Abstract
Purpose
To update the 2009 recommendations for the prevention of acute chemotherapy-induced emesis in children.
Methods
We updated the original systematic literature search. Randomized studies were included in the evidence to support this guideline if they were primary studies fully published in full text in English or French; included only children less than 18 years old or, for mixed studies of adults and children, reported the pediatric results separately or the median or mean age was no more than 13 years; evaluated acute chemotherapy-induced nausea and vomiting (CINV) prophylaxis; provided sufficient information to permit determination of the emetogenicity of the antineoplastic therapy administered or the study investigators stated the emetogenicity of the chemotherapy administered; included an implicit or explicit definition of complete acute CINV response; described the antiemetic regimen in full; and reported the complete acute CINV response rate as a proportion.
Results
Twenty-five randomized studies, including eight published since 2009, met the criteria for inclusion in this systematic review. Prophylaxis with a 5-HT3 antagonist (granisetron or ondansetron or palonosetron or tropisetron) ± dexamethasone ± aprepitant is recommended for children receiving highly or moderately emetogenic chemotherapy. For children receiving chemotherapy of low emetogenicity, a 5-HT3 antagonist is recommended.
Conclusions
The findings of several randomized trials were used to update recommendations for the prevention of acute CINV. However, significant research gaps remain and must be addressed before CINV control in children can be optimized.
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References
Roila F, Aapro M, Stewart A (1998) Optimal selection of antiemetics in children receiving cancer chemotherapy. Support Care Cancer 6(3):215–220
Roila F, Feyer P, Maranzano R, Olver I, Clark-Snow R, Warr D, Molassiotos A (2005) Antiemetics in children receiving chemotherapy. Support Care Cancer 13:129–131
Jordan K, Roila F, Molassiotis A, Maranzano E, Clark-Snow R, Feyer P (2011) Antiemetics in children receiving chemotherapy. MASCC/ESMO guideline update 2009. Support Care Cancer 19(Supplement 1):37–42
Roila F, Herrstedt J, Aapro M, Gralla R, Einhorn L, Ballatori E, Bria E, Clark-Snow R, Espersen B, Feyer P, Grunberg S, Hesketh P, Jordan K, Kris M, Maranzano E, Molassiotis A, Morrow G, Olver I, Rapoport B, Rittenberg C, Saito M, Tonato M, Warr D (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol 21(suppl 5):v232–v243
Dupuis L, Boodhan S, Sung L, Portwine C, Hain R, McCarthy P, Holdsworth M (2011) Guideline for the classification of the acute emetogenic potential of antineoplastic medication in pediatric cancer patients. Pediatr Blood Cancer 57:191–198
Dupuis LL, Boodhan S, Holdsworth M, Robinson PD, Hain R, Portwine C, O’Shaughnessy E, Sung L (2013) Guideline for the prevention of acute nausea and vomiting due to antineoplastic medication in pediatric cancer patients. Pediatr Blood Cancer 60:1073–1082
U.S. Food and Drug Administration (2010) Anzemet (dolasetron mesylate): Drug Safety Communication—reports of abnormal heart rhythms. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm237341.htm. Accessed July 5 2011
Roila F, Herrstedt J, Gralla R, Tonato M (2011) Prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: guideline update and results of the Perugia consensus conference. Support Care Cancer 19(Suppl 1):S63–S65
Tonato M (1998) Introduction. Support Care Cancer 6:193
Gralla RJ, Osoba D, Kris MG, Kirkbride P, Hesketh PJ, Chinnery LW, Clark-Snow R, Gill DP, Groshen S, Grunberg S, Koeller JM, Morrow GR (1999) Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines. J Clin Oncol 17:2971–2994
