Abstract
Purpose: The purpose of this review is to summarize and analyze recently published data (both original studies and reviews) on the oral drug NEPA, which consists of netupitant (a neurokinin-1 receptor antagonist [NK1RA], 300 mg dose). and palonosetron (5-hydroxytryptamine [serotonin or 5HT] type 3 receptor antagonist [5HT3RA], 0.5 mg dose), in the prevention of acute and delayed nausea and vomiting in patients receiving highly or moderately emetogenic chemotherapy. Methods: This review was based on a very limited number of available published trials consisting of two phase III studies and one phase II dose selection study. Results: These studies demonstrated some therapeutic advantages of NEPA for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV), as well as its favorable safety profile. Specifically, compared to a single 0.5 mg dose of palonosetron, the complete response rates for all CINV stages for the first cycle of highly emetogenic chemotherapy (with cisplatin) as well as moderately emetogenic anthracycline-based chemotherapy -cyclophosphamide, were significantly higher for the single dose. NEPA. The high efficacy of NEPA in terms of CINV prevention continued during repeated cycles of highly and moderately emetogenic therapies. Conclusion: It is currently recommended that patients receiving highly emetogenic chemotherapy regimens receive a three-drug combination consisting of NK1RA, 5HT3RA and dexamethasone. The recently available oral combination of NEPA plus dexamethasone provides an additional drug treatment option that could be considered in this setting.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 693-699 (see, other). |
| Number of pages | 7 |
| Magazine | Therapeutics and clinical risk management |
| Volume | 12 |
| Of the | |
| state | Published -May 2, 2016 |
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Janicki, P.K.(2016).Treatment of acute and delayed nausea and vomiting induced by chemotherapy: the role of the combination of netupitant and palonosetron.Therapeutics and clinical risk management,12, 693-699.https://doi.org/10.2147/TCRM.S81126
Janicki, Piotr K./Treatment of acute and delayed nausea and vomiting induced by chemotherapy: the role of the combination of netupitant and palonosetron. tu:Therapeutics and clinical risk management. 2016; vol. calle 12 693-699.
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title = "Treatment of acute and delayed nausea and vomiting induced by chemotherapy: role of the netupitant-palonosetron combination",
abstract = "Purpose: The purpose of this review is to summarize and analyze recently published data (both original studies and reviews) on the oral medication NEPA, which consists of netupitant (neurokinin-1 receptor antagonist [NK1RA], dose of 300 mg) and palonosetron (5-hydroxytryptamine [serotonin or 5HT] receptor type 3 antagonist [5HT3RA], 0.5 mg dose), in the prevention of acute and delayed nausea and vomiting in patients receiving moderately or highly chemotherapy emetogenic very limited number of available published trials consisting of two Phase III studies and one Phase II dose selection study Results: These studies demonstrated some therapeutic benefits of NEPA for the prophylaxis of chemotherapy-associated nausea and vomiting (CINV), such as its favorable safety profile In particular, compared to a single dose of palonosetron 0.5 mg, complete response rates for all CINV stages for the first cycle of highly emetogenic chemotherapy (with cisplatin), as well as for moderately emetogenic chemotherapy based on anthracycline-cyclophosphamide chemotherapy, they were significantly higher for single-dose NEPA. The high efficacy of NEPA in terms of CINV prevention continued during repeated cycles of highly and moderately emetogenic therapies. Conclusion: It is currently recommended that patients receiving highly emetogenic chemotherapy regimens receive a three-drug combination consisting of NK1RA, 5HT3RA, and dexamethasone. The recently available oral combination of NEPA plus dexamethasone provides an additional pharmacologic management option that could be considered in this setting.",
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Janicki, PK2016, 'Treatment of acute and delayed nausea and vomiting induced by chemotherapy: the role of the combination of netupitant and palonosetron',Therapeutics and clinical risk management, sv. 12, calle. 693-699.https://doi.org/10.2147/TCRM.S81126
Treatment of acute and delayed nausea and vomiting induced by chemotherapy: role of the netupitant-palonosetron combination./Janicki, Piotr K.
tu:Therapeutics and clinical risk management, Street. 12, 02.05.2016, p. 693-699 (screen, break).
Results of the investigation:Contribution to the magazine.›Browse the article›Peer Review
TY-DAN
T1 - Treatment of acute and delayed nausea and vomiting caused by chemotherapy
T2 - The role of the netupitant-palonosetron combination
AU - Janicki, Piotr K.
N1 - Publisher's Copyright: © 2016 Janicki. This work is published and licensed by Dove Medical Press Limited.
