Supportive Therapy in OncologySupportive Therapy in OncologyПоддерживающая терапия в онкологии3034-24733034-3178Publishing House ABV Press6710.17650/3034-2473-2025-2-3-48-64REVIEWSОБЗОРНЫЕ СТАТЬИReview ArticleCurrent possibilities of prevention of nausea and vomiting induced by antitumor therapyСовременные возможности профилактики тошноты и рвоты, индуцированных противоопухолевой терапиейhttps://orcid.org/0000-0002-1836-0851KorolevaIrina A.КоролеваИрина Альбертовна
Russian Federation

MD, PhD, Professor of the Department of Clinical Medicine of Postgraduate Education

д.м.н., профессор кафедры клинической медицины последипломного образования

alexthelynx-uni@yandex.ruhttps://orcid.org/0009-0001-0280-7778KorolevaAleksandra M.КоролеваАлександра Михайловна
Russian Federation
alexthelynx-uni@yandex.ruMedical University “Reaviz”Частное учреждение образовательная организация высшего образования «Медицинский университет «Реавиз»251220252348642208202518092025Copyright ©; 2025, Koroleva I.A., Koroleva A.M.Copyright ©; 2025, Королева И.А., Королева А.М.2025Koroleva I.A., Koroleva A.M.Королева И.А., Королева А.М.https://creativecommons.org/licenses/by/4.0https://stio.abvpress.ru/jour/article/view/67

Chemotherapy-induced nausea and vomiting (CINV) are the most frequent adverse events of antitumor therapy. Uncontrolled CINV lead to a significant decrease in the quality of life of patients, nutritional insufficiency, breaking of the chemotherapy regimen. In clinical trials of antiemetic drugs, the “complete response” is used as the primary endpoint. A complete response is the absence of nausea and vomiting and the need for additional antiemetic drugs. To prevent CINV during chemotherapy, combinations of corticosteroids, 5-HT3 receptor antagonists, and NK1 receptor antagonists are used according to clinical guidelines. Additionally, the neuroleptic olanzapine can be used to prevent CINV during highly emetogenic chemotherapy. The oral combination of netupitant and palonosetron (Akynzeo) is a modern drug for the prevention of CINV. The oral combination of netupitant and palonosetron has shown high efficacy in randomized trials and real-world clinical practice. Therapy for breakthrough and refractory CINV remains a significant challenge. Olanzapine has shown high efficacy for the treatment of breakthrough and refractory CINV. Additional options for the prevention of CINV, such as ginger preparations and music therapy, are being studied.

Индуцированные химиотерапией тошнота и рвота (ТиР) являются наиболее частым осложнением противоопухолевого лечения. Неконтролируемые ТиP приводят к значительному снижению качества жизни больных, нутритивной недостаточности, нарушению режима химиотерапии. В клинических исследованиях противорвотных препаратов в качестве первичной конечной точки используется показатель полного ответа. Полный ответ – это отсутствие ТиР и потребности в дополнительных противорвотных препаратах. Для профилактики ТиР при проведении химиотерапии применяют комбинации кортикостероидов, антагонистов 5-HT3-рецепторов, антагонист NK1-рецепторов согласно клиническим рекомендациям. Также для профилактики ТиР при высокоэметогенной химиотерапии может быть использован нейролептик оланзапин. Пероральная комбинация нетупитанта и палоносетрона (Акинзео) – современный препарат для профилактики ТиР, индуцированных химиотерапией. Пероральная комбинация нетупитанта и палоносетрона показала высокую эффективность в рандомизированных исследованиях и реальной клинической практике. Терапия «прорывной» и рефрактерной ТиР остается значимой проблемой. Оланзапин продемонстрировал высокую эффективность для терапии «прорывной» и рефрактерной ТиР. Продолжается изучение таких дополнительных опций профилактики ТиР, как препараты имбиря и музыкотерапия.

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