Oral Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Standardized ginger extract  improves quality of life associated with chemotherapy-induced nausea and vomiting (#75)

Wolfgang Marx 1 2 , Alexandra McCarthy 3 4 , Karin Ried 5 , Dan Mckavanagh 4 , Anna Lohning 1 , Luis Vitetta 6 , Avni Sali 5 , Elisabeth Isenring 1
  1. Bond University, Robina, QLD, Australia
  2. La Trobe Univeristy, Melbourne, Victoria, Australia
  3. Institute of Biomedical Innovation, Queensland University of Technology , Brisbane, Australia
  4. Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
  5. National Institute of Integrative Medicine, Melbourne, Vic, Australia
  6. Medlab, Sydney, NSW, Australia

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.