Most Read Articles
Jairia Dela Cruz, 4 days ago
The potassium-competitive acid blocker vonoprazan demonstrates superior efficacy in the treatment of patients with erosive oesophagitis compared with the proton pump inhibitor lansoprazole, with the results of a small trial showing that the former more rapidly provides complete sustained heartburn relief during the first week of therapy.
01 Mar 2016
Bathing with 2% chlorhexidine gluconate-medicated washcloth is cost-effective for the prevention of central line-associated bloodstream infection (CLABSI), based on a systematic review and meta-analysis of four studies.
31 May 2016
Tacrolimus is safe and effective in inducing and maintaining remission in paediatric patients with biologic refractory inflammatory bowel disease (IBD), according to a study presented at the 49th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition in Athens, Greece.
Rachel Soon, 25 Jul 2018

MIMS Pharmacist presents an overview of Lactobacillus plantarum 299v's physiological role, as well as contemporary research on its pharmacology and effects.

Netupitant-palonosetron combo + dexamethasone may prevent chemo-induced nausea, vomiting

Audrey Abella
02 May 2018

A single administration of the fixed-dose combination consisting of netupitant plus palonosetron (NEPA) in addition to dexamethasone may be an effective strategy for preventing chemotherapy-induced nausea and vomiting (CINV) among breast cancer patients receiving combination chemotherapy consisting of anthracycline and cyclophosphamide (AC), according to results from the GIM15-NEPA* trial presented at EBCC 2018.

A triple-drug combination consisting of an NK1RA**, a 5-HT3RA***, and dexamethasone is particularly recommended for breast cancer patients receiving AC-based chemotherapy to prevent CINV, which is likely to occur following chemotherapy due to the highly emetogenic nature of the agents used, noted the researchers.

NEPA is the first oral combination antiemetic that fulfils this requirement for the prevention of acute and delayed CINV as it consists of the highly selective NK1RA netupitant, and the 5-HT3RA palonosetron, said the researchers.

This open-label, multicentre study evaluated the efficacy of oral NEPA and dexamethasone 12 mg on 146 breast cancer patients undergoing AC-based chemotherapy. The antiemetic agents were administered on day 1 before each AC chemotherapy commenced, for a maximum of four cycles. The primary endpoint was the achievement of a complete response (CR), which pertains to the lack of emetic episode as well as the nonuse of rescue medication during the overall phase (0–120 hours) after the four cycles of chemotherapy. [EBCC-11, abstract PB-110]

The primary endpoint was achieved throughout all cycles (overall CR, 0.705, 90 percent confidence limit [CL], 0.641–0.769 for the first and second cycles; 0.724, 90 percent CL, 0.662–0.787 and 0.705, 90 percent CL, 0.642–0.770 for the third and fourth cycles, respectively).

NEPA was also well-tolerated, and most adverse events (AEs) were mild to moderate in intensity, which is consistent with the SmPC#-documented safety profile of NEPA, noted the researchers. The most common drug-related AE was fatigue (3.4 percent), followed by anaemia (2.7 percent), headache (2.1 percent), and reduction in neutrophil count (1.4 percent).

“[T]his study [demonstrated] a clinically relevant efficacy of one-day NEPA plus dexamethasone in preventing [CINV] during the entire period of … AC-based chemotherapy,” said the researchers.

These findings are consistent with evidence highlighting NEPA as a convenient, safe, and effective prophylactic antiemetic therapy for CINV, given its potential to target two antiemetic pathways with only a single dose. [Support Care Cancer 2018;26:1151-1159]

 

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Most Read Articles
Jairia Dela Cruz, 4 days ago
The potassium-competitive acid blocker vonoprazan demonstrates superior efficacy in the treatment of patients with erosive oesophagitis compared with the proton pump inhibitor lansoprazole, with the results of a small trial showing that the former more rapidly provides complete sustained heartburn relief during the first week of therapy.
01 Mar 2016
Bathing with 2% chlorhexidine gluconate-medicated washcloth is cost-effective for the prevention of central line-associated bloodstream infection (CLABSI), based on a systematic review and meta-analysis of four studies.
31 May 2016
Tacrolimus is safe and effective in inducing and maintaining remission in paediatric patients with biologic refractory inflammatory bowel disease (IBD), according to a study presented at the 49th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition in Athens, Greece.
Rachel Soon, 25 Jul 2018

MIMS Pharmacist presents an overview of Lactobacillus plantarum 299v's physiological role, as well as contemporary research on its pharmacology and effects.