NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®)

AKYNZEO® plus dexamethasone is recommended in the NCCN Guidelines as an option (Category 1) for CINV prevention in both HEC and MEC†,1

To help identify patients at greatest risk for emesis (>90% frequency of emesis) from intravenous antineoplastic agents‡§
  • AC combination (any chemotherapy
    regimen that contains an anthracycline and cyclophosphamide)
  • Carboplatin AUC ≥4
  • Carmustine (>250 mg/m2)
  • Cisplatin
  • Cyclophosphamide (>1500 mg/m2)
  • Dacarbazine
  • Doxorubicin (≥60 mg/m2)
  • Epirubicin (>90 mg/m2)
  • Ifosfamide (≥2 g/m2 per dose)
  • Mechlorethamine
  • Streptozocin
To help identify patients at moderate risk for emesis (>30%-90% frequency of emesis) from intravenous antineoplastic agents‡§
  • Aldesleukin (>12-15 million IU/m2)
  • Amifostine (>300 mg/m2)
  • Arsenic trioxide
  • Azacitidine
  • Bendamustine
  • Busulfan
  • Carboplatin AUC <4||
  • Carmustine (≤250 mg/m2)||
  • Clofarabine
  • Cyclophosphamide (≤1500 mg/m2)
  • Cytarabine (>200 mg/m2)
  • Dactinomycin||
  • Daunorubicin||
  • Dual-drug liposomal encapsulation of cytarabine and daunorubicin
  • Dinutuximab
  • Doxorubicin (<60 mg/m2)||
  • Epirubicin (<90 mg/m2)||
  • Idarubicin
  • Ifosfamide (<2 g/m2 per dose)||
  • Interferon alfa (≥10 million IU/m2)
  • Irinotecan||
  • Melphalan
  • Methotrexate (≥250 mg/m2)||
  • Oxaliplatin||
  • Temozolomide
  • Trabectedin||

Start before chemotherapy.
Proportion of patients who experience emesis in the absence of effective antiemetic prophylaxis.
§ Continuous infusion may make an agent less emetogenic.
|| These agents may be highly emetogenic in certain patients.


Adapted with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Antiemesis V.2.2018. ©2018 National Comprehensive Cancer Network, Inc. All rights reserved. The NCCN Guidelines® and illustrations herein may not be reproduced in any form for any purpose without the express written permission of NCCN. To view the most recent and complete version of the NCCN Guidelines, go online to NCCN.org. The NCCN Guidelines are a work in progress that may be refined as often as new significant data become available.


The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.


Efficacy of AKYNZEO for injection for the prevention of CINV has not been established in a clinical study of patients treated with AC or other moderately emetogenic chemotherapy


AC
=anthracycline-cyclophosphamide.
AUC
=area under the curve.
CINV
=chemotherapy-induced nausea and vomiting.
HEC
=highly emetogenic chemotherapy.
MEC
=moderately emetogenic chemotherapy.
NCCN
=National Comprehensive Cancer Network® (NCCN®).