Chemotherapy-induced nausea and vomiting (CINV) is the one of the most serious, unpleasant and even severe adverse effects of cancer treatment. Based on the emetogenic potential, chemotherapeutic drugs are classified as high, moderate or low-risk drugs. However, the risk of developing CINV is anywhere between 70% – 80% in cancer patients. Chemotherapy-administered cancer patients are more prone to nausea than vomiting, which is poorly treated by anti-emetic drugs.
CINV interferes with the patient’s treatment compliance or adherence, with increased incidences of depression, distress or anxiety, and impaired quality of life. CINV increases the use of healthcare resources, and also the economic burden of patients and caregivers.
CINV pathogenesis involves a complex network of anatomical, neurological, neurotransmitters and respective receptors. The vomiting process is coordinated by the medulla oblongata, the chemoreceptor trigger zone located in the floor of the fourth ventricle,