Treatment of breakthrough and prevention of refractory chemotherapy-induced nausea and vomiting in pediatric cancer patients: Clinical practice guideline update

Priya Patel; Paula D Robinson; Robert Phillips; Christina Baggott; Katie Devine; Paul Gibson; Gregory M T Guilcher; Mark T Holdsworth; Eloise Neumann; Andrea D Orsey; Daniela Spinelli; Jennifer Thackray; Marianne van de Wetering; Sandra Cabral; Lillian Sung; L Lee Dupuis

doi:10.1002/pbc.30395

Treatment of breakthrough and prevention of refractory chemotherapy-induced nausea and vomiting in pediatric cancer patients: Clinical practice guideline update

Pediatr Blood Cancer. 2023 Aug;70(8):e30395. doi: 10.1002/pbc.30395. Epub 2023 May 13.

Authors

Priya Patel^{1

2}, Paula D Robinson¹, Robert Phillips³, Christina Baggott⁴, Katie Devine⁵, Paul Gibson^{1

6}, Gregory M T Guilcher^{7

8}, Mark T Holdsworth⁹, Eloise Neumann¹⁰, Andrea D Orsey^{11

12}, Daniela Spinelli¹³, Jennifer Thackray¹⁴, Marianne van de Wetering¹⁵, Sandra Cabral¹, Lillian Sung^{16

17}, L Lee Dupuis^{2

17

18}

Affiliations

¹ Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada.
² Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada.
³ Department of Haematology and Oncology, NHS Trust, Leeds Teaching Hospital, Leeds, UK.
⁴ Cancer Clinical Trials Office, Stanford Cancer Institute, Palo Alto, California, USA.
⁵ Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.
⁶ Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
⁷ Section of Paediatric Oncology and Blood and Marrow Transplant, Alberta Children's Hospital, Calgary, Alberta, Canada.
⁸ Departments of Oncology and Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
⁹ College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA.
¹⁰ Birmingham Women's and Children's Hospital, Birmingham, UK.
¹¹ Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
¹² Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
¹³ Patient representative.
¹⁴ Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
¹⁵ Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands.
¹⁶ Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁷ Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁸ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.

PMID: 37178438
DOI: 10.1002/pbc.30395

Abstract

This clinical practice guideline update provides recommendations for treating breakthrough chemotherapy-induced nausea and vomiting (CINV) and preventing refractory CINV in pediatric patients. Two systematic reviews of randomized controlled trials in adult and pediatric patients informed the recommendations. In patients with breakthrough CINV, escalation of antiemetic agents to those recommended for chemotherapy of the next higher level of emetogenic risk is strongly recommended. A similar recommendation to escalate therapy is made to prevent refractory CINV in patients who did not experience complete breakthrough CINV control and are receiving minimally or low emetogenic chemotherapy. A strong recommendation to use antiemetic agents that controlled breakthrough CINV for the prevention of refractory CINV is also made.

Keywords: chemotherapy-induced nausea and vomiting; guideline; pediatric oncology; supportive care.

Publication types

Practice Guideline

MeSH terms

Adult
Antiemetics* / adverse effects
Antineoplastic Agents* / adverse effects
Child
Humans
Nausea / chemically induced
Nausea / drug therapy
Nausea / prevention & control
Neoplasms* / complications
Neoplasms* / drug therapy
Vomiting / chemically induced
Vomiting / drug therapy
Vomiting / prevention & control

Substances

Antiemetics
Antineoplastic Agents