title: 2016 updated MASCC/ESMO consensus recommendations: Prevention of acute chemotherapy-induced nausea and vomiting in children.
abstract: To update the 2009 recommendations for the prevention of acute chemotherapy-induced emesis in children.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors: Department of Pharmacy and Research Institute, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. lee.dupuis@sickkids.ca.|Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada. lee.dupuis@sickkids.ca.
authors: L Lee
authors: LL
authors: Dupuis
authors: Department of Pediatrics and Research Institute, The Hospital for Sick Children, Toronto, Canada.|Faculty of Medicine, University of Toronto, Toronto, Canada.
authors: Lillian
authors: L
authors: Sung
authors: School of Nursing and WHO Collaborating Centre for Community Health Services, The Hong Kong Polytechnic University, Hong Kong, China.
authors: Alexander
authors: A
authors: Molassiotis
authors: Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, CT, USA.|Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA.
authors: Andrea D
authors: AD
authors: Orsey
authors: Department of Pediatric Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
authors: Wim
authors: W
authors: Tissing
authors: Department of Paediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, Netherlands.
authors: Marianne
authors: M
authors: van de Wetering
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D006801:Humans; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents
keywords: Antiemetics; Chemotherapy-induced nausea; Chemotherapy-induced vomiting; Pediatrics; Supportive care