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ISSN (Print): 1568-0096
ISSN (Online): 1873-5576

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Review Article

Netupitant-palonosetron (NEPA) for Preventing Chemotherapy-induced Nausea and Vomiting: From Clinical Trials to Daily Practice

Author(s): Matti Aapro*, Karin Jordan, Florian Scotté, Luigi Celio, Meinolf Karthaus and Eric Roeland

Volume 22, Issue 10, 2022

Published on: 18 July, 2022

Page: [806 - 824] Pages: 19

DOI: 10.2174/1568009622666220513094352

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Abstract

Chemotherapy-induced nausea and vomiting (CINV) is a common adverse event associated with many anticancer therapies and can negatively impact patients' quality of life and potentially limit the effectiveness of chemotherapy. Currently, CINV can be prevented in most patients with guideline-recommended antiemetic regimens. However, clinicians do not always follow guidelines, and patients often face difficulties adhering to their prescribed treatments. Therefore, approaches to increase guideline adherence need to be implemented. NEPA is the first and only fixed combination antiemetic, composed of netupitant (oral)/fosnetupitant (intravenous) and palonosetron, which, together with dexamethasone, constitute a triple antiemetic combination recommended for the prevention of CINV for patients receiving highly emetogenic chemotherapy and for certain patients receiving moderately emetogenic chemotherapy. Thus, NEPA offers a convenient and straightforward antiemetic treatment that could improve adherence to guidelines. This review provides an overview of CINV, evaluates the accumulated evidence of NEPA's antiemetic activity and safety from clinical trials and real-world practice, and examines the preliminary evidence of antiemetic control with NEPA in daily clinical settings beyond those described in pivotal trials. Moreover, we review the utility of NEPA in controlling nausea and preserving patients’ quality of life during chemotherapy, two major concerns in managing patients with cancer.

Keywords: Netupitant-palonosetron (NEPA), chemotherapy-induced nausea and vomiting (CINV), NK1 receptor antagonist, 5-HT3 receptor antagonist, quality of life, antiemetic regimens.

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