Integrating nutrition, physical exercise, psychosocial support and antiemetic drugs into CINV management: The road to success
Lorenzo Belluomini, Alice Avancini, Marco Sposito, Letizia Pontolillo, Daniela Tregnago, Ilaria Trestini, Jessica Insolda, Luisa Carbognin, Michèle Milella, Emilio Bria, Sara Pilotto
Abstract
Over the years, advancements in antiemetic drugs have improved chemotherapy-induced nausea and vomiting (CINV) control. However, despite the antiemetics therapies, in a relevant number of adult patients (∼30 %), CINV is still persistent, leading to several complications, such as electrolyte imbalances, anorexia, and treatment discontinuation. Supportive care interventions have gained credibility in cancer care, helping to improve patients' psycho-physical condition, quality of life, and managing symptoms, including CINV. Physical exercise and tailored nutritional counseling have demonstrated benefits in reducing the severity of nausea and vomiting. Psychological intervention has been postulated as a key approach in controlling anticipatory nausea/vomiting, as well as acupuncture/acupressure has been shown to decrease nausea and vomiting after chemotherapy treatments. In the current review, we aim to provide a clinical update on current prophylactic and delayed antiemetic guidelines for CINV and an overview of the non-pharmacological interventions tested for alleviating CINV in patients with cancer. • CINV still represents a crucial issue during chemotherapy/anticancer therapies in patients with cancer. • The pharmacological approach is the cornerstone of CINV treatment. • Other interventions, such as psychological, nutritional and physical, may contribute to the antiemetic efficacy. • A comprehensive approach combining drugs and supportive care could further optimize CINV management.