Inclusion Criteria:  Adult patients aged ≥18 years Patients with a risk score of ≥ 13 as calculated by the algorithm - see 3.6.3.1. Baseline/screening: VISIT 0 Signed Informed consent Both sexes Patients with diagnosis of any cancer scheduled and intended to be treated for three consecutive cycles with a single dose of any IV MEC regimen, per cycle, including adjuvant or neo-adjuvant chemotherapy Patients with Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2 Use of Standard of Care defined as a 5-HT3 RA + Dexamethasone (or equivalent corticosteroid) based-regimen on day 1 of chemotherapy for CINV prevention Naïve and non- naïve to chemotherapy The enrolled women should be a) of non-childbearing potential or b) of childbearing potential using reliable contraceptive measures and having a negative urine pregnancy test done by health care team within 1-24 hours before dosing the antiemetic treatment in both arms and outcome recorded in the medical records Able to comply with study requirements  Exclusion Criteria:  Patients receiving highly emetogenic chemotherapy (including anthracycline+cyclophosphamide-based chemotherapy) Patients receiving oral moderately emetogenic chemotherapy drugs Patients receiving opioids within 2 weeks prior to trial enrollment (longer use allowed) Use of olanzapine as prophylaxis of CINV Patients scheduled to receive radiotherapy concurrently with chemotherapy Any illness or condition that, in the opinion of the physician, may confound the results of the study or pose unwarranted risks in administering the investigational product to the patient. Patients with mechanical risk factors for nausea (i.e. intestinal obstruction) Patients with liver disease (as nausea is a common presenting symptom) Patients with metabolic risk factors for nausea (i.e. electrolyte imbalances causing nausea/vomiting) Chronic treatment with steroids (with the exception of inhaled or topical steroids) Pregnancy and/or breast-feeding women Women of childbearing potential refusing to use effective contraception during the whole study treatment and up to one month after study treatment with Akynzeo® Use of Standard of Care including an NK-1 RA-based regimen to prevent CINV