Cinv - Nausea & Vomiting - Chemotherapy side effect This site development was supported by an unrestricted grant from Helsinn Healthcare SA
Patient name:

Emetic Risk – Single Oral Agents

Please click your patient's regimen from the list below.

Emetic risk Single Oral Agents
HIGH
  • Hexamethylmelamine
  • Procarbazine
MODERATE
  • Cyclophosphamide
  • Temozolomide
  • Vinorelbine
  • Imatinib
Low
  • Capecitabine
  • Tegafur Uracil
  • Etoposide
  • Sunitinib
  • Fludarabine
  • Everolimus
  • Lapatinib
  • Lenalidomide
  • Thalidomide
MINIMAL
  • Chlorambucil
  • Hydroxyurea
  • Melphalan
  • Methotrexate
  • 6-Thioguanine
  • Gefitinib
  • Sorafenib
  • Erlotinib
  • L-Phenylalanine mustard

Emetic Risk Groups – Single IV Agents

Please click your patient's regimen from the list below.

Emetic Risk Groups Single IV Agents  

High
Risk in nearly all patients (> 90%)

  • Cisplatin
  • Mechlorethamine
  • Streptozocin
  • Cyclophosphamide > 1500 mg/m2
  • Carmustine
  • Dacarbazine
 

Moderate
Risk in 30% to 90% of patients

  • Oxaliplatin
  • Cytarabine > 1000 mg/m2
  • Carboplatin
  • Ifosfamide
  • Cyclophosphamide < 1500 mg/m2
  • Azacitidine
  • Alemtuzumab
  • Doxorubicin
  • Daunorubicin
  • Epirubicin
  • Idarubicin
  • Irinotecan
  • Bendamustine
  • Clofarabine

Low
Risk in 10% to 30% of patients

  • Paclitaxel
  • Docetaxel
  • Mitoxantrone
  • Topotecan
  • Etoposide
  • Pemetrexed
  • Methotrexate
  • Doxorubicin HCL liposome injection
  • Temsirolimus
  • Ixabepilone
  • Mitomycin
  • Gemcitabine
  • Cytarabine < 1000 mg/m2
  • 5-Fluorouracil
  • Bortezomib
  • Cetuximab
  • Trastuzumab
  • Catumaxumab
  • Panitumumab
  • Temsirolimus

Minimal
Fewer than 10% at risk

  • Bleomycin
  • Busulfan
  • Cladribine
  • Fludarabine
  • Vinblastine
  • Vincristine
  • Vinorelbine
  • Bevacizumab
  • 2-Chlorodeoxyadenosine
 
Emetic risk of combination chemotherapy regimens used in the treatment
of non-hematologic cancers (regimens listed in alphabetical order)

Index: A B C D E F G I M T V

Please click your patient's regimen from the list below.
Regimen (reference) Agent/dose
(mg/m2)/route
Days of administration

in a single cycle
Most emetic agent Emetic risk

of the regimen (*)

A followed by CMF

(1)

Doxorubicin/75/IV

Cyclophosphamide/600/IV

Methotrexate/40/IV

Fluorouracil/600/IV

1

1

1

1

Cyclophosphamide

Doxorubicin

Moderate for A

Moderate for CMF

AC

(2)

Doxorubicin/60/IV

Cyclophosphamide/600/IV

1

1

Cyclophosphamide

Doxorubicin

High

AC followed by D

(3)

Doxorubicin/60/IV

Cyclophosphamide/600/IV

Docetaxel/100/IV

1

1

1

Cyclophosphamide

Doxorubicin

High for AC

Low for D

AC followed by T

(3)

Doxorubicin/60/IV

Cyclophosphamide/600/IV

Paclitaxel/80/IV

1

1

(weekly for 12 wks)

Cyclophosphamide

Doxorubicin

High for AC

Low for T

Dose-dense AC followed by T

(4)

Doxorubicin/60/IV

Cyclophosphamide/600/IV

Paclitaxel/175/IV

1

1

1

Cyclophosphamide

Doxorubicin

High for AC

Low for T

AD

(5)

Doxorubicin/50/IV

Docetaxel/75/IV

1

1

Doxorubicin

Moderate

AT

(6)

Doxorubicin/50/IV

Paclitaxel/125-220/IV

1

1

Doxorubicin

Moderate

BEP

(7)

Bleomycin/30 Units/IV

Etoposide/100 day/IV

Cisplatin/20 day/IV

3 (days 1,8,15)

5 (days 1-5)

5 (days 1-5)

Cisplatin

Moderate

CAF

(8)

Cyclophosphamide/100 day/PO

Doxorubicin/30/IV

Fluorouracil/500/IV

14 (days 1-14)

