Marx, W.M., Teleni, L., McCarthy, A.L., Vitetta, L., McKavanagh, D., Thomson, D., & Isenring, E. (2013). Ginger (Zingiber officinale) and chemotherapy-induced nausea and vomiting: A systematic literature review. Nutrition Reviews, 71, 245-254.

To review the current published research from randomized controlled trials (RCTs) and crossover trials evaluating the efficacy of ginger for prevention of chemotherapy-induced nausea and vomiting (CINV)

Databases searched were PubMed, CINAHL, and Cochrane library.

Search keywords were ginger, cancer , chemotherapy, nausea, emesis, vomiting, and CINV.

Studies were included in the review if they

• Were RCTs or crossover trials.
• Involved ginger as the main intervention.
• Were in English language.

Study exclusions were not reported.

• A total of 27 references were initially retrieved.
• Studies were rated using the National Health and Medical Research Council hierarchy of evidence. 
• The overall body of evidence was rated according to the American Dietetic Association quality criteria checklist.

• Seven studies were included in the final review.
• Sample sizes ranged from 36-576 patients in each trial for a total of 1,013 patients across all studies.
• One study was of children. Samples included male and female participants.

• All patients were in active antitumor treatment.
• The report has applications for pediatrics.

• Four studies reported positive results with ginger, and three showed no benefit. 
• Varied ginger doses were used, and various comparisons were used.
• Only one study involved use of a 5-HT₃ or other recommended CINV treatment in the regimen. 
• All studies were rated as level II (with level I as the highest level); however, not all studies reported how CINV was measured, and one involved multiple emetogenicity levels.

At best, findings show mixed results for use of ginger.  Overall body of evidence was rated as “C’ in which “D” was the lowest possible level.

• The number of studies was limited.
• The quality rating method used was questionable, because all studies were highly rated for quality but some did not even define the method of CINV measurement. 
• The review did not take into account what treatments were used for control comparisons, and many did not include recommended treatments.

This review does not support the use of ginger for CINV prevention.