Antiemetic research: A look to the future

The classification of receptor involved in the emetic reflex has completely changed during the past 10 years. Today investigation agents acting as combined 5-HT₃ antagonists/5-HT₄ agonists, dopamine D₂/D₃ antagonists and the neurokinin₁ antagonists are in focus. Positron emission tomography (PET) is rapidly advancing as an investigational tool in the detection and staging of cancer and in the evaluation of response to treatment. It is emphasized that PET could also be useful in further investigations of the pathophysiology of emesis. Through antiemetic treatment has been optimized, delayed emesis, emesis during multiple cycles and, especially, refractory emesis after chemotherapy continue to present significant challenges requiring further clinical investigation, as does the syndrome of chronic nausea and vomiting in patients with advanced cancer.