2 (days 1,8)

2 (days 1,8)

Cyclophosphamide

Doxorubicin

High

CapOx ±Bevacizumab

(9)

Capecitabine/2000 day/PO

Oxaliplatin/130/IV

14 (days 1-14)

1

Oxaliplatin

Moderate

CAV

(10)

Cyclophosphamide/1000/IV

Doxorubicin/45/IV

Vincristine/1.4/IV

1

1

1

Cyclophosphamide

Doxorubicin

High

Carbo+Docetaxel

(11)

Carboplatin/AUC5-6/IV

Docetaxel/60-75/IV

1

1

Carboplatin

Moderate

Carbo+Etoposide

(12)

Carboplatin/AUC5-6/IV

Etoposide/100 day/IV

1

3 (days 1-3)

Carboplatin

Moderate

Carbo+Irinotecan

(13)

Carboplatin/AUC5/IV

Irinotecan/50/IV

1

3 (days 1,8,15)

Carboplatin

Irinotecan

Moderate

Carbo+Paclitaxel ±Bevacizumab (14)

Paclitaxel/200/IV

Carboplatin/AUC6/IV

1

1

Carboplatin

Moderate

Carbo+Paclitaxel +Trastuzumab

(15)

Paclitaxel/175/IV

Carboplatin/AUC6/IV

1

1

Carboplatin

Moderate

CEF

(16)

Cyclophosphamide/75 day/PO

Epirubicin/60/IV

Fluorouracil/500/IV

14 (days 1-14)

2 (days 1,8)

2 (days 1,8)

Cyclophosphamide

Epirubicin

High

Cis+Capecitabine

(17)

Cisplatin/80/IV

Capecitabine/2000 day/PO

1

14 (days 1-14)

Cisplatin

High

Cis+Cetuximab

(18)

Cisplatin/100/IV

1

Cisplatin

High

Cis+Docetaxel

(19)

Cisplatin/75/IV

Docetaxel/75/IV

1

1

Cisplatin

High

Cis+Doxorubicin

(20)

Cisplatin/50/IV

Doxorubicin/60/IV

1

1

Cisplatin

High

Cis+Etoposide

(21)

Cisplatin/80/IV

Etoposide/100 day/IV

1

3 (days 1-3)

Cisplatin

High

Cis+Etoposide

(22)

Cisplatin/25 day/IV

Etoposide/100 day/IV

3 (days 1-3)

3 (days 1-3)

Cisplatin

Moderate

Cis+Fluorouracil

(23)

Cisplatin/100/IV

Fluorouracil/1000 day/CI

1

5 (days 1-5)

Cisplatin

High

Cis+Gemcitabine

(24)

Cisplatin/75/IV

Gemcitabine/1250/IV

1

2 (days 1,8)

Cisplatin

High

Cis+Gemcitabine

(25)

Cisplatin/25/IV

Gemcitabine/1000/IV

1

2 (days 1,8)

Cisplatin

Moderate

Cis+Irinotecan

(26)

Cisplatin/60/IV

Irinotecan/60/IV

1

3 (days 1,8,15)

Cisplatin

High

Cis+Paclitaxel

(27)

Cisplatin/75/IV

Paclitaxel/175/IV

1

1

Cisplatin

High

Cis+Pemetrexed

(24)

Cisplatin/75/IV

Pemetrexed/500/IV

1

1

Cisplatin

High

Cis+Vinorelbine

(28)

Cisplatin/80/IV

Vinorelbine/25/IV

1

2 (days 1,8)

Cisplatin

High

CIM

(29)

Cisplatin/20 day/IV

Ifosfamide/1500 day/IV

(Mesna/IV)

4 (days 1-4)

4 (days 1-4)

Cisplatin

Ifosfamide

Moderate

CMF

(30)

Cyclophosphamide/100 day/PO

Methotrexate/40/IV

Fluorouracil/600/IV

14 (days 1-14)

2 (days 1,8)

2 (days 1,8)

Cyclophosphamide

Moderate

DC

(31)

Docetaxel/75/IV

Cyclophosphamide/600/IV

1

1

Cyclophosphamide

Moderate

DC

+Trastuzumab

(32)

Docetaxel/75/IV

Carboplatin/AUC6/IV

1

1

Carboplatin

Moderate

DCF

(23)

Docetaxel/75/IV

Cisplatin/75/IV

Fluorouracil/750 day/CI

1

1

5 (days 1-5)

Cisplatin

High

EC

(33)

Epirubicin/75/IV

Cyclophosphamide/600/IV

1

1

Cyclophosphamide

Epirubicin

High

ECF

(34)

