Guideline for the classification of the acute emetogenic potential of antineoplastic medication in pediatric cancer patients

Abstract

This guideline provides clinicians caring for children with an approach to assessing the acute emetogenic potential of antineoplastic therapies. It was developed by an international, inter-professional panel of clinicians and researchers using AGREE and CAN-ADAPTE methods. The emetogenicity of antineoplastic agents was evaluated and ranked as high, moderate, low, or minimal. The emetogenicity of multiple-agent and multiple-day antineoplastic therapy was also classified. Gaps in the evidence used to underpin the guideline recommendations were identified. The contribution of this guideline to the prevention of antineoplastic-induced nausea and vomiting in individual children about to receive antineoplastic therapy requires prospective evaluation.

Guideline for the Treatment of Breakthrough and the Prevention of Refractory Chemotherapy‐Induced Nausea and Vomiting in Children With Cancer

“…The three previously published guidelines address chemotherapy emetogenicity, prevention of acute CINV, and management of anticipatory CINV in children with cancer. [2][3][4] Complete versions of all four guidelines may be viewed at http://www.pogo.ca/healthcare/practiceguidelines/. Our recommendations are based on the assumption that children are receiving CINV prophylaxis that is consistent with the previously published guidelines.…”

Guideline for the prevention of acute nausea and vomiting due to antineoplastic medication in pediatric cancer patients

“…The authors of several studies categorized the emetogenicity of the antineoplastic regimens they studied as high or moderate without providing sufficient detail to determine the emetic risk as per the first POGO AINV guideline [4,5]. In making recommendations, less weight was placed on the results of these studies than those where the emetogenicity of the antineoplastic regimens studied was able to be verified against the POGO classification.…”

“…Emetogenicity was defined as per the first POGO AINV guideline [4,5]. That is, high, moderate, low, and minimal emetogenicity were defined as a >90%, 30 to <90%, 10 to <30% and <10% chance of causing emesis when antiemetic prophylaxis was not provided.…”

“…The first of this series has been published [4]. Full versions of both guidelines in this series are available on-line [5,6].…”

IV Administration of Erwinia-Derived Asparaginase in Pediatric Patients with Acute Lymphoblastic Leukemia: Single-Centre Case Series

“…These observations indicate that IV EA should be classified as at least moderately emetogenic, requiring use of an antiemetic and potentially the addition of dexamethasone. [10][11][12] We continue to work toward optimizing antiemetic choices to better control antineoplastic-induced nausea and vomiting with IV administration of EA.…”