Top

Supportive Care in Cancer

Published in:

01-05-2009 | Original Article

Phase II trial of encapsulated ginger as a treatment for chemotherapy-induced nausea and vomiting

Authors: Suzanna M. Zick, Mack T. Ruffin, Julia Lee, Daniel P. Normolle, Rivka Siden, Sara Alrawi, Dean E. Brenner

Published in: Supportive Care in Cancer | Issue 5/2009

Abstract

Goals of work

Ginger has been used to treat numerous types of nausea and vomiting. Ginger has also been studied for its efficacy for acute chemotherapy-induced nausea and vomiting (CINV). However, its efficacy for delayed CINV in a diverse oncology population is unknown.

Materials and methods

We performed a randomized, double-blind, placebo-controlled trial in 162 patients with cancer who were receiving chemotherapy and had experienced CINV during at least one previous round of chemotherapy. All participants were receiving a 5-HT₃ receptor antagonists and/or aprepitant. Participants were randomized to receive either 1.0 g ginger, 2.0 g ginger daily, or matching placebo for 3 days. The primary outcome was change in the prevalence of delayed CINV. Secondary outcomes included acute prevalence of CINV, acute and delayed severity of CINV, and assessment of blinding.

Main results

There were no differences between groups in the prevalence of delayed nausea or vomiting, prevalence of acute CINV, or severity of delayed vomiting or acute nausea and vomiting. Participants who took both ginger and aprepitant had more severe acute nausea than participants who took only aprepitant. Participants were able to accurately guess which treatment they had received. Ginger appeared well tolerated, with no difference in all adverse events (AEs) and significantly less fatigue and miscellaneous AEs in the ginger group.

Conclusions

Ginger provides no additional benefit for reduction of the prevalence or severity of acute or delayed CINV when given with 5-HT₃ receptor antagonists and/or aprepitant.

Aeschbach R, Loliger J, Scott BC et al (1994) Antioxidant actions of thymol, carvacrol, 6-gingerol, zingerone and hydroxytyrosol. Food Chem Toxicol 32(1):31–36 doi:10.1016/0278-6915(84)90033-4 PubMedCrossRef

Baranowski JD (1985) High-performance liquid-chromatographic separation of pungency components of ginger. J Chromatogr A 319(3):471–474 doi:10.1016/S0021-9673(01)90593-X CrossRef

Bloechl-Daum B, Deuson RR, Mavros P, Hansen M, Herrstedt J (2006) Delayed nausea and vomiting continue to reduce patients’ quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol 24(27):4472–4478 doi:10.1200/JCO.2006.05.6382 PubMedCrossRef

Chrubasik S, Pittler MH, Roufogalis BD (2005) Zingiberis rhizoma: a comprehensive review on the ginger effect and efficacy profiles. Phytomedicine 12(9):684–701 doi:10.1016/j.phymed.2004.07.009 PubMedCrossRef

Coates A, Abraham S, Kaye SB et al (1983) On the receiving end-patient perception of the side-effects of cancer chemotherapy. Eur J Cancer Clin Oncol 19(2):203–208 doi:10.1016/0277-5379(83)90418-2 PubMedCrossRef

Cohen L, de Moor CA, Eisenberg P, Ming EE, Hu H (2007) Chemotherapy-induced nausea and vomiting: incidence and impact on patient quality of life at community oncology settings. Support Care Cancer 15(5):497–503 doi:10.1007/s00520-006-0173-z PubMedCrossRef

Colditz GA, Miller JN, Mosteller F (1989) How study design affects outcomes in comparisons of therapy. I: Medical. Stat Med 8(4):441–454 doi:10.1002/sim.4780080408 PubMedCrossRef

http://ctep.cancer.gov/forms/CTCAEv3.pdf. Accessed on March 25th 2008

Devereaux PJ, Manns BJ, Ghali WA et al (2001) Physician interpretations and textbook definitions of blinding terminology in randomized controlled trials. JAMA 285(15):2000–2003 doi:10.1001/jama.285.15.2000 PubMedCrossRef

10.

de Wit R, Herrstedt J, Rapoport B et al (2003) Addition of the oral NK1 antagonist aprepitant to standard antiemetics provides protection against nausea and vomiting during multiple cycles of cisplatin-based chemotherapy. J Clin Oncol 21(22):4105–4111 doi:10.1200/JCO.2003.10.128 PubMedCrossRef

11.