Epirubicin/50/IV

Cisplatin/60/IV

Fluorouracil/200 day/CI

1

1

21 (days 1-21)

Cisplatin

High

ECX

(34)

Epirubicin/50/IV

Cisplatin/60/IV

Capecitabine/1,250 day/PO

1

1

21 (days 1-21)

Cisplatin

High

EOX

(34)

Epirubicin/50/IV

Oxaliplatin/130/IV

Capecitabine/1250 day/PO

1

1

21 (days 1-21)

Epirubicin

Oxaliplatin

Moderate

ET

(33)

Epirubicin/75/IV

Paclitaxel/200/IV

1

1

Epirubicin

Moderate

FAC

(35)

Fluorouracil/500/IV

Doxorubicin/50/IV

Cyclophosphamide/500/IV

2 (days 1,8)

1

1

Cyclophosphamide

Doxorubicin

High

FEC

(36)

Fluorouracil/500/IV

Epirubicin/100/IV

Cyclophosphamide 500/IV

1

1

1

Cyclophosphamide

Epirubicin

High

FEC followed by D

(36)

Fluorouracil/500/IV

Epirubicin/100/IV

Cyclophosphamide/500/IV

Docetaxel/100/IV

1

1

1

1

Cyclophosphamide

Epirubicin

High for FEC

Low for D

FOLFIRI ±

a) Bevacizumab

b) Cetuximab

(37)

Fluorouracil/400/IV

Leucovorin/400/IV

Fluorouracil/1200 day/CI

Irinotecan/180/IV

1

1

2 (days 1,2)

1

Irinotecan

Moderate

FOLFOX-4 ±

a) Bevacizumab

b) Cetuximab

(38)

Fluorouracil/400 day/IV

Leucovorin/200 day/IV

Fluorouracil/600 day/CI

Oxaliplatin/85/IV

2 (days 1,2)

2 (days 1,2)

2 (days 1,2)

1

Oxaliplatin

Moderate

FOLFOXIRI

(39)

Irinotecan/165/IV

Oxaliplatin/85/IV

Fluorouracil/400 day/IV

Leucovorin/200/IV

Fluorouracil/1600 day/CI

1

1

1

1

2 (days 1,2)

Irinotecan

Oxaliplatin

Moderate

GEMOX

(40)

Gemcitabine/1000/IV

Oxaliplatin/130/IV

2 (days 1,8)

1

Oxaliplatin

Moderate

Ifosfamide+

Paclitaxel

(41)

Ifosfamide/1600 day/IV

Paclitaxel/135/IV

(Mesna/IV)

3 (days 1-3)

1

Ifosfamide

Moderate

Irinotecan +Cetuximab

(42)

Irinotecan/350/IV

1

Irinotecan

Moderate

mFOLFOX-6

(43)

Fluorouracil/400/IV

Leucovorin/400/IV

Fluorouracil/1200 day/CI

Oxaliplatin/85/IV

1

1

2 (days 1,2)

1

Oxaliplatin

Moderate

TAC

(44)

Docetaxel/75/IV

Doxorubicin/50/IV

Cyclophosphamide/500/IV

1

1

1

Cyclophosphamide

Doxorubicin

High

TAP

(20)

Paclitaxel/160/IV

Doxorubicin/45/IV

Cisplatin/50/IV

1

1

1

Cisplatin

High

TIP

(45)

Paclitaxel/250/IV

(Mesna/IV)

Ifosfamide/1500 day/IV

Cisplatin/25 day/IV

1

4 (days 2-5)

4 (days 2-5)

Cisplatin

Ifosfamide

Moderate

VeIP

(46)

Vinblastine/0.11mg/kg day/IV

(Mesna/IV)

Ifosfamide/1200 day/IV

Cisplatin/20 day/IV

2 (days 1,2)

5 (days 1-5)

5 (days 1-5)

Cisplatin

Ifosfamide

Moderate

VIP

(47)

Etoposide/75 day/IV

(Mesna/IV)

Ifosfamide/1200 day/IV

Cisplatin/20 day/IV

5 (days 1-5)

5 (days 1-5)

5 (days 1-5)

Cisplatin

Ifosfamide

Moderate

(*) Patients receiving multi-day chemotherapy are at risk for both acute and delayed nausea and emesis based upon the emetogenic potential of the individual agents and their sequence.   IV, intravenous; CI, continous infusion; PO, oral.

References
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47. Nichols CR, Catalano PJ, Crawford ED, et al. Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumours: an Eastern Cooperative Oncology group, Southwest Oncology Group, and Cancer and Leukemia Group B study. J Clin Oncol 1998; 16:1287-1293