetics: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2011;29:4189–98.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  40. MASCC/ESMO Antiemetic guideline 2011. 2011. Available from: http://www.mascc.org/index.php?option=com_content&view=article&id=261. Accessed 15 Nov 2013.

  41. Kris MG, Hesketh PJ, Somerfield MR, et al. American society of clinical oncology guideline for antiemetics in oncology: update 2006. J Clin Oncol. 2006;24:2932–47.

    CAS  CrossRef  PubMed  Google Scholar 

  42. Navari RM. Pathogenesis-based treatment of chemotherapy induced nausea and vomiting: two new agents. J Support Oncol. 2003;1:89–103.

    CAS  PubMed  Google Scholar 

  43. Geling O, Eichler H. Should 5-Hydroxytryptamine-3 receptor antagonists be administered beyond 24 hours after chemotherapy to prevent delayed emesis? Systematic re-evaluation of clinical evidence and drug cost implications. J Clin Oncol. 2005;23:1289–94.

    CAS  CrossRef  PubMed  Google Scholar 

  44. Rojas C, Thomas AG, Alt J, et al. Palonosetron triggers 5-HT3 receptor internalization and causes prolonged inhibition of receptor function. J Pharmacol. 2010;626:193–9.

    CAS  Google Scholar 

  45. Aapro M, Grunberg S, Manikhas G, et al. A phase III, double-blind, randomized trial of palonosetron compared with ondansetron in preventing chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy. Ann Oncol. 2006;17:1441.

    CAS  CrossRef  PubMed  Google Scholar 

  46. Eisenberg P, Figueroa-Vadillo J, Zamora R, et al. Improved prevention of moderately emetogenic chemotherapy-induced nausea and vomiting with palonosetron, a pharmacologically novel 5-HT3 receptor antagonist: results of a phase III, single-dose trial versus dolasetron. Cancer. 2003;98:2473–82.

    CAS  CrossRef  PubMed  Google Scholar 

  47. Saito M, Aogi K, Sekine I, et al. Palonosetron plus dexamethasone versus granisetron plus dexamethasone for prevention of nausea and vomiting during chemotherapy: a double-blind, double-dummy, randomised, comparative phase III trial. Lancet Oncol. 2009;10:115–24.

    CAS  CrossRef  PubMed  Google Scholar 

  48. Jordan K, Schmoll HJ, Aapro MS. Comparative activity of antiemetic drugs. Crit Rev Oncol Hematol. 2007;61:162–75.

    CrossRef  PubMed  Google Scholar 

  49. Hesketh PJ, Grunberg SM, Gralla RJ, et al. The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a multinational, randomized, double-blind, placebo-controlled trial in patients receiving high-dose cisplatin--the aprepitant protocol 052 study group. J Clin Oncol. 2003;21:4112–9.

    CAS  CrossRef  PubMed  Google Scholar 

  50. Schmoll HJ, Aapro MS, Poli-Bigelli S, et al. Comparison of an aprepitant regimen with a multiple-day ondansetron regimen, both with dexamethasone, for antiemetic efficacy in high-dose cisplatin treatment. Ann Oncol. 2006;17:1000–6.

    CAS  CrossRef  PubMed  Google Scholar 

  51. Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, et al. Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America. Cancer. 2003;97:3090–8.

    CAS  CrossRef  PubMed  Google Scholar 

  52. Warr DG, Hesketh PJ, Gralla RJ, et al. Efficacy and tolerability of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients with breast cancer after moderately emetogenic chemotherapy. J Clin Oncol. 2005;23:2822–30.

    CAS  CrossRef  PubMed  Google Scholar 

  53. Shadle CR, Lee Y, Majumdar AK, et al. Evaluation of potential inductive effects of aprepitant on cytochrome P450 3A4 and 2C9 activity. J Clin Pharmacol. 2004;44:215–23.

    CAS  CrossRef  PubMed  Google Scholar 

  54. Nygren P, Hande K, Petty KJ, et al. Lack of effect of aprepitant on the pharmacokinetics of docetaxel in cancer patients. Cancer Chemother Pharmacol. 2005;55(6):609–16.

