Efficacy of Netupitant–Palonosetron Combination Therapy Compared to Aprepitant-Based Regimens for Chemotherapy-Induced Nausea and Vomiting: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis

Dranitsaris G, Molassiotis A, Clemons M, et al. The development of a prediction tool to identify cancer patients at high risk for chemotherapy-induced nausea and vomiting. Ann Oncol. 2017;28(6):1260–7.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Moretti EW, Robertson KM, El-Moalem H, Gan TJ. Intraoperative colloid administration reduces postoperative nausea and vomiting and improves postoperative outcomes compared with crystalloid administration. Anesth Analg. 2003;96(2):611–7.

Article  PubMed  Google Scholar 

Krikorian S, Pories S, Tataronis G, et al. Adherence to oral chemotherapy: challenges and opportunities. J Oncol Pharm Pract. 2019;25(7):1590–8.

Article  PubMed  CAS  Google Scholar 

Woopen H, Richter R, Chekerov R, et al. Prognostic role of chemotherapy-induced nausea and vomiting in recurrent ovarian cancer patients: results of an individual participant data meta-analysis in 1213. Support Care Cancer. 2020;28(1):73–8.

Article  PubMed  Google Scholar 

Herrstedt J, et al. 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. ESMO Open. 2024. https://doi.org/10.1016/j.esmoop.2023.102195.

Article  PubMed  PubMed Central  Google Scholar 

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Antiemesis Version 1.2021. 2021.

Kris MG, Urba SG, Schwartzberg LS. Clinical roundtable monograph. Treatment of chemotherapy-induced nausea and vomiting: a post-MASCC 2010 discussion. Clin Adv Hematol Oncol. 2011;9(1):1–15.

PubMed  Google Scholar 

Hesketh PJ. Chemotherapy-induced nausea and vomiting. N Engl J Med. 2008;358(23):2482–94.

Article  PubMed  CAS  Google Scholar 

Grunberg SM, Osoba D, Hesketh PJ, et al. Evaluation of new antiemetic agents and definition of antineoplastic agent emetogenicity–an update. Support Care Cancer. 2005;13(2):80–4.

Article  PubMed  Google Scholar 

Wickham R. Nausea and vomiting. In: Yarbo CH, Frogge MH, Goodman M, editors. Cancer Symptom Management. 2nd ed. Jones and Bartlett Publishers; 1999. p. 228–63.

Google Scholar 

Schwartzberg L. Chemotherapy-induced nausea and vomiting: state of the art in 2006. J Support Oncol. 2006;4(2 Suppl 1):3–8.

PubMed  CAS  Google Scholar 

Pessi MA, Necchi A, Bossi P, et al. Nausea and vomiting during the first 3 intercycle periods in chemo-naive cancer patients receiving moderately/highly emetogenic therapy. Tumori. 2015;101(6):692–6.

Article  PubMed  CAS  Google Scholar 

US FDA. Akynzeo® (netupitant and palonosetron capsules; fosnetupitant and palonosetron for injection; fosnetupitant and palonosetron injection): US prescribing information. 2020. Available from: https://www.fda.gov. Accessed February 2024.

European Medicines Agency. Akynzeo: summary of product characteristics 2021. Available from: https://www.ema.europa.eu. Accessed February 2024.

Keating GM. Netupitant/palonosetron: a review in the prevention of chemotherapy-induced nausea and vomiting. Drugs. 2015;75(18):2131–41. https://doi.org/10.1007/s40265-015-0512-9.

Article  PubMed  CAS  Google Scholar 

Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. System Rev. 2015;4:1.

Article  Google Scholar 

Assessing risk of bias in a randomized trial. Available from: https://training.cochrane.org/handbook/current/chapter-08.

Completing ‘Summary of findings’ tables and grading the certainty of the evidence. Available from: https://training.cochrane.org/handbook/current/chapter-14.

Identifying and measuring heterogeneity. Available from: https://handbook-5-1.cochrane.org/chapter_9/9_5_2_identifying_and_measuring_heterogeneity.htm.

Gralla RJ, Bosnjak SM, Hontsa A, et al. A phase III study evaluating the safety and efficacy of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting over repeated cycles of chemotherapy. Ann Oncol. 2014;25(7):1333–9. https://doi.org/10.1093/annonc/mdu096.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Hesketh PJ, Rossi G, Rizzi G, et al. Efficacy and safety of NEPA, an oral combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting following highly emetogenic chemotherapy: a randomized dose-ranging pivotal study. Ann Oncol. 2014;25(7):1340–6. https://doi.org/10.1093/annonc/mdu110.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Zelek L, Debourdeau P, Bourgeois H, et al. A pragmatic study evaluating NEPA versus aprepitant for prevention of chemotherapy-induced nausea and vomiting in patients receiving moderately emetogenic chemotherapy. Oncologist. 2022;26(10):e1870–9. https://doi.org/10.1002/onco.13888.

