The safety and efficacy of NEPA (netupitant and palonosetron) in the treatment of chemotherapy-induced nausea and vomiting

ABSTRACT

Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life. The combination of a 5-hydroxytryptamine-3 (5-HT₃) receptor antagonist, dexamethasone, and a neurokinin-1 (NK-1) receptor antagonist has significantly improved the control of CINV. Palonosetronis a second generation 5-HT₃ receptor antagonist. Netupitant is a new NK-1 receptor antagonist with a high binding affinity and a long half-life of 90 hours. NEPA is an oral fixed-dose combination of netupitant and palonosetron (300 mg of netupitant plus 0.50 mg of palonosetron). Phase II and phase III clinical trials have demonstrated that NEPA significantly improved the prevention of CINV compared to the use of palonosetron alone in patients receiving either highly or moderately emetogenic chemotherapy. Adverse events were similar for the NEPA and the palonosetron groups. NEPA (Akynzeo) has recently been approved by the Food and Drug Administration (FDA) to treat nausea and vomiting in patients undergoing cancer chemotherapy.

KEYWORDS:

• 5-HT₃ receptor antagonists
• NK-1 receptor antagonists
• palonosetron
• netupitant
• chemotherapy-induced nausea and vomiting

Declaration of interests

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.