Abstract
BackgroundChemotherapy induced nausea- vomiting (CINV) is considered as the most common, feared and most troublesome side effect of chemotherapy. NEPA (NEtupitant 300 mg + PAlonosetron 0.50 mg) is the first commercially available oral fixed-dose combination (FDC) of two active antiemetic agents in India. The present study was planned to evaluate the effectiveness of NEPA in the real world setting of India.MethodsThis was a multicentric retrospective study conducted in two centers in India. The data of all chemonaive patients, who were prescribed NEPA was analyzed. Effectiveness i.e. complete response and complete protection in controlling overall, acute and delayed phase was analyzed.ResultsA total of 329 patients were enrolled in the study. 260 received highly emetogenic chemotherapy (HEC) regimen and 69 received moderately emetogenic chemotherapy (MEC) regimen. Among all the enrolled patients, complete response in acute, delayed and overall phase was 93, 85.71 and 85.41% respectively; and completed protection was 88.44, 81.76 and 80.54% respectively. Those who received HEC regimen, the completed response and complete protection in overall phase was 84.61 and 79.61% respectively and those who received MEC regimen the completed response and complete control in overall phase was 84.05 and 84.05% respectively.ConclusionA single oral dose of NEPA targeting dual pathways showed effective control of nausea-vomiting in patients on the HEC and MEC regimens and had good control over nausea-vomiting in acute, delayed and overall phase of nausea-vomiting.
Highlights
Chemotherapy induced nausea- vomiting (CINV) is considered as the most common, feared and most troublesome side effect of chemotherapy
With the availability of newer antiemetics, the control over vomiting is substantially good, but nausea, especially in the delayed phase (24–120 h), still continues to be bigger challenge and the unmet need in the present era [5]
The biggest barrier highlighted for the uncontrolled nausea /vomiting is poor adherence to the guidelines, as many studies have suggested that patients receiving chemotherapy do not receive guideline-backed antiemetics [6,7,8]
Summary
Chemotherapy induced nausea- vomiting (CINV) is considered as the most common, feared and most troublesome side effect of chemotherapy. Chemotherapy induced nausea- vomiting (CINV) is one such, which is considered the most common, feared and most troublesome side effect [1]. Decades after discovering the first antiemetic against CINV [2], CINV is still considered the oncologist’s nightmare, as more than 40% patients still experience nausea, vomiting, or both, following the administration of chemotherapy [3]. This may be because of the complex multi-factorial process involved between the receptors and neurotransmitters of the brain and the gastrointestinal tract [4]. The biggest barrier highlighted for the uncontrolled nausea /vomiting is poor adherence to the guidelines, as many studies have suggested that patients receiving chemotherapy do not receive guideline-backed antiemetics [6,7,8]
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