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Supportive care in oncology Learning Zone

Quick Quiz

Read time: 5 mins
Last updated: 25th Aug 2022
Published: 25th Aug 2022
Declaration of sponsorship: Sandoz
Supportive Care in Oncology – Overview

Supportive care emerged from a need to prevent and manage the adverse effects of cancer and its treatment. Supportive care involves input from a specialised multidisciplinary team. Take our Quick Quiz to test your knowledge of supportive care in oncology.

1. The Multinational Association of Supportive Care in Cancer (MASCC) defines supportive care as:

Answer: MASCC defines supportive care as “The prevention and management of the adverse effects of cancer and its treatment1. This includes management of physical and psychological symptoms and side effects across the continuum of the cancer experience from diagnosis through treatment to post-treatment care”.

2. The European Society for Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO) and the European Organisation for Research and Treatment of Cancer (EORTC) recommend the prophylactic use of antimicrobials to prevent febrile neutropenia:

Answer: ESMO, ASCO and the EORTC do not recommend prophylactic use of antimicrobials to prevent febrile neutropenia2-4.

3. Febrile neutropenia can be effectively prevented by administering granulocyte-colony stimulating factors (G-CSFs) in patients who:

Answer: People with a >20% risk of febrile neutropenia, who have serious comorbidities, and are over the age of 60, qualify for prophylactic administration of G-CSFs. They are not recommended for people with a low risk of febrile neutropenia.

4. What is the optimal course of management for a patient undergoing targeted therapy who has developed thrombocytopenia, and with a platelet count of <25/μL?

Answer: Treatment should be withheld until consultation with a haematologist. Oncology guidelines recommend administration of oral prednisone 1–2 mg/kg/day and IVIg 1 g/kg2-4.

5. In patients receiving high-emetic-risk chemotherapy, ESMO and MASCC recommend which of the following to prevent nausea and vomiting?

Answer: ESMO and MASCC recommend a 3-drug combination of a 5-HT3 receptor antagonist+ DEX + an NK1 receptor antagonist before chemotherapy, with the addition of olanzapine in instances of delayed-onset emesis5, while ASCO recommends a 4-drug combination of an NK1 receptor antagonist + a 5-HT3 receptor antagonist + DEX + olanzapine on day 1 of treatment6.

References 

  1. Multinational Association of Supportive Care in Cancer (MASCC). What is supportive care? https://mascc.org/what-is-supportive-care/. Accessed 27 June 2022.
  2. Cooper KL, Madan J, Whyte S, Stevenson MD, Akehurst RL. Granulocyte colony-stimulating factors for febrile neutropenia prophylaxis following chemotherapy: systematic review and meta-analysis. BMC Cancer. 2011;11:404.
  3. Zimmer AJ, Freifeld AG. Optimal Management of Neutropenic Fever in Patients With Cancer. J Oncol Pract. 2019;15(1):19-24.
  4. Boccia R, Glaspy J, Crawford J, Aapro M. Chemotherapy-Induced Neutropenia and Febrile Neutropenia in the US: A Beast of Burden That Needs to Be Tamed? Oncologist. 2022.
  5. Walsh D, Davis M, Ripamonti C, Bruera E, Davies A, Molassiotis A. 2016 Updated MASCC/ESMO consensus recommendations: Management of nausea and vomiting in advanced cancer. Support Care Cancer. 2017;25(1):333-340.
  6. Hesketh PJ, Kris MG, Basch E, Bohlke K, Barbour SY, Clark-Snow RA, et al. Antiemetics: ASCO Guideline Update. J Clin Oncol. 2020;38(24):2782-2797.

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