1. Introduction.- 2. The Physiology and Pharmacology of Nausea and Vomiting
Induced by Anti-Cancer Chemotherapy in Humans.- 3. First Generation 5HT-3
Receptor Antagonists.- 4. Second Generation Serotonin (5-HT3) Receptor
Antagonist Palonosetron.- 5. The Role of Neurokinin-1 Receptor Antagonists in
CINV.- 6. Olanzapine for the prevention of Chemotherapy-Induced Nausea and Vomiting.-
7. Gabapentin for the Prevention of CINV.- 8. Prevention of CINV in Patients Receiving
High-Dose Multiple-Day Chemotherapy.- 9. Clinical Management of CINV.- 10. Treatment
of Chemotherapy-Induced Nausea.- 11. Conclusions.- 12. Future Directions.
Dr. Navari received the Ph.D. degree at the University of
Virginia, and the M.D. degree at the Medical College of Virginia. He
received training in internal medicine at the University of Alabama in
Birmingham, and was a Fellow in Hematology and Oncology at the Fred Hutchinson
Cancer Research Center, University of Washington School of Medicine. He
is board certified in internal medicine and medical oncology. From 1983
to 1998, he served on the Clinical Faculty of the University of Alabama
Birmingham and was a practicing medical oncologist in the Simon-Williamson
Clinic. During this time, he was Chairman of the Department of Medicine
and President of the Simon-Williamson Clinic, Director of the Bone Marrow
Transplantation Program and Director of the Comprehensive Cancer Program at
Baptist Medical Center. In 1997, he was elected a Fellow of the American
College of Physicians. During 1998-99, he was a Fellow in Clinical
Medical Ethics in the MacLean Center for Clinical Medical Ethics at the
University of Chicago. He joined the faculty of the College of Science of
the University of Notre Dame (UND) in 1999 as Director of the Walther Cancer
Research Center. He was appointed Associate Dean, College of Science, in 2000.
In July, 2005, he became Professor of Medicine, Assistant Dean and Director,
Indiana University School of Medicine South Bend (IUSM SB), and Adjunct Professor
of Biochemistry, University of Notre Dame. In 2011, he was appointed Clinical
Director, Harper Cancer Research Institute, a partnership between IUSM SB and
UND. He was promoted to Associate Dean in 2012. Along with the medical students
at IUSM SB, he founded the IUSM SB Student Outreach Clinic in 2013 and was
appointed the Clinic’s first Medical Director.
In 2014, he joined the World Health Organization as Director
of the Cancer Care Program, Eastern Europe. In 2015, he was appointed Director
of the Cancer Care Program, Central and South America.
Dr. Navari's research interests include supportive care in
clinical oncology, development of antiemetics, palliative care, and the
doctor-patient relationship in clinical oncology. He has published over
one hundred and thirty peer reviewed articles, with the most recent dealing
with supportive care issues in clinical oncology.
This book provides a comprehensive review of new agents, a detailed description of new uses of current agents, and an integration of the available agents in clinical practice. A description of a detailed clinical approach provides clinical practitioners with the most up-to-date recommendations for the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in various clinical settings.
CINV is one of the most feared treatment related toxicities. Patient surveys for the past thirty years consistently demonstrate patients’ perception of deterioration in quality of life due to chemotherapy treatments. The introduction of the antiemetics, serotonin 5-HT3 receptor antagonists and the neurokinin-1 receptor antagonists, have improved the control of chemotherapy-induced emesis, but the treatment of chemotherapy-induced nausea remains a significant clinical problem. Patients continue to have quality of life issues which prevent normal functioning during active treatment. New agents such as the second generation 5-HT3 receptor antagonist palonosetron and the new neuroknin-1 receptor antagonists rolapitant and netupitant are being introduced into clinical practice, and it is anticipated that these new agents will improve the control of CINV. Agents such as olanzapine (a FDA approved anti-psychotic), gabapentin (a FDA approved neuroleptic), and ginger (a food additive), which have been used primarily for other indications, are now being tested as potential, effective antiemetics.
This work represents the first available comprehensive summary that details all new antiemetic agents and, particularly, their clinical role in treating patients; an important reference for practitioners seeking to improve the quality of life of patients undergoing chemotherapy.