Bakhshi S, Batra A, Biswas B, Dhawan D, Paul R, Sreenivas V (2015) Aprepitant as an add-on therapy in children receiving highly emetogenic chemotherapy: a randomized, double-blind, placebo-controlled trial. Support Care Cancer 23(11):3229–3223
Emir S, Erturgut P, Vidinlisan S (2013) Comparison of granisetron plus dexamethasone versus an antiemetic cocktail containing midazolam and diphenhydramine for chemotherapy induced nausea and vomiting in children. Indian J Med Paediatr Oncol : Off J Indian Soc Med Paediatr Oncol 34(4):270–273
Kang H, Loftus S, Taylor A, DiCristina C, Green S, Zwaan C (2015) Aprepitant for the prevention of chemotherapy-induced nausea and vomiting in children: a randomised, double-blind, phase 3 trial. Lancet Oncol 16(4):385–394. doi:10.1016/S1470-2045(15)70061-6
Kovacs G, Wachtel A, Basharova E, Spinelli T, Nicolas P, Kabickova E (2016) Efficacy and safety of palonosetron versus ondansetron in the preventions of chemotherapy-induced nausea and vomiting in paediatric patients with cancer receiving moderately or highly emetogenic chemotherapy: a randomised phase 3 double-blind non-inferiority study. Lancet Oncol 17(3):332–340. doi:10.1016/S1470-2045(15)00520-3
Pillai A, Sharma K, Gupta Y, Bakshi S (2011) Anti-emetic effect of ginger powder versus placebo as an add-on therapy in children and young adults receiving high emetogenic chemotherapy. Pediatr Blood Cancer 56:234–238
Yeh C, Chien L-C, Chiang Y, Lin S, Huang C, Ren D (2012) Reduction in nausea and vomiting in children undergoing cancer chemotherapy by either appropriate or sham auricular acupuncture points with standard care. J Altern Complement Med 18(4):334–340
Patil V, Prasada H, Prasad K, Shenoy U (2015) Comparison of antiemetic efficacy and safety of palonosetron vs ondansetron in the prevention of chemotherapy-induced nausea and vomiting in children. J Community Support Oncol 13(6):209–213
Traivaree C, Torcharus K, Lumkul R, Kormoltri C, Charuluxananan S (2011) Efficacy of intravenous dexamethasone for the prevention of vomiting associated with intrathecal chemotherapy and ketamine sedation in children: a randomized, double-blinded, crossover, placebo-controlled trial. Asian Biomed 5(4):441–448
Sepulveda-Vildosola A, Betanzos-Cabrera Y, Lastiri G, Rivera-Marquez H, Villasis-Keever M, del Angel V, Diaz F, Lopez-Aguilar E (2008) Palonosetron hydrochloride is an effective and safe option to prevent chemotherapy-induced nausea and vomiting in children. Arch Med Res 39:601–606
Alvarez O, Freeman A (1995) Randomized double-blind crossover ondansetron-dexamethasone versus ondansetron-placebo study for the treatment of chemotherapy-induced nausea and vomiting in pediatric patients with malignancies. J Pediatr Hematol Oncol 17(2):145–150
Koseoglu V, Kurekci A, Atay A, Ozcan O (1998) Comparison of the efficacy and side-effects of ondansetron and metoclopramide-diphenhydramine administered to control nausea and vomiting in children treated withantineoplastic chemotherapy: a prospective randomized study. Eur J Pediatr 157:806–810
Marshall G, Kerr S, Vowels M, O’Gorman-Hughes D, White L (1989) Antiemetic therapy for chemotherapy-induced vomiting: metoclopramide, benztropine, dexamethasone, and lorazepam regimen compared with chlorpromazine. J Pediatr 115:156–160
Aksoylar S, Akman SA, Ozgenc F, Kansoy S (2001) Comparison of tropisetron and granisetron in the control of nausea and vomiting in children receiving combined cancer chemotherapy. Pediatr Hematol Oncol 18(6):397–406
Brock P, Brichard B, Rechnitzer C, Langeveld N, Lanning M, Soderhall S, Laurent C (1996) An increased loading dose of ondansetron: a north European, double-blind randomised study in children, comparing 5 mg/m2 with 10 mg/m2. Eur J Cancer 32A:1744–1748
