{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T21:59:18Z","timestamp":1782338358775,"version":"3.54.5"},"reference-count":22,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Chemotherapy-induced nausea and vomiting (CINV) remains one of the significant challenges in oncology despite guideline-based prophylaxis, particularly in patients receiving highly emetogenic chemotherapy (HEC). While neurokinin-1 (NK-1) receptor antagonists are established as a key component of standard antiemetic regimens, evidence of their phase-specific effectiveness in real-world, homogeneous patient populations remains limited. This study aimed to determine which antiemetic regimen provides optimal control in each CINV phase to support a tailored prophylactic approach. Methods: This single-center, retrospective, real-world study included 260 female patients with stage II\u2013III breast cancer receiving anthracycline\u2013cyclophosphamide-based HEC. All patients had similar demographic and clinical characteristics, forming a relatively homogeneous cohort. Each received a triple antiemetic regimen consisting of a 5-HT3 receptor antagonist, dexamethasone, and an NK-1 receptor antagonist (either a single-dose intravenous fosaprepitant or a 3-day oral aprepitant). Complete response (no vomiting and no rescue therapy) and no-vomiting rates were assessed in the acute (0\u201324 h), delayed (24\u2013120 h), and overall (0\u2013120 h) phases. Results: In this relatively homogeneous cohort of high-risk patients, fosaprepitant-based prophylaxis achieved better symptom control during the acute phase, whereas aprepitant-based regimens were more effective in the delayed and overall phases. These findings suggest phase-specific variations in antiemetic effectiveness that reflect pharmacokinetic and administration-route differences rather than population heterogeneity. Conclusions: This real-world analysis demonstrates that antiemetic effectiveness varies by CINV phase, even within a relatively homogeneous, high-risk patient cohort. The results highlight the importance of phase-tailored prophylactic strategies to optimize symptom control and improve patient quality of life in highly emetogenic chemotherapy settings.<\/jats:p>","DOI":"10.3390\/curroncol33020078","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T17:40:22Z","timestamp":1769622022000},"page":"78","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing Antiemetic Strategies Across Phases of Chemotherapy-Induced Nausea and Vomiting: Real-World Evidence in Breast Cancer"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4275-2414","authenticated-orcid":false,"given":"Akif","family":"Do\u011fan","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Sancaktepe \u015eehit \u0130lhan Varank Training Research Hospital, Istanbul 34785, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3791-9157","authenticated-orcid":false,"given":"Hande Nur","family":"Er\u00f6lmez","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Health Sciences, Sancaktepe \u015eehit \u0130lhan Varank Training and Research Hospital, Istanbul 34785, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6221-0623","authenticated-orcid":false,"given":"Goncag\u00fcl","family":"Akda\u011f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Kartal L\u00fctfi K\u0131rdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2423-6902","authenticated-orcid":false,"given":"Sedat","family":"Y\u0131ld\u0131r\u0131m","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Kartal L\u00fctfi K\u0131rdar City Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-9360","authenticated-orcid":false,"given":"\u00d6zlem Nuray","family":"Sever","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University of Health Sciences, Sancaktepe \u015eehit \u0130lhan Varank Training Research Hospital, Istanbul 34785, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"ref_1","unstructured":"National Comprehensive Cancer Network (NCCN) (2025, May 12). 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