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Management of Chemotherapy-Induced Nausea and Vomiting in Pediatric Patients

Rudolph M Navari1

  • 1Division of Hematology Oncology, School of Medicine, University of Alabama Birmingham, 1802 Sixth Avenue South, North Pavillion 2540K, Birmingham, AL, 35294, USA. rnavari@uabmc.edu.

Paediatric Drugs
|April 28, 2017
PubMed

Insights

This review examines antiemetic drugs for chemotherapy-induced nausea and vomiting (CINV) in children. Current guidelines recommend 5-HT3 receptor antagonists and aprepitant for CINV prevention in pediatric patients.

Area of Science:

  • Pediatric Oncology
  • Pharmacology
  • Clinical Pharmacy

Background:

  • Chemotherapy-induced nausea and vomiting (CINV) significantly impacts children's quality of life.
  • Effective antiemetic prophylaxis is crucial for managing CINV in pediatric cancer patients.

Purpose of the Study:

  • To review the safety and efficacy of current antiemetic agents for preventing CINV in children.
  • To provide evidence-based recommendations for antiemetic use in pediatric populations.

Main Methods:

  • A literature review of peer-reviewed articles and current international guidelines on antiemetic prophylaxis for CINV in children.
  • Analysis of data on the safety and efficacy of various antiemetic classes.

Main Results:

  • 5-Hydroxytryptamine-3 (5-HT3) receptor antagonists are safe and effective for acute CINV, with mild headache as a side effect.
  • Aprepitant (a neurokinin-1 receptor antagonist) is approved for specific pediatric age/weight groups.
  • Limited data exist for delayed CINV prevention and for other NK1 antagonists (netupitant, rolapitant) in children.
  • Olanzapine shows promise but requires further study in pediatric CINV.

Conclusions:

  • Practitioners should adhere to international antiemetic guidelines for optimal CINV care in children.
  • Tailoring antiemetic selection and dosage based on chemotherapy emetogenicity is recommended.
  • Further research is needed for delayed CINV and novel antiemetic agents in pediatric populations.

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