Chan H, Correia J, MacLeod S (1987) Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children: a double-blind, crossover trial. Pediatrics 79:946–952
Corapcioglu F, Sarper N (2005) A prospective randomized trial of the antiemetic efficacy and cost-effectiveness of intravenous and orally disintegrating tablet of ondansetron in children with cancer. Pediatr Hematol Oncol 22:103–114
Dick GS, Meller ST, Pinkerton CR (1995) Randomised comparison of ondansetron and metoclopramide plus dexamethasone for chemotherapy induced emesis. Arch Dis Child 73:243–245
Hahlen K, Quintana E, Pinkerton CR, Cedar E (1995) A randomized comparison of intravenously administered granisetron versus chlorpromazine plus dexamethasone in the prevention of ifosfamide-induced emesis in children. J Pediatr 126(2):309–313
Hirota T, Honjo T, Kuroda R, Saeki K, Katano N, Sakakibara Y (1993) Comparison of granisetron and granisetron plus methylprednisolone as antiemetic prophylaxis. Jpn J Cancer Chemother 20(15):2369–2373
Jaing T-H, Tsay P-K, Hung I-J, Hu W-Y (2004) Single-dose oral granisetron versus multidose intravenous ondansetron for moderately emetogenic cyclophosphamide-based chemotherapy in pediatric outpatients with actue lymphoblastic leukemia. Pediatr Hematol Oncol 21:227–235
Mabro M, Cohn R, Zanesco L, Madon E, Hahlen K, Margueritte G, Breatnach F, Gentet J-C, Plouvier E (2000) Granisetron en solution buvable dans la prevention des vomissements chimio-induits de l’enfant: comparison en double aveugle de deux posologies. Bull Cancer 87:259–264
Mehta P, Gross S, Graham-Pole J, Gardner R (1986) Methylprednisolone for chemotherapy-induced emesis: a double-blind randomized trial in children. J Pediatr 108:774–776
Parker RI, Prakash D, Mahan RA, Giugliano DM, Atlas MP (2001) Randomized, double-blind, crossover, placebo-controlled trial of intravenous ondansetron for the prevention of intrathecal chemotherapy-induced vomiting in children. J Pediatr Hematol Oncol 23(9):578–581
Sandoval C, Corbi D, Strobino B, Ozkaynak M (1999) Randomized double-blind comparison of single high-dose ondansetron and multiple standard-dose ondansetron in chemotherapy-naive pediatric oncology patients. Cancer Investig 17(5):309–313
White L, Daly S, McKenna C, Zhestkova N, Leal C, Breatnach M, Smelhaus V, Hung I-J, Kowalczyk J, Ninane J, Mitchell T (2000) A comparison of oral ondansetron syrup or intravenous ondansetron loading dose regimens given in combination with dexamethasone for the prevention of nausea and emesis in pediatric and adolescent patients receiving moderately/highly emetogenic chemotherapy. Pediatr Hematol Oncol 17:445–455
Baxter A, Watcha M, Baxter W, Leong T, Wyatt M (2011) Development and validation of a pictorial nausea rating scale for children. Pediatrics 127:e1542–e1549
Dupuis LL, Taddio A, Kerr EN, Kelly A, MacKeigan L (2006) Development and validation of a pediatric nausea assessment tool (PeNAT) for use by children receiving antineoplastic agents. Pharmacotherapy 26:1221–1231
Hahlen K, Quintana E (1995) A randomized comparison of intravenously administered granisetron versus chlorpromazine plus dexamethasone in the prevention of ifosfamide-induced emesis in children. J Pediatr 126(2):309–313
Phillips R, Friend A, Gibson F, Houghton E, Gopaul S, Craig J, Pizer B (2016) Antiemetic medication for prevention and treatment of chemotherapy-induced nausea and vomiting in childhood. Cochrane Database of Syst Rev (2):Art. No.: CD007786. doi:10.1002/14651858.CD007786.pub3
Gündisch S, Boeckeler E, Behrends U, Amtmann E, Ehrhardt H, Jeremias I (2012) Glucocorticoids augment survival and proliferation of tumor cells. Anticancer Res 32(10):4251–4261
