Abstract
PurposeChemotherapy-induced nausea and vomiting (CINV) is one of the most feared and disturbing adverse events of cancer treatment associated with decreased adherence to effective chemotherapy regimens. For high-risk soft tissue sarcoma patients, receiving multiple-day chemotherapy (MD-CT), antiemetic guidelines recommend a combination of an NK1 receptor antagonist (NK1-RA), a 5-HT3 receptor antagonist (5HT3-RA), and dexamethasone on each day of the antineoplastic treatment. NEPA is the first oral fixed-dose combination of a highly selective NK1-RA, netupitant, and second-generation 5HT3-RA, palonosetron. So far, no data has been published in literature about the efficacy of a single dose of NEPA in MD-CT.MethodsWe performed a prospective, non-comparative study to assess the efficacy of one shot of NEPA plus dexamethasone in sarcoma patients receiving MD-CT. The primary efficacy endpoint was a complete response (CR: no emesis, no rescue medication) during the overall phase (0–120 h) in cycle 1. The main secondary endpoints were CR during the overall phase of cycles 2 and 3.ResultsThe primary endpoint was reached in 88.9% of patients. Cycles 2 and 3 overall CR rates were 88.9% and 82.4%, respectively. The antiemetic regimen was well tolerated.ConclusionsThis pilot study showed the benefit of one shot of NEPA to prevent CINV in sarcoma patients receiving MD-chemotherapy.
Highlights
Chemotherapy is still the mainstay treatment of several solid tumors, and chemotherapy side effects (CSEs) are often responsible for quality of life (QoL) deterioration impairingGiuseppe Badalamenti and Lorena Incorvaia contributed to this work
Lorusso et al highlighted that chemotherapy-induced nausea and vomiting (CINV) is one of the most feared adverse events before starting chemotherapy and is still the most commonly experienced during treatment
All patients received a single dose of netupitant mg plus palonosetron 0.50 mg (NEPA) on day 1 only and dexamethasone 12 mg on days 1, 2, and 3
Summary
Chemotherapy is still the mainstay treatment of several solid tumors, and chemotherapy side effects (CSEs) are often responsible for quality of life (QoL) deterioration impairingGiuseppe Badalamenti and Lorena Incorvaia contributed to this work. Chemotherapy is still the mainstay treatment of several solid tumors, and chemotherapy side effects (CSEs) are often responsible for quality of life (QoL) deterioration impairing. Lorusso et al highlighted that chemotherapy-induced nausea and vomiting (CINV) is one of the most feared adverse events before starting chemotherapy and is still the most commonly experienced during treatment. Prophylaxis for CINV is still an unmet medical need in cancer treatment, and antiemetic strategies should be improved in the future [2]. CINV risk factors are well defined for both chemotherapy regimens and patients: type, dose and chemotherapy schedule, female gender, young age (< 55 years), non-users of alcohol, previous nausea and vomiting due to cancer treatment or pregnancy, anxiety, and motion sickness [3]
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