Related Experiment Video
Updated: Mar 15, 2026
Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
Published on: June 21, 2024
2016 updated MASCC/ESMO consensus recommendations: Prevention of acute chemotherapy-induced nausea and vomiting in
L Lee Dupuis1,2, Lillian Sung3,4, Alexander Molassiotis5
1Department of Pharmacy and Research Institute, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. lee.dupuis@sickkids.ca.
Insights
Updated guidelines recommend 5-HT3 antagonists with or without dexamethasone and aprepitant for children receiving highly or moderately emetogenic chemotherapy. For low emetogenicity, a 5-HT3 antagonist is advised for preventing chemotherapy-induced nausea and vomiting.
Area of Science:
- Pediatric Oncology
- Clinical Pharmacology
- Evidence-Based Medicine
Background:
- Acute chemotherapy-induced nausea and vomiting (CINV) significantly impacts children's quality of life.
- Previous recommendations for pediatric CINV prevention were established in 2009.
- There is a need for updated evidence-based guidelines for pediatric CINV prophylaxis.
Purpose of the Study:
- To update the 2009 clinical practice guidelines for the prevention of acute chemotherapy-induced emesis in pediatric patients.
- To incorporate recent evidence from randomized controlled trials into CINV prevention strategies for children.
Main Methods:
- A systematic literature search was conducted to identify relevant randomized studies published in English or French.
- Studies included pediatric patients (<18 years) or reported pediatric data separately.
- Inclusion criteria focused on studies evaluating acute CINV prophylaxis, specifying chemotherapy emetogenicity and antiemetic regimens.
Main Results:
- Twenty-five randomized studies, including eight new since 2009, met the inclusion criteria.
- For highly or moderately emetogenic chemotherapy, prophylaxis with a 5-HT3 antagonist (e.g., ondansetron) ± dexamethasone ± aprepitant is recommended.
- For low emetogenicity chemotherapy, a 5-HT3 antagonist is recommended.
Conclusions:
- Updated recommendations for acute CINV prevention in children are based on recent randomized trial findings.
- Significant research gaps persist, highlighting the need for further investigation to optimize CINV control in pediatric oncology.
- Continued research is crucial for improving antiemetic strategies and patient outcomes.
Purpose:
To update the 2009 recommendations for the prevention of acute chemotherapy-induced emesis in children.
Methods:
We updated the original systematic literature search. Randomized studies were included in the evidence to support this guideline if they were primary studies fully published in full text in English or French; included only children less than 18 years old or, for mixed studies of adults and children, reported the pediatric results separately or the median or mean age was no more than 13 years; evaluated acute chemotherapy-induced nausea and vomiting (CINV) prophylaxis; provided sufficient information to permit determination of the emetogenicity of the antineoplastic therapy administered or the study investigators stated the emetogenicity of the chemotherapy administered; included an implicit or explicit definition of complete acute CINV response; described the antiemetic regimen in full; and reported the complete acute CINV response rate as a proportion.
Results:
Twenty-five randomized studies, including eight published since 2009, met the criteria for inclusion in this systematic review. Prophylaxis with a 5-HT3 antagonist (granisetron or ondansetron or palonosetron or tropisetron) ± dexamethasone ± aprepitant is recommended for children receiving highly or moderately emetogenic chemotherapy. For children receiving chemotherapy of low emetogenicity, a 5-HT3 antagonist is recommended.
Conclusions:
The findings of several randomized trials were used to update recommendations for the prevention of acute CINV. However, significant research gaps remain and must be addressed before CINV control in children can be optimized.
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