ASCO Guidelines provide recommendations with comprehensive review and analyses of the relevant literature for each recommendation, following the guideline development process as outlined in the ASCO Guidelines Methodology Manual . ASCO Guidelines follow the ASCO Conflict of Interest Policy for Clinical Practice Guidelines . Clinical Practice Guidelines and other guidance (“Guidance”) provided by ASCO is not a comprehensive or definitive guide to treatment options. It is intended for voluntary use by clinicians and should be used in conjunction with independent professional judgement. Guidance may not be applicable to all patients, interventions, diseases or stages of diseases. Guidance is based on review and analysis of relevant literature, and is not intended as a statement of the standard of care. ASCO does not endorse third-party drugs, devices, services, or therapies and assumes no responsibility for any harm arising from or related to the use of this information. See complete disclaimer in Appendix 1 and 2 (online only) for more. PURPOSE Extravasation is an uncommon but high-risk adverse event that occurs when an agent with the potential to cause tissue damage leaks out of the intended administration space into the surrounding area. This guideline presents evidence-based side effect management recommendations to support interprofessional teams in decision making to minimize severity or progression of extravasation injury from antineoplastic treatment in individuals with cancer. METHODS The Oncology Nursing Society and American Society of Clinical Oncology appointed health care professionals and patient representative members to a panel for guideline development focused on antineoplastic vesicants and irritants with vesicant properties. The panel applied GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology and followed the National Academies of Sciences, Engineering, and Medicine criteria for trustworthy guidelines. A systematic review of studies examining outcomes of antineoplastic agent extravasation in adults informed the guideline. The panel assessed the certainty of the evidence using the GRADE approach. RESULTS The panel agreed on recommendations related to the use of antidotes for antineoplastic vesicants and irritants with vesicant properties, thermal compress application and duration, and early surgical referral or escalation to specialty care for central venous access device extravasation. RECOMMENDATIONS This guideline summarizes evidence-based interventions for the management of extravasation of antineoplastic vesicants or irritants with vesicant properties to guide clinical care.
Thomas et al. (2025) studied this question.