Meta-Analysis

. 2022 Nov;30(11):8855-8869.

doi: 10.1007/s00520-022-07287-w. Epub 2022 Aug 12.

Interventions for the prevention of acute phase chemotherapy-induced nausea and vomiting in adult and pediatric patients: a systematic review and meta-analysis

Priya Patel^{1

2}, Paula D Robinson¹, Nora Wahib³, Patrick Cheung³, Thomas Wong³, Sandra Cabral¹, Arden Parker⁴, Marie Cohen⁵, Katie Devine⁶, Paul Gibson^{1

7}, Mark T Holdsworth⁸, Eloise Neumann⁹, Andrea Orsey^{10

11}, Robert Phillips¹², Daniela Spinelli¹³, Jennifer Thackray¹⁴, Marianne van de Wetering¹⁵, Deborah Woods¹⁶, Lillian Sung^{17

18}, L Lee Dupuis^{19

20

21}

Affiliations

¹ Pediatric Oncology Group of Ontario, Toronto, Canada.
² Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada.
³ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
⁴ McGill University, Montreal, Canada.
⁵ , Leeds, UK.
⁶ Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
⁷ Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Canada.
⁸ College of Pharmacy, University of New Mexico, Albuquerque, USA.
⁹ Birmingham Women's and Children's Hospital, Birmingham, UK.
¹⁰ Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, USA.
¹¹ Department of Pediatrics, University of Connecticut School of Medicine, Farmington, USA.
¹² Department of Haematology and Oncology, Leeds Teaching Hospital, NHS Trust, Leeds, UK.
¹³ , Toronto, Canada.
¹⁴ Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
¹⁵ Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands.
¹⁶ Davis Health, Pediatric Hematology/Oncology, University of California, Davis, USA.
¹⁷ Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
¹⁸ Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
¹⁹ Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada. lee.dupuis@sickkids.ca.
²⁰ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada. lee.dupuis@sickkids.ca.
²¹ Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. lee.dupuis@sickkids.ca.

PMID: 35953731
PMCID: PMC10153509
DOI: 10.1007/s00520-022-07287-w

Meta-Analysis

Interventions for the prevention of acute phase chemotherapy-induced nausea and vomiting in adult and pediatric patients: a systematic review and meta-analysis

Priya Patel et al. Support Care Cancer. 2022 Nov.

. 2022 Nov;30(11):8855-8869.

doi: 10.1007/s00520-022-07287-w. Epub 2022 Aug 12.

Authors

Affiliations

¹ Pediatric Oncology Group of Ontario, Toronto, Canada.
² Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada.
³ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
⁴ McGill University, Montreal, Canada.
⁵ , Leeds, UK.
⁶ Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
⁷ Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Canada.
⁸ College of Pharmacy, University of New Mexico, Albuquerque, USA.
⁹ Birmingham Women's and Children's Hospital, Birmingham, UK.
¹⁰ Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, USA.
¹¹ Department of Pediatrics, University of Connecticut School of Medicine, Farmington, USA.
¹² Department of Haematology and Oncology, Leeds Teaching Hospital, NHS Trust, Leeds, UK.
¹³ , Toronto, Canada.
¹⁴ Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
¹⁵ Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands.
¹⁶ Davis Health, Pediatric Hematology/Oncology, University of California, Davis, USA.
¹⁷ Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
¹⁸ Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
¹⁹ Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada. lee.dupuis@sickkids.ca.
²⁰ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada. lee.dupuis@sickkids.ca.
²¹ Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. lee.dupuis@sickkids.ca.

PMID: 35953731
PMCID: PMC10153509
DOI: 10.1007/s00520-022-07287-w

Abstract

Purpose: To identify effective and safe interventions to prevent acute phase chemotherapy-induced nausea and vomiting (CINV) in adult and pediatric patients.

Methods: We conducted a systematic review of randomized trials evaluating interventions to prevent acute CINV. Outcomes assessed were complete chemotherapy-induced vomiting (CIV) control, complete chemotherapy-induced nausea (CIN) control, complete CINV control, and discontinuation of antiemetics due to adverse effects.

Results: The search identified 65,172 citations; 744 were evaluated at full-text, and 295 (25 pediatric) met eligibility criteria. In patients receiving highly emetogenic chemotherapy (HEC), complete CIV (risk ratio (RR) 1.23, 95% confidence interval (CI) 1.05-1.44) and CIN (RR 1.34, 95% CI 1.10-1.62) control improved when olanzapine was added. The addition of a neurokinin-1 receptor antagonist (NK1RA) to a corticosteroid plus a serotonin-3 receptor antagonist (5HT3RA) also improved complete CIV (RR 1.11, 95% CI 1.08-1.14) and CIN (RR 1.05, 95% CI 1.01-1.08) control. Compared to granisetron/ondansetron, palonosetron provided improved complete CIV control when the 5HT3RA was given alone or when combined with dexamethasone. In patients receiving moderately emetogenic chemotherapy (MEC), dexamethasone plus a 5HT3RA improved complete CIV control compared to a 5HT3RA alone (RR 1.29, 95% CI 1.21-1.39). Only a single meta-analysis evaluating the safety outcome was possible.

Conclusions: For patients receiving HEC, various antiemetic regimens improved CIV and CIN control. For patients receiving MEC, administration of a 5HT3RA plus dexamethasone improved CIV control. Analysis of antiemetic safety was constrained by lack of data.

Keywords: Chemotherapy; Nausea; Pediatrics; Supportive care; Vomiting.

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Conflict of interest statement

Competing Interests

Financial interests: LLD has received grants from Heron Therapeutics for work outside of this clinical practice guideline. AO owns Pfizer stock.

No other author has relevant financial or non-financial interests to disclose.

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References

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Interventions for the prevention of acute phase chemotherapy-induced nausea and vomiting in adult and pediatric patients: a systematic review and meta-analysis

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Interventions for the prevention of acute phase chemotherapy-induced nausea and vomiting in adult and pediatric patients: a systematic review and meta-analysis

Authors

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Abstract

Conflict of interest statement

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