Innovative approaches in the treatment of emesis

Over the last 15 years, appreciation of the role of dopaminergic (D-2) receptors and serotonergic (5-HT3) receptors has led to the development of a series of highly effective antiemetic agents. However, in spite of the suggestion of additional significant receptors (such as the NK-1 receptor and the opiate mu receptor), recent innovations in antiemetic treatment have concentrated on refinement of schedule, route, and dose. Single-dose regimens and oral formulations improve the convenience of antiemetic administration, while identification of the minimum effective dose has important economic implications. Involvement of experienced supportive care investigators in objective determination of utility scores for various supportive care modalities will be vital for rational inclusion of supportive care in pharmacoeconomic analysis, critical pathways, and clinical guidelines.