Evidence map›Paper›PMID 39432169›Full record

SynthesisSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2024

Multi-day vs single-day dexamethasone for the prophylaxis of chemotherapy-induced nausea and vomiting: systematic review and meta-analysis.

Ronald Chow, Luigi Celio, James Im, Saverio Caini, Lawson Eng, Elizabeth Prsic, Florian Scotté, Matti Aapro

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Global inequitable distribution of seminal studies of chemotherapy-induced nausea and vomiting.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ronald ChowPrincess Margaret Cancer Centre, University Health Network, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. ronald.chow@uhn.ca.
Luigi CelioMedical Oncology Unit 4, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
James ImFaculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Saverio CainiInstitute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
Lawson EngPrincess Margaret Cancer Centre, University Health Network, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Elizabeth PrsicYale Cancer Center, Yale University, New Haven, CT, USA.
Florian ScottéInstitut Gustave Roussy, Villejuif, France.
Matti AaproGenolier Cancer Center, Genolier, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOver the past decade, several randomized controlled trials have compared single-day dexamethasone (dexamethasone-sparing) regimens to the current standard multi-day dexamethasone antiemetic regimen for chemotherapy-induced nausea and vomiting (CINV). The aim of this systematic review and meta-analysis is to compare the efficacy and safety of dexamethasone-sparing regimens to standard multi-day dexamethasone, used for the prophylaxis of CINV.

methodsOvid Medline and Embase were searched from database inception to March 2024. Studies were included if they reported on randomized controlled trials of adult cancer patients receiving different scheduling of dexamethasone, for the endpoints of complete response, complete control, no nausea, no vomiting, and no use of rescue medication. Safety was also assessed. Meta-analysis, leave-one-out meta-analysis, and cumulative meta-analysis were conducted to generate summary effect estimates and assess the influence of single trials on the summary effect estimate.

resultsTen trials reporting on 2234 patients were included. Dexamethasone-sparing regimens were found to be no different to control arm in the acute (Risk Ratio [RR] 1.01; 95% CI, 0.94-1.08), delayed (RR 0.97; 95% CI, 0.89-1.05) and overall phases (RR 0.98; 95% CI, 0.90-1.06) for complete response. There was likewise no difference for complete control, no nausea, no vomiting, and no use of rescue medication. Safety profile was similar. There was no concern for bias in the published literature. No difference was found between studies reporting on anthracycline/cyclophosphamide-based highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC).

conclusionIn this comprehensive systematic review and meta-analysis, dexamethasone-sparing regimens were found to be no different to current multi-day regimens with respect to efficacy and safety for MEC and anthracycline/cyclophosphamide-based regimens. Clinicians and future guidelines should strongly consider greater adoption and endorsement of dexamethasone-sparing regimens.

Indexed as

AntiemeticsAntineoplastic AgentsDexamethasoneNauseaVomitingDrug Administration ScheduleHumansNeoplasmsRandomized Controlled Trials as TopicAntiemeticsAntineoplastic AgentsDexamethasoneChemotherapy-induced nausea and vomitingDexamethasoneDexamethasone-sparingEfficacyProphylaxisSafety

Identifiers

PMID39432169

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.