title: Review of oral fixed-dose combination netupitant and palonosetron (NEPA) for the treatment of chemotherapy-induced nausea and vomiting.
abstract: Current guidelines recommend the combination of a neurokinin-1 (NK1) receptor antagonist (RA) and a 5-hydroxytryptamine-3 (5-HT3) RA, together with corticosteroids, in order to prevent chemotherapy-induced nausea and vomiting with anthracycline-cyclophosphamide and highly emetogenic chemotherapy, and it is to be considered with moderately emetogenic chemotherapy. Netupitant and palonosetron (NEPA) is a fixed-dose combination of netupitant, a novel, highly selective NK1 RA, and palonosetron, a new-generation 5-HT3 RA, targeting two major emetic pathways in a single oral capsule. In clinical trials, NEPA administered on day 1 together with dexamethasone was highly effective and well tolerated in the prevention of chemotherapy-induced nausea and vomiting in patients with solid tumors undergoing moderately emetogenic chemotherapy or highly emetogenic chemotherapy. NEPA offers maximal convenience, and as a simple guideline-based regimen, has the potential to improve adherence to guidelines.
authors.affiliation: Medical Oncology Unit, National Cancer Institute Giovanni Paolo II, 70124 Bari, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Lorusso
authors.forename: Meinolf
authors.initials: M
authors.lastname: Karthaus
authors.forename: Matti
authors.initials: M
authors.lastname: Aapro
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004338:Drug Combinations; D004347:Drug Interactions; D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry / Q000493:pharmacokinetics; D009325:Nausea / Q000188:drug therapy* / Q000209:etiology*; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D000077924:Palonosetron; D011725:Pyridines / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry / Q000493:pharmacokinetics; D011812:Quinuclidines / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry / Q000493:pharmacokinetics; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists / Q000008:administration & dosage / Q000737:chemistry / Q000493:pharmacokinetics; D016896:Treatment Outcome; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology*; D010879:Piperazines; D044482:Benzeneacetamides
chemical_list: D004338:Drug Combinations; D007546:Isoquinolines; D000077924:Palonosetron; D011725:Pyridines; D011812:Quinuclidines; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists; C508854:netupitant; D010879:Piperazines; D044482:Benzeneacetamides
keywords: NEPA; antiemetic; chemotherapy-induced nausea and vomiting; netupitant; palonosetron