Ali has been receiving cisplatin 75 mg/m2/day on day 1 in co…

Ali has been receiving cisplatin 75 mg/m2/day on day 1 in combination with paclitaxel 175 mg/m2/day on day 1 for advanced ovarian cancer every 3 weeks (plan for 6 cycles). Recently Ali has been experiencing nausea on days 2 and 3 despite the current preventative antiemetic regimen. Which breakthrough medication would you recommend adding to Ali’s current regimen (you can assume dose and dosing intervals are correct)? Current regimen: Fosaprepitant 150 mg IV on day 1 Palonosetron 0.25 mg IV on day 1 Olanzapine 5 mg PO on day 1-4 Dexamethasone 12 mg PO day 1, 8 mg PO days 2-4