Genolier Cancer Centre, Clinique de Genolier, Genolier, Switzerland.
Department Haematology, Oncology and Palliative Care, Ernst von Bergmann Klinikum Potsdam, Potsdam, Germany.
Curr Cancer Drug Targets. 2022;22(10):806-824. doi: 10.2174/1568009622666220513094352.
Chemotherapy-induced nausea and vomiting (CINV) is a common adverse event associated with many anticancer therapies and can negatively impact patients' quality of life and potentially limit the effectiveness of chemotherapy. Currently, CINV can be prevented in most patients with guideline-recommended antiemetic regimens. However, clinicians do not always follow guidelines, and patients often face difficulties adhering to their prescribed treatments. Therefore, approaches to increase guideline adherence need to be implemented. NEPA is the first and only fixed combination antiemetic, composed of netupitant (oral)/fosnetupitant (intravenous) and palonosetron, which, together with dexamethasone, constitute a triple antiemetic combination recommended for the prevention of CINV for patients receiving highly emetogenic chemotherapy and for certain patients receiving moderately emetogenic chemotherapy. Thus, NEPA offers a convenient and straightforward antiemetic treatment that could improve adherence to guidelines. This review provides an overview of CINV, evaluates the accumulated evidence of NEPA's antiemetic activity and safety from clinical trials and real-world practice, and examines the preliminary evidence of antiemetic control with NEPA in daily clinical settings beyond those described in pivotal trials. Moreover, we review the utility of NEPA in controlling nausea and preserving patients' quality of life during chemotherapy, two major concerns in managing patients with cancer.
化疗引起的恶心和呕吐 (CINV) 是许多抗癌治疗相关的常见不良反应，会对患者的生活质量产生负面影响，并可能限制化疗的效果。目前，许多指南推荐的止吐方案可以预防大多数患者发生 CINV。然而，临床医生并不总是遵循指南，患者经常难以坚持其规定的治疗方案。因此，需要实施增加指南遵循率的方法。NEPA 是第一个也是唯一一个固定剂量组合止吐药，由奈妥匹坦（口服）/福沙奈坦（静脉）和帕洛诺司琼组成，与地塞米松一起构成三重止吐组合，推荐用于预防接受高致吐性化疗的患者和某些接受中致吐性化疗的患者的 CINV。因此，NEPA 提供了一种方便且直接的止吐治疗方法，可以提高对指南的遵循率。这篇综述概述了 CINV，评估了从临床试验和真实世界实践中积累的关于 NEPA 止吐活性和安全性的证据，并考察了 NEPA 在关键试验以外的日常临床环境中控制恶心和维持患者生活质量的初步证据，这两点是管理癌症患者的主要关注点。
