Emetogenic potential of single intravenous antineoplastic agents

High
Anthracycline/cyclophosphamide combination^* Carmustine Chlormethine (mechlorethamine) Cisplatin Cyclophosphamide ≥1500 mg/m² Dacarbazine Streptozocin
Moderate
Alemtuzumab Arsenic trioxide Azacitidine Bendamustine Busulfan Carboplatin^¶ Clofarabine Cyclophosphamide <1500 mg/m² Cytarabine >1000 mg/m² Cytarabine/daunorubicin liposomal Daunorubicin Dinutuximab beta Doxorubicin Epirubicin	Idarubicin Ifosfamide Irinotecan Irinotecan peg-liposomal Lurbinectedin Naxitamab Oxaliplatin Romidepsin Sacituzumab-govitecan^Δ Temozolomide^◊ Thiotepa^§ Trabectedin Trastuzumab-deruxtecan^Δ
Low
Aflibercept Amivantamab Axicabtagene-ciloleucel Belinostat Blinatumomab Bortezomib Brentuximab-vedotin Cabazitaxel Carfilzomib Catumaxomab Cetuximab Copanlisib Cytarabine ≤1000 mg/m² Decitabine Docetaxel Doxorubicin peg-liposomal Elotuzumab Enfortumab-vedotin Eribulin Etoposide 5-Fluorouracil Gemcitabine Gemtuzumab-ozogamicin Inotuzumab-ozogamicin Isatuximab	Ixabepilone Loncastuximab-tesirine Margetuximab Melphalan-flufenamide Methotrexate Mirvetuximab-soravtansine Mitomycin Mitoxantrone Moxetumomab-pasudotox Necitumumab Nelarabine Paclitaxel Paclitaxel nab-albumin Panitumumab Pemetrexed Pertuzumab Tafasitamab Tagraxofusp Teclistamab Temsirolimus Tisagenlecleucel Tisotumab-vedotin Topotecan Trastuzumab-emtansine Vinflunine
Minimal
Asparaginase^¥ Atezolizumab Avelumab Belantamab-mafodotin Bevacizumab Bleomycin Cemiplimab Cladribine (2-chlorodeoxyadenosine) Daratumumab Dostarlimab Durvalumab Emapalumab Fludarabine Ipilimumab Mosunetuzumab	Nivolumab Obinutuzumab Ofatumumab Pembrolizumab Pixantrone Polatuzumab-vedotin Pralatrexate Ramucirumab Rituximab Trastuzumab Tremelimumab Vinblastine Vincristine Vinorelbine

* The combination of an anthracycline and cyclophosphamide in patients with breast cancer is highly emetogenic.

¶ Emetic potential appears to be at the high end of the moderate category.

Δ Emetic potential appears to be at the high end of the moderate category, most closely resembling that of carboplatin.

◊ No direct evidence found for temozolomide IV; as all sources indicate a similar safety profile of oral temozolamide, the classification was based on oral temozolomide.

§ Classification refers to individual evidence from pediatric trials.

¥ Asparaginase erwinia chrysanthemi (crisantaspase) and asparaginase (calaspargase pegol).

From: Jordan K, Chan A, Gralla RJ, et al. Emetic risk classification and evaluation of the emetogenicity of antineoplastic agents—updated MASCC/ESMO consensus recommendation. Support Care Cancer 2023; 32:53. Copyright © 2023 The Authors. Available at: https://link.springer.com/article/10.1007/s00520-023-08220-5 (Accessed on April 11, 2024). Reproduced under the terms of the Creative Commons Attribution License 4.0.

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Emetogenic potential of single intravenous antineoplastic agents