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Updated: Apr 10, 2026

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Dexamethasone for Chemotherapy-Induced Nausea and Vomiting Prevention in Pediatric Patients: International Consensus

Negar Shavandi1, Paula D Robinson2, Shana Jacobs3

  • 1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.

Pediatric Blood & Cancer
|April 9, 2026
PubMed

Insights

Dexamethasone benefits as an antiemetic outweigh risks for pediatric cancer patients with certain tumors or undergoing stem cell transplant. However, risks may outweigh benefits for those receiving CAR T-cell therapy or with fungal infections.

Area of Science:

  • Pediatric Oncology
  • Supportive Care
  • Pharmacology

Background:

  • Dexamethasone is frequently used as an antiemetic in pediatric cancer patients.
  • Determining the optimal use of dexamethasone requires careful consideration of its risks and benefits.

Purpose of the Study:

  • To establish consensus statements on the appropriate use of dexamethasone as an antiemetic in pediatric patients receiving chemotherapy.
  • To delineate scenarios where the risks of dexamethasone outweigh its benefits.

Main Methods:

  • An international Delphi panel of pediatric supportive care experts was convened.
  • Four electronic surveys and three virtual meetings were conducted to gather expert opinions.
  • Consensus was defined as at least 75% panelist response and 80% agreement.

Main Results:

  • Consensus was reached that dexamethasone benefits outweigh risks for pediatric patients with specific tumors (bone, germ cell, hepatoblastoma, retinoblastoma, rhabdomyosarcoma) and those undergoing autologous hematopoietic stem cell transplant.
  • Consensus indicated that dexamethasone benefits do not outweigh risks in pediatric patients undergoing chimeric antigen receptor T-cell therapy or with known fungal infections.

Conclusions:

  • The developed consensus statements offer guidance for using dexamethasone as an antiemetic in chemotherapy-naïve pediatric patients.
  • These guidelines aid clinicians in optimizing dexamethasone use for managing chemotherapy-induced nausea and vomiting in pediatric oncology.
Abstract

Keywords:
antiemetic agentschemotherapy‐induced vomitingdexamethasone

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