Table 1.

Key recommendations of antiemetic guideline groups.

Emetic risk category	MASCC/ESMO (2010) [3]		ASCO (2011) [4]		NCCN (2014) [5]
	Day 1	Days 2-3	Day 1	Days 2-3	Day 1	Days 2-3
High	NK1 RA + 5-HT3 RA + DEX	NK1 RAa + DEX	Same as MASCC	Same as MASCC	Same as MASCCc or olanzapine + PALO + DEX	NK1 RAa + DEXd or olanzapinee
AC	NK1 RA + 5-HT3 RA + DEX	NK1 RAa	Same as MASCCb	DEX + NK1 RAa	Same as MASCCc or olanzapine + PALO + DEX	Same as MASCCd or olanzapineg
Moderate	PALO + DEX	DEX	Same as MASCC	Same as MASCC	Same as MASCCc or NK1 RA + 5-HT3 RA + DEXf (in select patients)	5-HT3 RAh or DEX
Low	DEX or 5-HT3 RA or DRA	No routine prophylaxis	DEX	Same as MASCC	Same as MASCCi	Same as MASCC
Minimal	No routine prophylaxis	No routine prophylaxis	Same as MASCC	Same as MASCC	Same as MASCC	Same as MASCC

  ^aNK₁ RA (aprepitant) is given only if aprepitant was given on Day 1; if fosaprepitant was used then no follow-up NK₁ RA is administered.

^bAC is classified as highly emetogenic.

^cPalonosetron is preferred 5-HT₃.

^dGiven on Days 2–4 (i.e., an additional day).

^eIf olanzapine regimen was given on Day 1.

^fAs per highly emetogenic recommendations an NK₁ regimen should be administered with certain MEC agents (e.g., carboplatin, doxorubicin, epirubicin, ifosfamide, irinotecan, and methotrexate).

^gIf olanzapine was given on Day 1.

^hOnly an option if a 5-HT₃ other than PALO was used on Day 1.

ⁱSpecifically metoclopramide or prochlorperazine.

AC: anthracycline cyclophosphamide; NK₁ RA: neurokinin 1 receptor antagonist; 5-HT₃ RA: serotonin receptor antagonist; DEX: dexamethasone; DRA: dopamine receptor antagonist; PALO: palonosetron.