Netupitant-palonosetron (NEPA) was a safe and effective strategy for managing chemotherapy-induced nausea and vomiting (CINV) in patients with lung cancer receiving platinum-based chemotherapy, according to a study published in Supportive Care in Cancer.

For this study, researchers conducted post-hoc analysis of 2 trials. The first trial was a phase 2 study in which researchers randomly assigned patients to receive NEPA, palonosetron, or ondansetron plus aprepitant. The second trial was a randomized phase 3 study in which patients were assigned to receive NEPA or oral aprepitant plus palonosetron.

Efficacy outcomes for both studies were complete response (CR) and no significant nausea (NSN) during acute, delayed, and overall postchemotherapy phases.

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Results of the study showed that CR rates were more than 88% and 75% among patients treated with cisplatin and carboplatin, respectively, who received NEPA for CINV, across the acute, delayed, and overall phases. Higher rates of CR were observed in patients treated with NEPA compared with palonosetron alone, and CR rates (more than 75%) were maintained over multiple cycles of chemotherapy.

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NSN rates were greater than 79% during cycle 1, and were maintained over multiple cycles of chemotherapy.

NEPA was well tolerated among all study patients. The most frequently reported adverse events included asthenia, hiccups, neutropenia, leukopenia, anemia, alopecia, and headache.

The authors concluded, “[a]s a highly effective oral combination antiemetic agent administered as a single dose once per cycle, NEPA may offer a convenient, simplified, prophylactic antiemetic.”


Hesketh RJ, Palmas M, Nicolas P. Preventing chemotherapy-induced nausea and vomiting in patients with lung cancer: efficacy of NEPA (netupitant-palonosetron), the first combination antiemetic [published online October 28, 2017]. Support Care Cancer. doi: 10.1007/s00520-017-3936-9