PURPOSE: Prevention of chemotherapy-induced nausea and vomiting (CINV) remains an essential supportive care need for patients receiving cancer treatment. Due to inadequate access to antiemetics in many countries, guideline-recommended CINV prophylaxis is not always possible. Our goal was to formulate antiemetic recommendations for resource-limited settings and define alternative antiemetic regimens for the CINV prophylaxis after highly (HEC) and moderately emetic chemotherapy (MEC), when NK METHODS: The recommendations based on the MASCC/ESMO 2023 Guideline Update were considered as the best option. The stratification based on a meta-analysis published by Filetti et al. (2023) was used in order to select and rank NK RESULTS: For the prevention of acute CINV, in patients receiving HEC (HEC-cisplatin and AC-HEC) with no access to an NK CONCLUSION: The most effective prevention of CINV recommended by the MASCC/ESMO 2023 Guideline Update must be given when available and affordable. These recommendations were developed to facilitate decision on which regimen to use when the best MASCC/ESMO 2023 recommended regimen is not accessible because NK