Article  CAS  Google Scholar 

Zhang L, Lu S, Feng J, et al. A randomized phase III study evaluating the efficacy of single-dose NEPA, a fixed antiemetic combination of netupitant and palonosetron, versus an aprepitant regimen for prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (HEC). Ann Oncol. 2018;29(2):452–8. https://doi.org/10.1093/annonc/mdx698.

Article  PubMed  CAS  Google Scholar 

Navari RM. Profile of netupitant/palonosetron (NEPA) fixed dose combination and its potential in the treatment of chemotherapy-induced nausea and vomiting (CINV). Drug Des Devel Ther. 2014;9:155–61. https://doi.org/10.2147/DDDT.S76158.

Article  PubMed  PubMed Central  Google Scholar 

Navari RM. Palonosetron for the treatment of chemotherapy-induced nausea and vomiting. Expert Opin Pharmacother. 2014;15(17):2599–608. https://doi.org/10.1517/14656566.2014.972366.

Article  PubMed  CAS  Google Scholar 

Rojas C, Thomas AG, Alt J, et al. Palonosetron triggers 5-HT(3) receptor internalization and causes prolonged inhibition of receptor function. Eur J Pharmacol. 2010;626(2–3):193–9. https://doi.org/10.1016/j.ejphar.2009.10.002.

Article  PubMed  CAS  Google Scholar 

Rojas C, Slusher BS. Pharmacological mechanisms of 5-HT3 tachykinin NK-1 receptor antagonism to prevent chemotherapy-induced nausea and vomiting. Eur J Pharmacol. 2012;684:1–7.

Article  PubMed  CAS  Google Scholar 

Rojas C, Raje M, Tsukamoto T, Slusher BS. Molecular mechanisms of 5-HT3 and NK-1 receptor antagonists in prevention of emesis. Eur J Pharmacol. 2014;722:26–37.

Article  PubMed  CAS  Google Scholar 

Aapro M, Rugo H, Rossi G, et al. A randomized phase III study evaluating the efficacy and safety of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy. Ann Oncol. 2014;25(7):1328–33. https://doi.org/10.1093/annonc/mdu101.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Aapro MS, Karthaus M, Schwartzberg LS, et al. Phase 3 study of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting during repeated moderately emetogenic chemotherapy (MEC) cycles. J Clin Oncol. 2014;32(Suppl 5):9502. https://doi.org/10.1200/jco.2014.32.15_suppl.9502.

Article  Google Scholar 

Rossi G, Tilola SO, Rudengren C. A positron emission tomography study to assess the degree of neurokinin-1 receptor occupancy in the human brain after single doses of netupitant to healthy male subjects [abstract]. J Clin Oncol. 2012;30(Suppl):9054.

Article  Google Scholar 

Spinelli T, Calcagneli S, Giuliano C. Netupitant PET imaging and ADME studies in humans. J Clin Pharm. 2014;54:97–108.

Article  CAS  Google Scholar 

Rizzi A, Campi B, Camarda V, et al. In vitro and in vivo pharmacological characterization of the novel NK₁ receptor selective antagonist Netupitant. Peptides. 2012;37(1):86–97. https://doi.org/10.1016/j.peptides.2012.06.010.

Article  PubMed  CAS  Google Scholar 

Curran MP, Robinson DM. Aprepitant: a review of its use in the prevention of nausea and vomiting. Drugs. 2009;69:1853–8.

Article  PubMed  CAS  Google Scholar 

Sankhala KK, Pandya DM, Sarantopoulos J, et al. Prevention of chemotherapy induced nausea and vomiting: a focus on aprepitant. Expert Opin Drug Metab Toxicol. 2009;5(12):1607–14. https://doi.org/10.1517/17425250903451675.

Article  PubMed  CAS  Google Scholar 

National Cancer Institute Drug Dictionary. Available from: http://www.cancer.gov/drug dictionary. Accessed February 2024.

Navari RM. Palonosetron for the prevention of chemotherapy-induced nausea and vomiting in patients with cancer. Future Oncol. 2010;6:1074–84.

Comments (0)

No login
gif