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

Author:

Patel Priya12,Robinson Paula D.1,Phillips Robert3,Baggott Christina4,Devine Katie5ORCID,Gibson Paul16,Guilcher Gregory M. T.78,Holdsworth Mark T.9,Neumann Eloise10,Orsey Andrea D.1112,Spinelli Daniela13,Thackray Jennifer14ORCID,van de Wetering Marianne15,Cabral Sandra1,Sung Lillian1617,Dupuis L. Lee21718ORCID

Affiliation:

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

Abstract

AbstractThis 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.

Publisher

Wiley

Subject

Oncology,Hematology,Pediatrics, Perinatology and Child Health

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