295TiP Assessing the benefit of NEPA (fixed combination of netupitant/palonosetron) for preventing chemotherapy-induced nausea and vomiting (CINV) in patients at increased emetic risk receiving moderately emetogenic chemotherapy

Abstract

In patients receiving moderately emetogenic chemotherapy (MEC), antiemetic guidelines lack evidence to recommend an NK1 receptor antagonist (RA) for all patients; therefore, they endorse a 5-HT3 RA + dexamethasone (DEX). However, the NCCN guidelines recognize that this approach is inadequate prophylaxis for many patients and include an NK1 RA-containing option selectively for those with individual emetic risk factors (e.g., prior CINV, age <50, female). Evidence shows that NEPA (a fixed combination of an NK1 RA, (fos)netupitant, and a 5-HT3 RA, palonosetron) is effective in a non-interventional real-world setting (Zelek 2021) in a heterogeneous population of patients with cancer receiving highly emetogenic or MEC and in patients with CINV risk factors.