Children receiving intermediate, high dose MTX experience poor CINV control

Share this content:

the ONA take:

Children with cancer receiving methotrexate had a poor complete chemotherapy-induced nausea and vomiting (CINV) rate, both in the acute and delayed phases, according to a new study published in the journal Supportive Care in Cancer.

For the prospective study, 30 children received intermediate-dose (ID-MTX: >1 to <12/g/m2/dose) or high-dose methotrexate (HD-MTX: ≥12 g/m2/dose). CINV prophylaxis was provided to pediatric patients at the discretion of the clinician.

Researchers documented antiemetic administration, nausea severity, and emetic episodes during the acute phase (for 24 hours from the start of the methotrexate infusion) and the delayed phase (for up to a further 168 hours).

Researchers found that CINV prophylaxis received ondansetron or granisetron plus dexamethasone or nabilone. Results showed that among the 10 patients that received HD-MTX, 0% achieved complete control during the acute phase and 30% experienced complete control in the delayed phase.

Among the 20 patients that received ID-MTX, the complete control rates were 20% and 5% in the acute and delayed phase, respectively.

The findings confirm the classification of HD-MTX as highly emetogenic chemotherapy and suggest that ID-be reclassified as highly emetogenic chemotherapy, as well.

When caring for pediatric oncology patients, awareness of patients’ emotional needs is important.
Children with cancer receiving methotrexate had a poor complete chemotherapy-induced nausea and vomiting (CINV) rate.
Chemotherapy emetogenicity is the most important known determinant of chemotherapy-induced vomiting (CIV) in children. However, direct evidence regarding the emetogenic potential of chemotherapeutic agents in children is limited. This study describes the prevalence of complete control of acute and delayed phase chemotherapy-induced nausea and vomiting (CINV) in children receiving methotrexate.
You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings


Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs