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Mesothelioma and chemotherapy-induced vomiting: Mesothelioma and chemotherapy-induced vomiting Expert commentary Jeremy Steele Expert commentary Jeremy Steele 

Mesothelioma and chemotherapy-induced vomiting: Mesothelioma and chemotherapy-induced vomiting Expert commentary Jeremy Steele Expert commentary Jeremy Steele
Chapter:
Mesothelioma and chemotherapy-induced vomiting: Expert commentary Jeremy Steele
Source:
Challenging Concepts in Oncology
Author(s):

Sarah Payne

DOI:
10.1093/med/9780199688883.003.0003

Malignant mesothelioma, a tumour of the pleura or peritoneum, is associated with previous asbestos exposure. It frequently presents with diffuse disease, which is not amenable to surgery. Chemotherapy in advanced disease has been shown to increase the time to disease progression and overall survival. Second-line treatment is ideally offered within a clinical trial. Radiotherapy offers good, but short-lived, symptomatic relief for chest pain. This case illustrates the management of a patient with inoperable mesothelioma, receiving chemotherapy and developing the complication of chemotherapy-induced vomiting (CINV). This is thought to be triggered by the activation of the chemoreceptor trigger zone, as well as the direct irritation of the gastrointestinal tract. Neurokinin-1 inhibitors, substance P inhibitors, and glucocorticoids represent the most effective groups of drugs to manage CINV in the prophylactic and refractory setting.

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