Ginger supplementation could be an effective adjuvant treatment for chemotherapy-induced nausea and vomiting (CINV); however, previous trials in this area have significant methodological limitations that preclude recommending the routine use of ginger in clinical practice.
The aim of this double-blind randomised controlled trial was to overcome these limitations and thereby determine the effect of adjuvant time- and dose-standardised ginger on chemotherapy-induced nausea (CIN)-related quality of life (QoL), compared to placebo, in chemotherapy-naïve patients over three cycles of moderately- or highly-emetogenic chemotherapy.
Fifty-one patients were randomly allocated to receive either 1.2 g of a standardised ginger extract or placebo per day, in addition to anti-emetic therapy. The supplements were divided into four capsules per day, consumed every four hours for five days during the first three cycles of chemotherapy. The primary outcome was CIN-related QoL measured with the Functional Living Index- Emesis (FLIE) questionnaire. Secondary outcomes included acute and delayed nausea, vomiting, and retching as well as cancer-related fatigue, nutritional status, and CIN and vomiting-specific prognostic factors.
In chemotherapy cycle 1, intervention participants reported significantly better Qol related to CIN (Median [25th, 75th percentile] = 61.5 [56.1, 63] vs 54 [46, 63]; p=0.029), CINV-related QoL (Median [25th, 75th percentile] = 124.5 [113, 126] vs 111 [99.2, 126]; p= 0.043), global QoL (Mean±standard deviation = 85.1±18.9 vs 71.9±18.3; p= 0.003) and less fatigue (Mean±standard deviation = 41.8±13.1 vs 32.2±10.8; p=0.007) than placebo participants. In cycle 3, global QoL (Median [25th, 75th percentile] = 83.6±15.0 vs 75.1±13.9; p=0.040) and fatigue (Mean±standard deviation = 42.4±10.2 vs 36.1±7.2; p=0.013) were significantly better in the intervention group compared to placebo. There was no difference in reported adverse effects.
This trial suggests adjuvant ginger supplementation is associated with better chemotherapy-induced nausea-related quality of life and less cancer-related fatigue, with no difference in adverse effects compared to placebo.