Reducing dexamethasone antiemetic prophylaxis during the COVID-19 pandemic : recommendations from Ontario, Canada
PURPOSE: People with cancer face an elevated risk of infection and severe sequelae from COVID-19. Dexamethasone is commonly used for antiemetic prophylaxis with systemic therapy for cancer. However, dexamethasone is associated with increased risk of viral and respiratory infections, and causes lymphopenia, which is associated with worse outcomes during COVID-19 infections. Our purpose was to minimize dexamethasone exposure during antiemetic prophylaxis for systemic therapy for solid tumors during the COVID-19 pandemic, while maintaining control of nausea and emesis.
METHODS: We convened an expert panel to systematically review the literature and formulate consensus recommendations.
RESULTS: No studies considered the impact of dexamethasone-based antiemetic regimens on the risk and severity of COVID-19 infection. Expert consensus recommended modifications to the 2019 Cancer Care Ontario Antiemetic Recommendations.
CONCLUSION: Clinicians should prescribe the minimally effective dose of dexamethasone for antiemetic prophylaxis. Single-day dexamethasone dosing is recommended over multi-day dosing for regimens with high emetogenic risk excluding high-dose cisplatin, preferably in combination with palonosetron, netupitant, and olanzapine. For regimens with low emetogenic risk, 5-HT3 antagonists are recommended over dexamethasone.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer - 28(2020), 10 vom: 29. Okt., Seite 5031-5036 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Grant, Robert C [VerfasserIn] |
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| Links: |
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| Themen: |
7S5I7G3JQL |
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| Anmerkungen: |
Date Completed 01.09.2020 Date Revised 18.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00520-020-05588-6 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM311799078 |
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| 100 | 1 | |a Grant, Robert C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Reducing dexamethasone antiemetic prophylaxis during the COVID-19 pandemic |b recommendations from Ontario, Canada |
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| 500 | |a Date Completed 01.09.2020 | ||
| 500 | |a Date Revised 18.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: People with cancer face an elevated risk of infection and severe sequelae from COVID-19. Dexamethasone is commonly used for antiemetic prophylaxis with systemic therapy for cancer. However, dexamethasone is associated with increased risk of viral and respiratory infections, and causes lymphopenia, which is associated with worse outcomes during COVID-19 infections. Our purpose was to minimize dexamethasone exposure during antiemetic prophylaxis for systemic therapy for solid tumors during the COVID-19 pandemic, while maintaining control of nausea and emesis | ||
| 520 | |a METHODS: We convened an expert panel to systematically review the literature and formulate consensus recommendations | ||
| 520 | |a RESULTS: No studies considered the impact of dexamethasone-based antiemetic regimens on the risk and severity of COVID-19 infection. Expert consensus recommended modifications to the 2019 Cancer Care Ontario Antiemetic Recommendations | ||
| 520 | |a CONCLUSION: Clinicians should prescribe the minimally effective dose of dexamethasone for antiemetic prophylaxis. Single-day dexamethasone dosing is recommended over multi-day dosing for regimens with high emetogenic risk excluding high-dose cisplatin, preferably in combination with palonosetron, netupitant, and olanzapine. For regimens with low emetogenic risk, 5-HT3 antagonists are recommended over dexamethasone | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antiemetic | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Chemotherapy | |
| 650 | 4 | |a Glucocorticoids | |
| 650 | 4 | |a Supportive care | |
| 650 | 7 | |a Antiemetics |2 NLM | |
| 650 | 7 | |a Antineoplastic Agents |2 NLM | |
| 650 | 7 | |a Dexamethasone |2 NLM | |
| 650 | 7 | |a 7S5I7G3JQL |2 NLM | |
| 700 | 1 | |a Rotstein, Coleman |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Geoffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Forbes, Leta |e verfasserin |4 aut | |
| 700 | 1 | |a Vu, Kathy |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Roy |e verfasserin |4 aut | |
| 700 | 1 | |a Ng, Pamela |e verfasserin |4 aut | |
| 700 | 1 | |a Krzyzanowska, Monika |e verfasserin |4 aut | |
| 700 | 1 | |a Warr, David |e verfasserin |4 aut | |
| 700 | 1 | |a Knox, Jennifer |e verfasserin |4 aut | |
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