{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:35:14Z","timestamp":1787758514528,"version":"build-2784847793"},"reference-count":103,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The use of herbal medical preparation (HMP) is rising among pediatric oncology patients, often to manage treatment\u2010related symptoms. Their effectiveness remains uncertain, and the risk of herb\u2013drug interactions is underestimated. Objectives were to evaluate the benefit\u2013risk balance of commonly used herbal medicines in pediatric oncology and provide evidence\u2010based recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of herbal medicine\u2010related inquiries submitted to the Angers Regional Pharmacovigilance Centre (2016\u20132019) was conducted. Fourteen medicinal plants were selected on the basis of their use for abdominal pain, appetite loss, nausea\/vomiting, sleep, and anxiety. Their suitability for pediatric use, efficacy, toxicity, pharmacological mechanisms, and potential interactions with anticancer and supportive therapies were evaluated. Data were sourced from European Medicines Agency (EMA) monographs, PubMed, Memorial Sloan\u2010Kettering Cancer Center (MSKCC), and pharmacological reference texts. Benefit\u2013risk ratios and recommendation levels were assigned, and recommendations of proper use were summarized for herbal medicines without any objections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six medicinal plants were deemed to have a favorable benefit\u2013risk profile: leaf of peppermint, lemon balm and sweet fennel for abdominal pain; ginger for nausea and vomiting; lime tree and valerian for anxiety and sleep disorders. However, evidence remains limited, and product quality may vary. Sweet fennel and valerian should be used with caution in the presence of cytochrome P450 3A4 substrate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Some medicinal plants may be cautiously considered in pediatric oncology, but the risks of pharmacokinetic and pharmacodynamic interactions are substantial. This study proposes a shortlist of plants that may be considered and HMPs with potentially good benefit\u2013risk ratios. These findings should not be interpreted as therapeutic recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70459","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T03:29:53Z","timestamp":1785382193000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rational Use of Herbal Products in Pediatric Patients Treated With Anticancer Drugs in the European Union"],"prefix":"10.1002","volume":"73","author":[{"given":"Orianne","family":"Mahot","sequence":"first","affiliation":[{"name":"Department Pharmacy Faculty of Health Sciences University of Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Corvaisier","sequence":"additional","affiliation":[{"name":"Department Pharmacy Faculty of Health Sciences University of Angers  Angers France"},{"name":"UNIV ANGERS, EA4638, University of Angers  Angers France"},{"name":"Department of Pharmacy Angers University Hospital  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Spiesser\u2010Robelet","sequence":"additional","affiliation":[{"name":"Department Pharmacy Faculty of Health Sciences University of Angers  Angers France"},{"name":"Department of Pharmacy Angers University Hospital  Angers France"},{"name":"EA 3412 Health Education and Promotion Laboratory University of Sorbonne Paris Nord  Bobigny France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myl\u00e8ne","family":"Duplan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Angers University Hospital  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Pellier","sequence":"additional","affiliation":[{"name":"Department Pharmacy Faculty of Health Sciences University of Angers  Angers France"},{"name":"Department of Pediatric Oncology Angers University Hospital  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Bourneau\u2010Martin","sequence":"additional","affiliation":[{"name":"Department of Pharmacology\u2010Toxicology and Pharmacovigilance Angers University Hospital  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9verine","family":"Derbr\u00e9","sequence":"additional","affiliation":[{"name":"Department Pharmacy Faculty of Health Sciences University of Angers  Angers France"},{"name":"UNIV ANGERS, SONAS, SFR QUASAV University of Angers  Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"WHO Global Report on Traditional and Complementary Medicine 2019","author":"World Health Organization","year":"2019"},{"key":"e_1_2_11_3_1","unstructured":"A.del'Anses Rapport d'expertise collective. \u00c9tude individuelle nationale des consommations alimentaires 3 (INCA 3)[Internet](2017) https:\/\/www.anses.fr\/sites\/default\/files\/NUT2014SA0234Ra.pdf."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bulcan.2018.11.017"},{"key":"e_1_2_11_5_1","volume-title":"Phytochimie, Plantes M\u00e9dicinales","author":"Bruneton J.","year":"2016"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-002-1113-7"},{"key":"e_1_2_11_7_1","volume-title":"Herbal Medicinal Products","author":"EMA","year":"2024"},{"key":"e_1_2_11_8_1","unstructured":"Memorial Sloan Kettering Cancer Center Integrative Medicine: Search About Herbs(Memorial Sloan Kettering Cancer Center 2024) https:\/\/www.mskcc.org\/cancer\u2010care\/diagnosis\u2010treatment\/symptom\u2010management\/integrative\u2010medicine\/herbs\/search."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_11_10_1","unstructured":"Universit\u00e9 Libre de Bruxelles Universit\u00e9 Grenoble Alpes. 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