    CAS  CrossRef  PubMed  Google Scholar 

  55. Langford P, Chrisp P. Fosaprepitant and aprepitant: an update of the evidence for their place in the prevention of chemotherapy-induced nausea and vomiting. Core Evid. 2010;5:77.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  56. Hursti TJ, Fredrikson M, Steineck G, et al. Endogenous cortisol exerts antiemetic effect similar to that of exogenous corticosteroids. Br J Cancer. 1993;68:112–4.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  57. Roila F, Tonato M, Cognetti F, et al. Prevention of cisplatin-induced emesis: a double-blind multicenter randomized crossover study comparing ondansetron and ondansetron plus dexamethasone. J Clin Oncol. 1991;9:675–8.

    CAS  PubMed  Google Scholar 

  58. Latreille J, Stewart D, Laberge F, et al. Dexamethasone improves the efficacy of granisetron in the first 24 h following high-dose cisplatin chemotherapy. Support Care Cancer. 1995;3:307–12.

    CAS  CrossRef  PubMed  Google Scholar 

  59. Vardy J, Chiew KS, Galica J, et al. Side effects associated with the use of dexamethasone for prophylaxis of delayed emesis after moderately emetogenic chemotherapy. Br J Cancer. 2006;94:1011–5.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  60. Herr I, Ucur E, Herzer K, et al. Glucocorticoid cotreatment induces apoptosis resistance toward cancer therapy in carcinomas. Cancer Res. 2003;63:3112–20.

    CAS  PubMed  Google Scholar 

  61. Lohr L. Chemotherapy-induced nausea and vomiting. Cancer J. 2008;14:85–93.

    CAS  CrossRef  PubMed  Google Scholar 

  62. Kris MG, Gralla RJ, Tyson LB, et al. Controlling delayed vomiting: double-blind, randomized trial comparing placebo, dexamethasone alone, and metoclopramide plus dexamethasone in patients receiving cisplatin. J Clin Oncol. 1989;7:108–14.

    CAS  PubMed  Google Scholar 

  63. Aapro MS. How do we manage patients with refractory or breakthrough emesis? Support Care Cancer. 2002;10:106–9.

    CrossRef  PubMed  Google Scholar 

  64. Olver IN, Wolf M, Laidlaw C, et al. A randomised double-blind study of high-dose intravenous prochlorperazine versus high-dose metoclopramide as antiemetics for cancer chemotherapy. Eur J Cancer. 1992;28A(11):1798–802.

    CAS  CrossRef  PubMed  Google Scholar 

  65. Zhang W, Bymaster FP. The in vivo effects of olanzapine and other antipsychotic agents on receptor occupancy and antagonism of dopamine D1, D2, D3, 5HT2A and muscarinic receptors. Psychopharmacology (Berl). 1999;141:267–78.

    CAS  CrossRef  Google Scholar 

  66. Tan L, Liu J, Liu X, et al. Clinical research of olanzapine for the prevention of chemotherapy-induced nausea and vomiting. J Exp Clin Cancer Res. 2009;28:1–7.

    CrossRef  Google Scholar 

  67. Navari R, Gray SE, Carr AC. Olanzapine versus aprepitant for the prevention of chemotherapy induced nausea and vomiting (CINV): a randomized phase III trial. J Clin Oncol. 2010;28:9020.

    Google Scholar 

  68. Mandala M, Cremonesi M, Rocca A, et al. Midazolam for acute emesis refractory to dexamethasone and granisetron after highly emetogenic chemotherapy: a phase II study. Support Care Cancer. 2005;13:375–80.

    CAS  CrossRef  PubMed  Google Scholar 

  69. Martin BR, Wiley JL. Mechanism of action of cannabinoids: How it may lead to treatment of cachexia, emesis, and pain. J Support Oncol. 2004;2:305–14.

    CAS  PubMed  Google Scholar 

  70. Freund TF, Katona I, Piomelli D. Role of endogenous cannabinoids in synaptic signaling. Physiol Rev. 2003;83:1017–66.

    CAS  CrossRef  PubMed  Google Scholar 

  71. Cruz FM, de Iracema Gomes Cubero D, Taranto P, et al. Gabapentin for the prevention of chemotherapy- induced nausea and vomiting: a pilot study. Support Care Cancer. 2012;20:601–6.

    CrossRef  PubMed  Google Scholar 

  72. North Central Cancer Treatment Group. Gabapentin in preventing nausea and vomiting in patients receiving chemotherapy [Clinicaltrials.gov ID: NCT00880191]. US National Institutes of Health, ClinicalTrials.gov. http://www.clinicaltrials.gov. Accessed 25 Jan 2013.

