Guideline for the prevention of acute nausea and vomiting due to antineoplastic medication in pediatric cancer patients

Abstract

This guideline provides an approach to the prevention of acute antineoplastic‐induced nausea and vomiting (AINV) in children. It was developed by an international, inter‐professional panel using AGREE and CAN‐IMPLEMENT methods. Evidence‐based interventions that provide optimal AINV control in children receiving antineoplastic agents of high, moderate, low, and minimal emetogenicity are recommended. Recommendations are also made regarding selection of antiemetic agents for children who are unable to receive corticosteroids for AINV control, the role of aprepitant and optimal doses of antiemetic agents. Gaps in the evidence used to support the recommendations were identified. The contribution of this guideline to AINV control in children requires prospective evaluation. Pediatr Blood Cancer 2013; 60: 1073–1082. © 2013 Wiley Periodicals, Inc.

Palonosetron versus ondansetron for prevention of chemotherapy-induced nausea and vomiting in paediatric patients with cancer receiving moderately or highly emetogenic chemotherapy: a randomised, phase 3, double-blind, double-dummy, non-inferiority study

“…2 In later guidance, the Pediatric Oncology Group of Ontario (POGO) Guideline for the Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients recommended that children scheduled to receive highly emetogenic therapy should receive antiemetic prophylactic therapy of ondansetron or granisetron plus dexamethasone and aprepitant (≥12 years of age and receiving antineoplastic agents not known to interact with aprepitant) or ondansetron or granisetron plus dexamethasone (<12 years of age or receiving aprepitant interacting agents). 12 For patients scheduled to receive moderately emetogenic chemotherapy, the recommendation in the POGO guidelines is that patients should receive ondansetron or granisetron plus dexamethasone._ENREF_12…”

IV Administration of Erwinia-Derived Asparaginase in Pediatric Patients with Acute Lymphoblastic Leukemia: Single-Centre Case Series

“…We recommend that IV EA be reclassified as moderately to highly emetogenic and that patients receive suitable prophylaxis, including, at a minimum, a serotonin inhibitor and potentially other adjuvant agents. 10 For patients with inadequate control of nausea, IM administration of EA remains an option.…”

“…These observations indicate that IV EA should be classified as at least moderately emetogenic, requiring use of an antiemetic and potentially the addition of dexamethasone. [10][11][12] We continue to work toward optimizing antiemetic choices to better control antineoplastic-induced nausea and vomiting with IV administration of EA.…”

“…10,11 Factors that influence the emetic risk include the chemotherapeutic agent, patient characteristics, frequency of administration, dosage of medication, and route of administration. Inadequate control of antineoplastic-induced nausea and vomiting can lead to anticipatory nausea and vomiting in 10% to 44% of patients.…”

Palonosetron compared with ondansetron in pediatric cancer patients: multicycle analysis of a randomized Phase III study

“…While fewer studies of these agents have been performed in pediatric cancer patients than in adults, at the time of the study design, the combination of a 5-HT 3 receptor antagonist with a corticosteroid was recommended for pediatric patients receiving HEC or MEC chemotherapy regimens [2,5,6]. In later guidance from the Pediatric Oncology Group of Ontario (POGO), children scheduled to receive HEC are recommended to receive antiemetic prophylactic therapy of ondansetron or granisetron plus dexamethasone and aprepitant (≥12 years of age and receiving antineoplastic drugs not known to interact with aprepitant) or ondansetron or granisetron plus dexamethasone (<12 years of For reprint orders, please contact: reprints@futuremedicine.com research article Kovács, Wachtel, Basharova, Spinelli, Nicolas & Kabickova future science group age or receiving aprepitant interacting agents) [8].…”