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, Paula D. Robinson, Nora Wahib, Patrick Cheung, Thomas Wong, Sandra Cabral, Arden Parker, Marie Cohen, Katie Devine, Paul Gibson, Mark T. Holdsworth, Eloise Neumann, Andrea Orsey, Robert Phillips, Daniela Spinelli, Jennifer Thackray, Marianne van de Wetering, Deborah Woods, Lillian Sung, L. Lee Dupuis

Onderzoeksoutput: Bijdrage aan tijdschriftArtikel recenserenpeer review

1 Citaat (Scopus)

Samenvatting

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.

Originele taal-2Engels
Pagina's (van-tot)8855-8869
Aantal pagina's15
TijdschriftSupportive Care in Cancer
Volume30
Nummer van het tijdschrift11
DOI's
StatusGepubliceerd - nov. 2022

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