Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 May 13;17(5):e84070.
doi: 10.7759/cureus.84070. eCollection 2025 May.

Expert Consensus Guidance on the Management of Chemotherapy-Induced Nausea and Vomiting: An Indian Perspective

Boman Dhabhar  1 , Prabrajya N Mahapatra  2 , Vamshi M Krishna  3 , Jatin Sarin  4 , Tara Chand Gupta  5 , Aseem Samar  5 , Bivas Biswas  6 , Aditya Murli  7 , Rajesh Kota  8 , Suyash Bharat  9 , Richa Tripathi  9
Affiliations
Review

Expert Consensus Guidance on the Management of Chemotherapy-Induced Nausea and Vomiting: An Indian Perspective

Boman Dhabhar et al. Cureus. .

Abstract

Chemotherapy-induced nausea and vomiting (CINV) significantly impact patients' quality of life and treatment adherence, with high incidence rates despite the use of antiemetic prophylaxis. While international guidelines provide recommendations for managing CINV, the diverse healthcare landscape in India necessitates tailored, region-specific guidelines. This study was conducted to develop and validate consensus-based clinical statements on CINV management tailored to the Indian context, aiming to enhance the quality of cancer care across the nation by aligning international insights with local experiences. A comprehensive literature review and a consensus-based methodology were employed. 150 Indian oncologists participated in developing 14 clinical statements through the modified Delphi method. Two rounds of voting were conducted to assess agreement levels, categorizing the statements into the following three categories: consensus, near or fair consensus, and no consensus. Consensus was achieved for 11, while three received near or fair consensus. In areas where data or agreement was lacking, expert opinions were incorporated to supplement the findings. One of the findings from this study indicated strong consensus for the use of netupitant and palonosetron along with dexamethasone as the preferred CINV prophylactic regimens in an Indian setting. The consensus statements developed in this study will assist Indian oncologists in making informed, tailored decisions regarding CINV prevention and management across diverse healthcare settings.

Keywords: antiemetic prophylaxis; cancer care; chemotherapy-induced nausea and vomiting (cinv); clinical guidelines; indian consensus; modified delphi method.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Dr. Suyash Bharat, Ms. Richa Tripathi declare(s) employment from Zydus Lifesciences Ltd. The article processing charges for this manuscript were funded by Zydus Lifesciences Ltd. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Preferred agent used for anticipatory nausea and vomiting.
CINV: chemotherapy-induced nausea and vomiting; HEC: highly emetogenic chemotherapy; MEC: moderately emetogenic chemotherapy; NK1-RA: neurokinin-1 receptor antagonist; 5HT3-RA: 5-hydroxytryptamine receptor antagonists
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Chemotherapy-induced nausea and vomiting: pathogenesis, recommendations, and new trends. Gupta K, Walton R, Kataria SP. Cancer Treat Res Commun. 2021;26 - PubMed
    1. Chemotherapy-induced nausea and vomiting (CINV) with GI cancer chemotherapy: do we need CINV risk score over and above antiemetic guidelines in prescribing antiemetic regime? D'Souza A, Pawar D, Ramaswamy A, et al. South Asian J Cancer. 2020;9:240–244. - PMC - PubMed
    1. Nausea and vomiting related to cancer treatment (PDQ) - health professional version. [ Mar; 2025 ];PDQ® Supportive and Palliative Care Editorial Board. https://www.cancer.gov/about-cancer/treatment/side-effects/nausea/nausea... Updated. 2023 30:2025.
    1. Breakthrough chemotherapy-induced nausea and vomiting: report of a nationwide survey by the CINV Study Group of Japan. Tamura K, Aiba K, Saeki T, et al. Int J Clin Oncol. 2017;22:405–412. - PubMed
    1. Delayed chemotherapy-induced nausea and vomiting: pathogenesis, incidence, and current management. Rapoport BL. Front Pharmacol. 2017;8 - PMC - PubMed

LinkOut - more resources