PY - 2.5.2016
Y1 - 2.5.2016
N2 - Purpose: The purpose of this review is to summarize and analyze recently published data (both original studies and reviews) on the oral drug NEPA, which consists of netupitant (neurokinin-1 receptor antagonist [NK1RA], 300 mg dose ) and palonosetron (5-hydroxytryptamine [serotonin or 5HT] receptor antagonist type 3 [5HT3RA], 0.5 mg dose), in the prevention of acute and delayed nausea and vomiting in patients receiving highly or moderately emetogenic chemotherapy. Methods: This review was based on a very limited number of available published trials consisting of two phase III studies and one phase II dose selection study. Results: These studies demonstrated some therapeutic advantages of NEPA for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV), as well as its favorable safety profile. Specifically, compared to a single 0.5 mg dose of palonosetron, the complete response rates for all CINV stages for the first cycle of highly emetogenic chemotherapy (with cisplatin) as well as moderately emetogenic anthracycline-based chemotherapy -cyclophosphamide, were significantly higher for the single dose. NEPA. The high efficacy of NEPA in terms of CINV prevention continued during repeated cycles of highly and moderately emetogenic therapies. Conclusion: It is currently recommended that patients receiving highly emetogenic chemotherapy regimens receive a three-drug combination consisting of NK1RA, 5HT3RA, and dexamethasone. The recently available oral combination of NEPA plus dexamethasone provides an additional drug treatment option that could be considered in this setting.
AB - Purpose: The purpose of this review is to summarize and analyze recently published data (both original studies and reviews) on the oral drug NEPA, which consists of netupitant (neurokinin-1 receptor antagonist [NK1RA], 300 mg dose ) and palonosetron (5-hydroxytryptamine [serotonin or 5HT] receptor antagonist type 3 [5HT3RA], 0.5 mg dose), in the prevention of acute and delayed nausea and vomiting in patients receiving highly or moderately emetogenic chemotherapy. Methods: This review was based on a very limited number of available published trials consisting of two phase III studies and one phase II dose selection study. Results: These studies demonstrated some therapeutic advantages of NEPA for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV), as well as its favorable safety profile. Specifically, compared to a single 0.5 mg dose of palonosetron, the complete response rates for all CINV stages for the first cycle of highly emetogenic chemotherapy (with cisplatin) as well as moderately emetogenic anthracycline-based chemotherapy -cyclophosphamide, were significantly higher for the single dose. NEPA. The high efficacy of NEPA in terms of CINV prevention continued during repeated cycles of highly and moderately emetogenic therapies. Conclusion: It is currently recommended that patients receiving highly emetogenic chemotherapy regimens receive a three-drug combination consisting of NK1RA, 5HT3RA, and dexamethasone. The recently available oral combination of NEPA plus dexamethasone provides an additional drug treatment option that could be considered in this setting.
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Janicki PK.Treatment of acute and delayed nausea and vomiting induced by chemotherapy: the role of the combination of netupitant and palonosetron.Therapeutics and clinical risk management. May 2, 2016; 12: 693-699. doi: 10.2147/TCRM.S81126
FAQs
What is the most effective treatment for delayed chemotherapy-induced nausea and vomiting? ›
Netupitant and rolapitant are second-generation neurokinin-1 receptor antagonists that provide effective prophylaxis against delayed chemotherapy-induced vomiting and also have an antinausea benefit.
Which drug is recommended as part of combination treatment for chemotherapy-induced nausea and vomiting? ›Olanzapine may be used in combination with palonosetron and dexamethasone for the prevention of CINV in moderate- and high-emetogenic chemotherapies. Olanzapine has demonstrated a significant reduction in acute (P <. 0001) and delayed (P <. 004) nausea at a dose of 5 mg twice daily.
What is the use of Netupitant Palonosetron? ›The combination of netupitant and palonosetron is used to prevent nausea and vomiting caused by cancer chemotherapy. Netupitant is in a class of medications called neurokinin (NK1) antagonists. It works by blocking neurokinin, a natural substance in the brain that causes nausea and vomiting.
How do you treat chemotherapy nausea and vomiting? ›Eat bland foods, such as dry toast and crackers. Eat food cold or at room temperature to decrease its smell and taste. Avoid fatty, fried, spicy, or very sweet foods. Try small amounts of foods high in calories that are easy to eat (such as pudding, ice cream, sherbets, yogurt, and milkshakes) several times a day.
What is the most effective drug for chemotherapy-induced vomiting? ›For patients receiving moderately emetogenic chemotherapy, the NCCN and ASCO recommend a 2-drug combination of a 5-HT3 receptor antagonist, preferably palonosetron, with dexamethasone. Dexamethasone is recommended by both organizations for the prevention of CINV in patients with low or minimal emetogenic potential.
What are three commonly used medications to treat nausea vomiting associated with chemotherapy? ›- Aprepitant (Emend®)
- Dolasetron (Anzemet®)
- Granisetron (Kytril®)
- Ondansetron (Zofran®)
- Palonosetron (Aloxi®)
- Proclorperazine (Compazine®)
Studies have shown that dexamethasone is the most potent antiemetic for prevention of delayed nausea and vomiting.
Which chemo drugs cause delayed nausea? ›Delayed (or late) N&V: N&V that occurs more than 24 hours after chemotherapy administration. Delayed N&V is associated with cisplatin, cyclophosphamide, and other drugs (e.g., doxorubicin and ifosfamide) given at high doses or on 2 or more consecutive days.
