“For patients receiving chemotherapy, the use of the oral combination of netupitant (a neurokinin 1 receptor antagonist) and palonosetron (a 5-hydroxytryptamine-3 receptor antagonist) is beneficial for prevention of acute and delayed nausea and vomiting, according to a focused guideline update published online Nov. 2 in the Journal of Clinical Oncology.
“Paul J. Hesketh, M.D., from the Lahey Hospital and Medical Center in Burlington, Mass., and colleagues conducted a targeted systematic literature review to update guidelines on use of the oral combination of netupitant and palonosetron for prevention of acute and delayed nausea and vomiting among patients receiving chemotherapy.”
The gist: With a stamp of approval from the U.S. Food and Drug Administration (FDA), doctors in the U.S. are now free to prescribe a new treatment to combat nausea and vomiting caused by chemotherapy. The treatment combines the drugs netupitant and palonosetron (Akynzeo). Akynzeo was approved on its own in 2008, and netupitant is a new drug. Clinical trials have shown that the combo works better than Akynzeo alone.
The gist: Some cancer patients who are treated with chemotherapy experience nausea and vomiting as side effects. Researchers recently conducted three clinical trials with volunteer patients to test a treatment for chemotherapy-induced nausea and vomiting (CINV). The trials compared two different dosing schedules of a treatment that combines the drugs netupitant and palonosetron (aka Aloxi). The researchers reported that a single-dose schedule solved the CINV problem for more patients than a multidose schedule.
“A single-dose antiemetic regimen provided superior control of chemotherapy-induced nausea and vomiting (CINV) as compared with a standard multidose regimen, according to results of three randomized trials.
“In each trial, the fixed-dose combination of netupitant and palonosetron (Aloxi) led to a significantly higher rate of complete response during the delayed phase of the first cycle of chemotherapy versus control regimens. Complete response rates with netupitant-palonosetron (NEPA) regimen ranged from 76% to 89%, representing absolute differences of 5% to 14% versus the control groups.
“Taken together, results of the three trials suggest a ‘winning team’ in the search for optimal management of CINV, reported Matti Aapro, MD, of the Multidisciplinary Oncology Institute in Genolier, Switzerland, and colleagues in the July issue of Annals of Oncology.
” ‘If the present registration trial results are replicated in the “real” clinical world, then the NEPA formulation appears to be an advance in terms of overall efficacy and simplicity of dosing regime with the maintenance of efficacy over multiple cycles of chemotherapy being particularly encouraging,’ Paul L.R. Andrews, PhD, of St George’s University of London, said in an accompanying editorial.”