Emetogenic Risk Of Chemotherapy And Biotherapy Agents

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Emetogenic Risk of 
NCCN Levels of Emetogenicity: 
 
Level 5 – High Emetic Risk: 90% frequency of emesis 
Chemotherapy and 
Level 3/4 – Moderate Emetic Risk: 30‐90% frequency of emesis 
 
 
Level 2 – Low Emetic Risk: 10‐30% frequency of
emesis 
Biotherapy Agents  
 
Level 1 – Minimal Emetic Risk: <10% frequency of emesis
 
Emetogenicity 
Emetogenicity 
Agents (alphabetically) 
Agents (alphabetically) 
 
 
 
AC combo: doxorubicin or epirubicin + cyclophosphamide 
5 
2 
Gemcitabine 
Alemtuzumab 
1 
1 
Gemtuzumab ozogamicin 
Alpha Interferon < 5000 IU/m2 
1 
1 
Gefitinib (oral) 
Amifostine < 300 mg 
2 
3 
Hexamethylmelamine (oral) 
Amifostine > 300 ‐ 500 mg/m2 
4 
1 
Hydroxyurea (oral) 
Androgens 
1 
1 
Ibritumomab tiuxetan 
Arsenic trioxide 
3 
3 
Ifosfamide 
Asparaginase 
1 
1 
Imatinib mesylate (oral) 
Azacitadine 
3 
3 
Interleukin‐2 > 12‐15 million units/m2 
Bendamustine 
3 
3 
Irinotecan 
Bevacizumab 
1 
1 
Ixabepilone 
Bexarotene (oral) 
2 
1 
Lapatinib (oral) 
Bleomycin 
1 
2 
Lenalidomide 
Bortezomib 
1 
3 
Lomustine (oral) 
Busulfan > 4 mg/d 
4 
5 
Mechlorethamine 
Capecitabine (oral) 
2 
1 
Melphalan (oral low‐dose) 
Carboplatin 
4 
4 
Melphalan > 50 mg/m2 
Carmustine ≤ 250 mg/m2 
4 
1 
Methotrexate ≤ 50 mg/m2 
Carmustine > 250 mg/m2 
5 
2 
Methotrexate > 50 mg/m2 < 250 mg/m2 
Cetuximab 
1 
3 
Methotrexate 250‐1,000 mg/m2 
Chlorambucil (oral) 
1 
4 
Methotrexate > 1,000 mg/m2 
Cisplatin ≥50 mg/m2 
5 
2 
Mitomycin 
Cisplatin < 50 mg/m2 
4 
2 
Mitoxantrone < 15 mg/m2 
Cladribine 
1 
1 
Nelarabine 
Clofarabine 
3 
3 
Oxaliplatin > 75 mg/m2 
Corticosteroids 
1 
2 
Paclitaxel/Paclitaxel albumin‐bound 
Cyclophosphamide (oral) 
3 
1 
Panitumumab 
Cyclophosphamide ≤ 750 mg/m2 
3 
2 
Pemetrexed 
Cyclophosphamide > 750 mg/m2 to ≤ 1,500 mg/m2 
4 
1 
Pentostatin 
Cyclophosphamide > 1,500 mg/m2 
5 
5 
Procarbazine (oral) 
Cytarabine (low dose) 100‐200 mg/m2 
2 
1 
Rituximab 
Cytarabine > 1 g/m2 
4 
2 
Sorafenib (oral) 
Dacarbazine 
5 
5 
Streptozocin 
Dactinomycin 
4 
2 
Sunitinib (oral) 
Dasatinib (oral) 
1 
3 
Temozolomide (oral) 
Daunorubicin 
3 
1 
Temsirolimus 
Denileukin diftitox 
1 
2 
Teniposide 
Dexrazoxane 
1 
1 
Thioguanine (oral) 
Docetaxel 
2 
2 
Topotecan 
Doxorubicin (liposomal) 
2 
1 
Tositumomab 
Doxorubicin < 60 mg/m2 
3 
1 
Trastuzumab 
Doxorubicin >60mg/m2 
4 
1 
Tretinoin (oral) 
Epirubicin ≤ 90 mg/m2 
3 
1 
Vinblastine 
Epirubicin > 90 mg/m2 
4 
1 
Vincristine 
Erlotinib (oral) 
1 
1 
Vinorelbine 
Etoposide 
2 
3 
Vinorelbine (oral) 
Fluorouracil 
2 
2 
Vorinostat (oral) 
Fludarabine 
1/2 
 

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