SAN ANTONIO – Netupitant/palonosetron (NEPA) is an efficacious and safe option for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (HEC) and moderately emegotenic chemotherapy (MEC), a study presented at the 2016 San Antonio Breast Cancer Symposium (SABCS) has shown.1

5HT3 receptor antagonists in combination with NK-1 receptor antagonists and dexamethasone are recommended by international antiemesis guidelines for patients receiving HEC, including anthracycline-cyclophosphamide (AC)-containing regimens, and MEC.

“The 2016 published updated antiemetic guideline of the Multinational Association of Supportive Care in Cancer (MASCC) recommends the use of this triple combination also for carboplatin-based regimens,” said Jorg P. Schilling, MD, Gynaeco-oncology, Berlin, Germany. NEPA is a fixed combination capsule combining the long lasting NK-1 receptor antagonist netupitant and the 5HT3 receptor antagonist palonosetron.”

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To evaluate the efficacy and safety of NEPA in patients receiving MEC or HEC, researchers in Germany conducted a noninterventional study of 2500 patients with cancer receiving care at more than 100 centers. Participants were receiving single-day or 2-day MEC or HEC.

To date, 1263 patients have been enrolled, of which 86.4% were women and 68.8% had breast cancer. The most common chemotherapy regimens were AC-based regimens, carboplatin-based regimens, and cisplatin-based regimens.

Results showed that in cycle 1, 88.5% achieved a complete response during the acute phase, 85.1% had a complete response in the delayed phase, and 79.3% had a complete response overall; in addition, 94%, 99%, and 93% had no emesis in cycle 1, respectively.

“NEPA was well tolerated with low-grade constipation being the most frequent treatment-related adverse event,” Dr Schilling added.

Researchers also found that 83.5% of patients rated the efficacy of NEPA as very good or good during cycle 1, while only 0.8% felt NEPA poorly controlled their nausea and vomiting.

“The efficacy as rated by physicians was similar during all 3 chemotherapy cycles with approximately 90% good or very good efficacy in each cycle,” said Dr Schilling.

“NEPA proved to be very effective in the prevention of chemotherapy-induced emesis and nausea in the acute and delayed phases of highly and moderately emetogenic, as well as AC-based, chemotherapy,” concluded Dr Schilling.


1. Schilling JP, Karthaus M, Klare P, et al. Non interventional study with netupitant/ palonosetron (NEPA) as CINV prophylaxis in highly or moderately emetogenic chemotherapy. Poster presented at: 2016 San Antonio Breast Cancer Symposium; December 6-10, 2016; San Antonio, TX.