Emetic risk of single intravenous antineoplastic agents in adults

Risk level	Agent
High (>90%)	Anthracycline/cyclophosphamide combination Carmustine Cisplatin Cyclophosphamide ≥1500 mg/m² Dacarbazine Mechlorethamine Streptozocin
Moderate (30 to 90%)	Alemtuzumab Arsenic trioxide Azacitidine Bendamustine Busulfan^* Carboplatin Clofarabine Cyclophosphamide <1500 mg/m² Cytarabine >1000 mg/m² Daunorubicin Daunorubicin and cytarabine liposome Doxorubicin	Epirubicin Fam-trastuzumab deruxtecan-nxki Idarubicin Ifosfamide Irinotecan Irinotecan liposomal injection Oxaliplatin Romidepsin Temozolomide^¶ Thiotepa^Δ Trabectedin
Low (10 to 30%)	Aflibercept Axicabtagene ciloleucel Belinostat Blinatumomab Bortezomib Brentuximab Cabazitaxel Carfilzomib Catumaxumab Cetuximab Copanlisib Cytarabine ≤1000 mg/m² Decitabine Docetaxel Elotuzumab Enfortumab vedotin-ejfv Eribulin Etoposide Fluorouracil Gemcitabine Gemtuzumab ozogamicin	Inotuzumab ozogamicin Ixabepilone Methotrexate Mitomycin Mitoxantrone Moxetumomab pasudotox Nab-paclitaxel Necitumumab Nelarabine Paclitaxel Panitumumab Pegylated liposomal doxorubicin Pemetrexed Pertuzumab Tagraxofusp-erzs Temsirolimus Tisagenlecleucel Topotecan Trastuzumab-emtansine Vinflunine
Minimal (<10%)	Atezolizumab Avelumab Bevacizumab Bleomycin Cemiplimab 2-Chlorodeoxyadenosine Cladribine Daratumumab Durvalumab Emapalumab Fludarabine Ipilimumab Nivolumab	Obinutuzumab Ofatumumab Pembrolizumab Pixantrone Polatuzumab vedotin Pralatrexate Ramucirumab Rituximab Trastuzumab Vinblastine Vincristine Vinorelbine

* Reclassified based on errata.^[1]

¶ No direct evidence found for intravenous temozolomide; because all sources indicate a similar safety profile to the oral formulation, the classification was based on oral temozolomide.

Δ Classification refers to individual evidence from pediatric trials.

Reference:

Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO guideline update: Errata. J Clin Oncol 2020; 38:3825

Reproduced with permission from Wolters Kluwer Health, Inc.: Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO guideline update. J Clin Oncol 2020; 38(24):2782-2797. Copyright © 2020 American Society of Clinical Oncology. https://ascopubs.org/journal/jco.

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Emetic risk of single intravenous antineoplastic agents in adults

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