Ginger Reduce Chemotherapy-Related Nausea in large RCT

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Ginger Reduce Chemotherapy-Related Nausea in large RCT

Oral Presentation
Lead Author: Julie L. Ryan, PhD, MPH
Saturday, May 30, 2:00 PM ET
University of Rochester Medical Center
Level 2, West Hall F5
Rochester, NY

First Large, Randomized Study Shows Ginger Supplements Reduce Chemotherapy-Related Nausea

In the largest study to date evaluating the benefits of ginger for patients undergoing chemotherapy,
researchers report that early use of ginger supplements, in combination with traditional antinausea drugs,
significantly reduces chemotherapy-related nausea in patients with cancer.

“As many as 70 percent of patients who undergo chemotherapy experience nausea and vomiting. We
found that patients who received traditional anti-nausea drugs along with ginger supplements prior to
chemotherapy experienced significantly less nausea associated with their chemotherapy,” explained Julie
Ryan, PhD, MPH, assistant professor of dermatology and radiation oncology at the University of
Rochester and the study’s lead author. “However, as with all supplements, patients should speak with
their doctors first before taking ginger.”

Ginger is well-absorbed by the body and may have anti-inflammatory properties in the GI tract. Prior,
smaller studies assessing the benefit of ginger for chemotherapy-related nausea have produced
inconsistent results, and did not examine ginger supplementation before initiating chemotherapy, which
allows for earlier absorption by the body.

In this National Cancer Institute-funded study, 644 patients were randomly assigned to receive a placebo
or 0.5g, 1.0g or 1.5g of ginger (in capsule form) divided into two doses given each day for six days,
starting three days before the first day of a chemotherapy cycle. All patients also received traditional
drugs used to manage nausea associated with chemotherapy (antiemetics).

Patients rated their nausea at various times of day during the first four days of the chemotherapy cycle.
(Patients are most likely to experience the most unpleasant nausea on the first day of chemotherapy and
are less likely to have nausea on subsequent days if they don’t experience it on the first day.) The
findings showed that all doses of ginger significantly reduced nausea more than the placebo, with the 0.5g
and 1.0g doses having the greatest effect.

Abstract 9511
Ginger for chemotherapy-related nausea in cancer patients: A URCC CCOP randomized, double-blind,
placebo-controlled clinical trial of 644 cancer patients
J. L. Ryan, C. Heckler, S. R. Dakhil, J. Kirshner, P. J. Flynn, J. T. Hickok, G. R. Morrow
Background: Despite the widespread use of antiemetics, post-chemotherapy nausea and vomiting continue to be
reported by up to 70% of patients receiving chemotherapy. Ginger (Zingiber Officinale), an ancient spice, is used by
practitioners worldwide to treat nausea and vomiting. We conducted a multi-site, phase II/III randomized, placebo-
controlled, double-blind clinical trial to assess the efficacy of ginger for chemotherapy-related nausea in cancer
patients at the University of Rochester-affiliated Community Clinical Oncology Program (CCOP) member sites.
Methods: Cancer patients who experienced nausea following any chemotherapy cycle and were scheduled to
receive at least three additional cycles were eligible. Patients were randomized into four arms: 1) placebo, 2) 0.5g
ginger, 3) 1.0g ginger, or 4) 1.5g ginger. All patients received 5-HT3 receptor antagonist antiemetics on Day 1 of all
cycles and took three 250mg capsules of ginger or placebo twice daily for six days starting three days before the first
day of the next two cycles. Patients reported the severity of nausea during the morning, afternoon, evening, and night
on a 7-point semantic rating scale ("1" = "Not at all Nauseated" and "7" = "Extremely Nauseated”) for Days 1-4 of
each cycle. The goal was to determine if ginger was more effective than placebo in controlling chemotherapy-related
nausea in participants given a 5-HT3 receptor antagonist antiemetic. Results: A total of 644 patients were accrued
(90% female, mean age = 53). Breast (66%), alimentary (6.5%), and lung (6.1%) cancers were the most common
cancer types. Analysis of covariance (ANCOVA) examined change in nausea in the four study arms on Day 1 of
cycles 2 and 3. All doses of ginger significantly reduced nausea (p=0.003). The largest reduction in nausea occurred
with 0.5g and 1.0g of ginger. Also, time of day had a significant effect on nausea (p over 24 hours for patients using ginger. Conclusions: Ginger supplementation at daily dose of 0.5g-1.0g significantly
aids in reduction of nausea during the first day of chemotherapy. Supported by NCI PHS grants 1R25CA10618 and