Fergusson D, Glass K, Waring D, Shapiro S (2004) Turning a blind eye: the success of blinding reported in a random sample of randomized, placebo controlled trials. BMJ 328:7437

12.

Feyer P, Kleeberg UR, Steingraber M, Gunther W, Behrens M (2008) Frequency of side effects in outpatient cancer care and their influence on patient satisfaction—a prospective survey using the PASQOC(R) questionnaire. Support Care Cancer 16:567–575 doi:10.1007/s00520-008-0422-4 PubMedCrossRef

13.

Grunberg SM, Deuson RR, Mavros P et al (2004) Incidence of chemotherapy-induced nausea and emesis after modern antiemetics. Cancer 100(10):2261–2268 doi:10.1002/cncr.20230 PubMedCrossRef

14.

Grzanna R, Lindmark L, Frondoza CG (2005) Ginger—an herbal medicinal product with broad anti-inflammatory actions. J Med Food 8(2):125–132 doi:10.1089/jmf.2005.8.125 PubMedCrossRef

15.

Gupta YK, Sharma M (2001) Reversal of pyrogallol-induced delay in gastric emptying in rats by ginger (Zingiber officinale). Methods Find Exp Clin Pharmacol 23(9):501–503 doi:10.1358/mf.2001.23.9.662137 PubMedCrossRef

16.

Henry DH, Viswanathan HN, Elkin EP, Traina S, Wade S, Cella D (2008) Symptoms and treatment burden associated with cancer treatment: results from a cross-sectional national survey in the U.S. Support Care Cancer 16:791–801 doi:10.1007/s00520-007-0380-2 PubMedCrossRef

17.

Hoffman D (1983) The new holistic herbal. Element Books Limited, Shaftesbury, Dorset

18.

Huang QR, Iwamoto M, Aoki S, Tanaka N, Tajima K, Yamahara J, Takaishi Y, Yoshida M, Tomimatsu T, Tamai Y (1991) Anti-5-hydroxytryptamine3 effect of galanolactone, diterpenoid isolated from ginger. Chem Pharm Bull (Tokyo) 39(2):397–399

19.

Jolad SD, Lantz RC, Chen GJ, Bates RB, Timmermann BN (2005) Commercially processed dry ginger (Zingiber officinale): composition and effects on LPS-stimulated PGE2 production. Phytochemistry 66(13):1614–1635 doi:10.1016/j.phytochem.2005.05.007 PubMedCrossRef

20.

Jolad SD, Lantz RC, Solyom AM, Chen GJ, Bates RB, Timmermann BN (2004) Fresh organically grown ginger (Zingiber officinale): composition and effects on LPS-induced PGE2 production. Phytochemistry 65(13):1937–1954 doi:10.1016/j.phytochem.2004.06.008 PubMedCrossRef

21.

Kris MG, Hesketh PJ, Somerfield MR et al (2006) American Society of Clinical Oncology guideline for antiemetics in oncology: update 2006. J Clin Oncol 24(18):2932–2947PubMedCrossRef

22.

Krishnakantha TP, Lokesh BR (1993) Scavenging of superoxide anions by spice principles. Indian J Biochem Biophys 30(2):133–134PubMed

23.

Lantz RC, Chen GJ, Sarihan M, Solyom AM, Jolad SD, Timmermann BN (2007) The effect of extracts from ginger rhizome on inflammatory mediator production. Phytomedicine 14(2–3):123–128 doi:10.1016/j.phymed.2006.03.003 PubMedCrossRef

24.

