2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting

Key words preventionnausea and vomitingMASCC–ESMO Clinical Practice Guidelineradiotherapychemotherapy Introduction Nausea and vomiting are still considered to be two of the most troublesome adverse events (AEs) for patients treated with antineoplastic therapy. To optimise the utility of available antiemetic prophylaxis, updated reviews of the relevant literature and evidence-based guideline recommendations are crucial. The European Society for Medical Oncology (ESMO) and the Multinational Association of Supportive Care in Cancer (MASCC) completed the fourth Consensus Conference on Antiemetics for the prevention of nausea and vomiting in patients with cancer in Copenhagen in June 2015.1 This article is an update of the 2015 guidelines. Methodology The methodology for the guideline process is described in detail in the 2010 publication.2 The reporting of the literature search followed the PRISMA criteria for systematic reviews.3 The current update of the recommendations includes studies published from 1 June 2015 to 31 January 2023 (for details of the literature search and reporting, refer to the paragraphs reviewing the specific topic). The Consensus Committee consisted of 34 multidisciplinary, health care professionals with expertise in antiemetic research (physicians, nurses, pharmacists and pharmacologists) and three patient advocates representing a total of 18 countries and five continents. To change a 2015 recommendation or for a new guideline recommendation to be accepted, a consensus of at least 67% of the expert panellists was needed. The panel considered changes of ≥10% to be sufficient to warrant the changing of a 2015 recommendation. Levels of evidence (I-V) and grades of recommendation (A-E) are given according to the adapted version of the grading of the Infectious Diseases Society of America.4 In order to update the recommendations, seven working groups (WGs) were established, each including f