Marx, W., McCarthy, A.L., Ried, K., McKavanagh, D., Vitetta, L., Sali, A., . . . Isenring, E. (2017). The effect of a standardized ginger extract on chemotherapy-induced nausea-related quality of life in patients undergoing moderately or highly emetogenic chemotherapy: A double blind, randomized, placebo controlled trial. Nutrients, 9, 867.

To determine if the addition of a standard dose ginger supplement to a standard antiemetic protocol for moderately to highly emetogenic chemotherapy in patients who were chemotherapy naïve reduced the incidence of CINV and positively affected quality of life. Secondarily, to determine the effect on fatigue and malnutrition in these same study patients

The study group received 1.2 g of ginger extract in addition to standard unspecified antiemetics while the control group was given a placebo. The ginger or placebo was taken in divided doses four times per day for five days starting the day of chemotherapy and four days after for three cycles. Both the ginger and the placebo were in similar capsule forms.

• N = 34   
• AGE: 57
• MALES: 37%  
• FEMALES: 63%
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: Breast cancer, colon cancer, lymphoma
• OTHER KEY SAMPLE CHARACTERISTICS: Moderately- and highly-emetogenic chemotherapy, Karnofsky score of 60, aged 18 years or older, no known coexisting disease process that causes nausea, and no use of over-the-counter drugs or complementary products.

• SITE: Single site   
• SETTING TYPE: Not specified    
• LOCATION: Brisbane, Australia

PHASE OF CARE: Active anti-tumor treatment

Double blinded, randomized, placebo controlled trial

Functional Living Index Emesis 5 Day Recall (FLIE-5DR), Rhodes Inventory of Nausea, Vomiting, and Retching (INVR), Patient-Generated Subjective Global (FACT-G) assessed nutrition; Functional Assessment of Cancer Therapy-Global (FACT-G) assessed fatigue and QOL; Functional Assessment of Chronic Illness Therapy-Fatigue (FACTIT-F) and an assessment of factors that are known to increase the risk of CINV; symptom assessment using the Edmonton Symptom Assessment Scale to determine any adverse reactions to the ginger/placebo.

The group receiving ginger had better nausea-related QOL and better total CINV-related QOL, less fatigue, and better overall cancer-related QOL, although clinical significance was minimal. There was no significant improvement in CINV occurrence or intensity.

Ginger had some benefits, including better nausea-related quality of life and better total CINV-related quality of life as well as less fatigue. The overall clinical significance of these findings is minimal. No significant improvement in CINV occurrence or intensity was noted.

• Small sample (< 100)
• Subject withdrawals ≥ 10%  
• Other limitations/explanation: The group receiving ginger were able to guess they were receiving ginger due to the smell, taste, or reflux and lack of nausea.

There was no indication as to the cost or availability of this ginger extract, which may affect relevance. Also many assessment tools were used which questions validity. This manuscript suggests that ginger may be effective on nausea-related quality of life and fatigue, but a larger study would need to be done to confirm these findings.