Appropriate Use of Antiemetics to Prevent Chemotherapy-Induced Nausea and Vomiting

Overuse of low-value oncology services has received increasing attention recently.¹ National campaigns, such as “Choosing Wisely,” have prompted medical specialty societies to identify areas for reducing use of low-value services. The use of antiemetic drugs to prevent chemotherapy-induced nausea and vomiting (CINV) exemplifies an area with high potential for overuse and was targeted in the 2013 set of Choosing Wisely recommendations put forth by the American Society of Clinical Oncology (ASCO).² Specifically, oncologists were cautioned not to use potent antiemetics (ie, neurokinin-1 receptor antagonists), which are intended for use among patients taking chemotherapy with a high risk of CINV, for patients initiating chemotherapy with a low or moderate risk of CINV.²