Dix D, Cellot S, Price V, Gillmeister B, Ethier M, Johnston D, Lewis V, Michon B, Mitchell D, Stobart K, Yanofsky R, Portwine C, Silva M, Bowes L, Zelcer S, Brossard J, Traubici J, Allen U, Beyene J, Sung L (2012) Association between corticosteroids and infection, sepsis, and infectious death in pediatric acute myeloid leukemia (AML): results from the Canadian infections in AML research group. Clin Infect Dis 55(12):1608–1614
Straathof CS, van den Bent MJ, Ma J, Schmitz PI, Kros JM, Stoter G, Vecht CJ, Schellens JH (1998) The effect of dexamethasone on the uptake of cisplatin in 9 L glioma and the area of brain around tumor. J Neuro-Oncol 37(1):1–8
Dupuis LL, Lingertat-Walsh K, Walker S (2009) Stability of an extemporaneous oral liquid aprepitant formulation. Support Care Cancer 17:701–706
Sanchez RI, Wang RW, Newton DJ, Bakhtiar R, Lu P, Chiu SH, Evans DC, Huskey SE (2004) Cytochrome P450 3 A4 is the major enzyme involved in the metabolism of the substance P receptor antagonist aprepitant. Drug Metab Dispos 32:1287–1292
U.S. Food and Drug Administration (2014) Drug development and drug interactions: table of substrates, inhibitors and inducers. <http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/DrugInteractionsLabeling/ucm093664.htm>. 2016 January 27
Dupuis LL, MacKeigan L, Taddio A, Kerr E, Kelly A (2002) Development and validation of a pediatric nausea assessment tool for use by children receiving antineoplastic agents: preliminary analysis. Pharmacotherapy 22(abstract):1389
Flank J, Thackray J, Nielson D, August A, Schechter T, Alexander S, Sung L, Dupuis L (2015) Olanzapine for treatment and prevention of acute chemotherapy-induced vomiting in children: a retrospective, multi-center review. Pediatr Blood Cancer 62:496–501
Navari R (2015) Rolapitant for the treatment of chemotherapy-induced nausea and vomiting. Expert Rev Anticancer Ther 15(10):1127–1133
Jones E, Isom S, Kemper KJ, McLean TW, Jones E, Isom S, Kemper KJ, McLean TW (2008) Acupressure for chemotherapy-associated nausea and vomiting in children. J Soc Integr Oncol 6(4):141–145
Chan C, Lam L, Li C, Cheung J, Cheng K, Chik K, Chan H, So W, Tang W (2015) Feasibility of psychoeducational interventions in managing chemotherapy-associated nausea and vomiting (CANV) in pediatric oncology patients. Eur J Oncol Nurs 19:182–190
Acknowledgments
The MASCC Pediatric Guideline Development Panel is grateful to the Pediatric Oncology Group of Ontario (POGO) for granting permission to edit and update the evidence tables prepared for the 2013 POGO Guideline for the Prevention of Acute Nausea and Vomiting Due to Antineoplastic Medication in Pediatric Cancer Patients. The guidance of Dr. P.D. Robinson with respect to clinical practice guideline methods is acknowledged with thanks. The assistance of Ms. Elizabeth Uleryk, Library Scientist, with the literature search is also gratefully acknowledged as is the assistance of Dr. Priya Patel and Ms. Mila Khanna.
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L.L. Dupuis has participated in research partially supported by Sea-Band Ltd. A. Molassiotis has received honoraria and support from MSD Merck, Helsinn, Tesaro, Norgine, and Acacia Pharma. A. Orsey holds stock in Pfizer. Other authors had no disclosures to declare.
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Dupuis, L.L., Sung, L., Molassiotis, A. et al. 2016 updated MASCC/ESMO consensus recommendations: Prevention of acute chemotherapy-induced nausea and vomiting in children. Support Care Cancer 25, 323–331 (2017). https://doi.org/10.1007/s00520-016-3384-y
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DOI: https://doi.org/10.1007/s00520-016-3384-y