Manusirivithaya S, Sripramote M, Tangjitgamol S et al (2004) Antiemetic effect of ginger in gynecologic oncology patients receiving cisplatin. Int J Gynecol Cancer 14(6):1063–1069 doi:10.1111/j.1048-891X.2004.14603.x PubMedCrossRef

25.

Mills S, Bone K (2000) Principles and practice of phytotherapy. Churchill Livingstone, Oxford

26.

Morrow GR (1992) A patient report measure for the quantification of chemotherapy induced nausea and emesis: psychometric properties of the Morrow assessment of nausea and emesis (MANE). Br J Cancer Suppl 19:S72–S74PubMed

27.

Ody P (1993) The complete medicinal herbal. Dorling-Kindersley, New York

28.

Pace J (1987) Oral ingestion of encapsulated ginger and reported self-care action for the relief of chemotherapy-associated N & E. Dissertations Abstracts International 47:3297–B

29.

Pecoraro A, Patel J, Guthrie T, Ndubisi B (1998) Efficacy of ginger as an adjunctive anti-emetic in acute chemotherapy-induced nausea and vomiting. ASHP Mid-Year Clinical Meeting, 429E

30.

Platel K, Srinivasan K (2000) Influence of dietary spices and their active principles on pancreatic digestive enzymes in albino rats. Nahrung 44(1):42–46 doi:10.1002/(SICI)1521-3803(20000101)44:1<42::AID-FOOD42>3.0.CO;2-D PubMedCrossRef

31.

Sharma SS, Gupta YK (1998) Reversal of cisplatin-induced delay in gastric emptying in rats by ginger (Zingiber officinale). J Ethnopharmacol 62(1):49–55 doi:10.1016/S0378-8741(98)00053-1 PubMedCrossRef

32.

Shibata C, Sasaki I, Naito H, Ueno T, Matsuno S (1999) The herbal medicine Dai-Kenchu-Tou stimulates upper gut motility through cholinergic and 5-hydroxytryptamine 3 receptors in conscious dogs. Surgery 126(5):918–924PubMed

33.

Sontakke S, Thawani V, Naik MS (2003) Ginger as an antiemetic in nausea and vomiting induced by chemotherapy: a randomized, cross-over, double-blind study. Indian J Pharmacol 35:32–36

34.

Surh YJ, Lee E, Lee JM (1998) Chemoprotective properties of some pungent ingredients present in red pepper and ginger. Mutat Res 402(1–2):259–267 doi:10.1016/S0027-5107(97)00305-9 PubMed

35.

Yamahara J, Huang QR, Iwamoto M, Kobayash G, Matsuda H, Fujimura H (1989) Active components of ginger exhibiting anti-serotonergic action. Phytother Res 3:70–71 doi:10.1002/ptr.2650030208 CrossRef

36.

Yamahara J, Huang QR, Li YH, Xu L, Fujimura H (1990) Gastrointestinal motility enhancing effect of ginger and its active constituents. Chem Pharm Bull (Tokyo) 38(2):430–431

Title: Phase II trial of encapsulated ginger as a treatment for chemotherapy-induced nausea and vomiting
Authors: Suzanna M. Zick
Mack T. Ruffin
Julia Lee
Daniel P. Normolle
Rivka Siden
Sara Alrawi
Dean E. Brenner
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 5/2009
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-008-0528-8

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Goals of work

Materials and methods

Main results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2009

Designing an oral mucositis assessment instrument for use in children: generating items using a nominal group technique

Nurses’ knowledge, attitudes, and practices regarding provision of sexual health care in patients with cancer: critical review of the evidence

Patterns of fatigue related to advanced disease and radiotherapy in patients with cancer—a comparative cross-sectional study of fatigue intensity and characteristics

Hospitalizations for infection in cancer patients: impact of an aging population

Prognostic implications of emergency admission and delays in patients with breast cancer

The Medical Care Continuity (MCC) project. A pilot study of video-assisted home care within the eTEN European Community program. The Italian experience

Keynote webinar | Spotlight on antibody–drug conjugates in cancer