  73. Rossi G, Tilkola SO, Rudengren C, et al. A positron emission tomography study to assess the degree of neurolinin-1 receptor occupancy in the human brain after single doses of netupitant to healthy male subjects. J Clin Oncol. 2012;30(Suppl; abstr 9054).

    Google Scholar 

  74. Molassiotis A, Stricker CT, Eaby B, Velders L, Coventry PA. Understanding the concept of chemotherapy-related nausea: the patient experience. Eur J Cancer Care. 2008;17:444e453.

    CrossRef  Google Scholar 

  75. Figueroa-Moseley C, Jean-Pierre P, Roscoe JA, et al. Behavioral interventions in treating anticipatory nausea and vomiting. J Natl Compr Canc Netw. 2007;5:44–50.

    PubMed  Google Scholar 

  76. Navari RM, Nagy CK, Gray SE. Olanzapine versus metoclopramide for the treatment of breakthrough chemotherapy-induced nausea and vomiting in patients receiving highly emetogenic chemotherapy. Support Care Cancer. 2013;21:1655–63.

    CrossRef  PubMed  Google Scholar 

  77. Rapoport BL, Jordan K, Boice JA, et al. Aprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with a broad range of moderately emetogenic chemotherapies and tumor types: a randomized, double-blind study. Support Care Cancer. 2010;18:423–31.

    CrossRef  PubMed  Google Scholar 

  78. Navari RM. Prevention of emesis from multiple-day chemotherapy regimens. J Natl Compr Canc Netw. 2007;5:51–9.

    CAS  PubMed  Google Scholar 

  79. Giralt SA, Mangan KF, Maziarz RT, et al. Three palonosetron regimens to prevent CINV in myeloma patients receiving multiple-day high-dose melphalan and hematopoietic stem cell transplantation. Ann Oncol. 2011;22:939–46.

    CAS  CrossRef  PubMed  Google Scholar 

  80. Albany C, Brames ML, Fausel C, et al. Randomized, double-blind, placebo-controlled, phase III crossover study evaluating the oral neurokinin-1 antagonist aprepitant in combination with a 5-HT3 antagonist plus Dexamethasone in patients with germ cell tumor receiving 5-day cisplatin combination chemotherapy regimens: a hoosier oncology group (HOG) study. J Clin Oncol. 2012;30:3998–4003.

    CAS  CrossRef  PubMed  Google Scholar 

  81. Jordan K, Kinitz I, Voigt W, et al. Safety and efficacy of a triple antiemetic combination with the NK-1 antagonist aprepitant in highly and moderately emetogenic multiple-day chemotherapy. Eur J Cancer. 2009;45:1184–7.

    CAS  CrossRef  PubMed  Google Scholar 

  82. Chawla SP, Grunberg SM, Gralla RJ, et al. Establishing the dose of the oral NK1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting. Cancer. 2003;97:2290–300.

    CAS  CrossRef  PubMed  Google Scholar 

  83. Hickok JT, Roscoe JA, Morrow GR, et al. Nausea and emesis remain significant problems of chemotherapy despite prophylaxis with 5-hydroxytryptamine-3 antiemetics. Cancer. 2003;97:2880–6.

    CAS  CrossRef  PubMed  Google Scholar 

  84. Grote T, Hajdenberg J, Cartmell A, et al. Combination therapy for chemotherapy-induced nausea and vomiting in patients receiving moderately emetogenic chemotherapy: palonosetron, dexamethasone, and aprepitant. J Support Oncol. 2006;4:403–8.

    CAS  PubMed  Google Scholar 

  85. Grunberg SM, Dugan M, Muss H, Wood M, Burdette-Radoux S, Weisberg T, Siebel M. Effectiveness of a single-day three-drug regimen of dexamethasone, palonosetron, and aprepitant for the prevention of acute and delayed nausea and vomiting caused by moderately emetogenic chemotherapy. Support Care Cancer. 2009;17(5):589–94.

    Google Scholar 

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Bean, L.M., Plaxe, S. (2016). Delayed Nausea/Emesis. In: Alberts, D., Lluria-Prevatt, M., Kha, S., Weihs, K. (eds) Supportive Cancer Care. Springer, Cham. https://doi.org/10.1007/978-3-319-24814-1_9

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