# Awareness of chemotherapy-induced nausea and vomiting and adherence to guidelines: results of a multinational and multicenter survey, part of the THRIVE program

## TL;DR

This study surveyed oncologists about their awareness and adherence to guidelines for managing chemotherapy-induced nausea and vomiting, revealing significant gaps and variability in practice.

## Contribution

The study provides new insights into oncologists' adherence to CINV guidelines and highlights discrepancies in managing newer chemotherapy agents and protocols.

## Key findings

- 65% of oncologists use multiple guidelines, but discrepancies exist, especially for newer agents and carboplatin dosing.
- 39% of respondents did not include neurokinin 1 receptor antagonist in MEC protocols for patients with additional risk factors.
- 35% of physicians rely solely on patient self-reports for delayed CINV assessment.

## Abstract

Chemotherapy-induced nausea and vomiting (CINV) is a common adverse effect that clearly benefits from prophylactic management. Awareness of CINV and adherence to CINV management guidelines was assessed under a continuing medical education program involving a personal practice assessment (PPA)—THRIVE (Training to Help Reduce CINV ratEs).

Forty-six medical oncologists from Canada (n = 21), Brazil (n = 20), and Argentina (n = 5) answered an anonymous survey of their practices during patient consultations. The questionnaire was developed by a group of medical oncologist experts.

The survey included data on 446 patients with multiple cancer types undergoing treatment with highly emetogenic chemotherapy (HEC; 60%) and moderately emetogenic chemotherapy (MEC; 40%). Although 65% of respondents reported using more than one guideline to establish CINV management protocols, discrepancies between respondents’ classifications and major guidelines were observed, particularly for newer agents and carboplatin dosing. In addition, 11% of respondents did not discuss personal additional risk factors for CINV with patients. Regarding CINV prophylactic protocol for MEC, 39% of respondents did not include neurokinin 1 receptor antagonist (NK-1 RA) in the regimen for patients with additional risk factors on MEC. The survey also revealed significant variability in the time points adopted for assessing CINV, with 35% of physicians relying solely on spontaneous reports by patients of delayed CINV.

There is a pressing need to explore and support initiatives for effective implementation of guidelines and identifying the causes of nonadherence.

The online version contains supplementary material available at 10.1007/s00520-026-10460-0.