Is palonosetron used for delayed nausea and vomiting? ›These analyses showed that palonosetron plus dexamethasone was statistically superior to ondansetron plus dexamethasone in providing protection from both acute and delayed emesis and numerically superior to ondansetron plus dexamethasone in providing protection from nausea.
Is palonosetron better than ondansetron for chemotherapy? ›In adult patients receiving moderately emetogenic chemotherapy, palonosetron has been shown to be superior as a single agent to ondansetron or dolasetron at preventing both acute and delayed chemotherapy-induced nausea and vomiting.
What is the difference between ondansetron and palonosetron? ›
Palonosetron is a second-generation 5-HT3 antagonist initially used in the prevention of nausea and vomiting associated with chemotherapy. It differs from the other serotonergic antagonists, such as ondansetron, due to its high affinity for, and allosteric action on, 5-HT3 receptors.
What medication to give to prevent nausea and vomiting before chemotherapy? ›- Corticosteroids, such as dexamethasone and methylprednisolone.
- Monoamine antagonists, such as olanzapine.
- Serotonin antagonists, such as dolasetron, granisetron.
- Substance P/NK1 Antagonists, including aprepitant, fosaprepitant and others.
Most people undergoing chemotherapy receive anti-nausea (anti-emetic) medications to prevent nausea and vomiting. There are many medications used to prevent nausea and vomiting. Your doctor chooses anti-nausea medications based on how likely your chemotherapy drugs are to cause nausea and vomiting.
What is acute chemotherapy-induced nausea and vomiting? ›CINV is classified as acute, delayed, anticipatory, break- through, or refractory. Acute CINV occurs less than 24 hours after chemotherapy (Jordan, Sippel, & Schmoll, 2007; Schwartz- berg, 2006), whereas delayed CINV is defined as nausea and vomiting occurring 24 hours or more after chemotherapy.
What is the combination chemotherapy? ›Listen to pronunciation. (KOM-bih-NAY-shun KEE-moh-THAYR-uh-pee) Treatment using more than one anticancer drug.
What is an example of combination chemotherapy? ›Some prominent examples where combination chemotherapy has made a dramatic impact in oncology are CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) in non-Hodgkin's lymphoma, and BEP (bleomycin, etoposide, and cisplatin) in testicular cancer.
Why is a combination of drugs used in chemotherapy? ›The rationale for combination therapy is to use drugs that work by different mechanisms, thereby decreasing the likelihood that resistant cancer cells will develop. When drugs with different effects are combined, each drug can be used at its optimal dose, without intolerable side effects.
Is palonosetron hcl a chemo drug? ›Palonosetron injection is used to prevent nausea and vomiting that may occur within 24 hours after receiving cancer chemotherapy or surgery. It is also used to prevent delayed nausea and vomiting that may occur several days after receiving certain chemotherapy medications.
How often is palonosetron given? ›Palonosetron is a long acting medication that has a duration of action of 3 to 5 days. In most instances, only one dose needs to be given to prevent nausea and vomiting from chemotherapy. However, in some cases where chemotherapy is given for more than three days in a row, a second dose of palonosetron may be given.
What are the disadvantages of palonosetron? ›Palonosetron may cause a serious condition called serotonin syndrome if taken together with some medicines such as fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), tramadol (Ultram®), or medicines to treat depression (such as mirtazapine, Remeron®).
What is the brand of Netupitant and Palonosetron? ›
Netupitant/palonosetron, sold under the brand name Akynzeo, is a fixed-dose combination medication used for the prevention of acute and delayed chemotherapy-induced nausea and vomiting.
What is the cost of palonosetron? ›Local pharmacy prices
Pay $ 25.73 chevron_right at CVS Pharmacy with a GoodRx discount.
Regarding vomiting, palonosetron controlled more than 90% of cases in patients receiving each anti-cancer drug, regardless of inclusion in the 2- or 3-drug group. However, regarding nausea, the control rates ranged widely (78.6–91.3%) in the 2-drug group and were not markedly improved in the 3-drug group (75.0–100.0%).
What are the side effects of ondansetron? ›- headache.
- constipation.
- weakness.
- tiredness.
- chills.
- drowsiness.
Lorazepam (Ativan) is the drug from this group that doctors most often use for chemotherapy sickness. You usually have it with other types of anti sickness drugs. You might have lorazepam to help treat anticipatory nausea and vomiting.
Does Benadryl help with chemo nausea? ›IV infusion is given over a 15-minute span, starting 30 minutes before chemotherapy. Precaution: This drug interacts with many drugs, so make sure the pharmacist knows about every drug your child takes. Our go-to drugs for nausea and vomiting are Zofran ® and Benadryl ®.
What is the strongest anti nausea medication? ›One of the most effective anti-nausea medications is Zofran (ondansetron) which was developed to solve this problem. Zofran is available as tablets, dissolvable tablets, strips, or liquid.
What is the mechanism of action of chemotherapy-induced nausea and vomiting? ›The central nervous system plays a critical role in the pathophysiology of CINV, by receiving and processing a variety of emetic stimuli and then generating and sending efferent signals to a number of organs and tissues, which result in nausea and vomiting.
What is the drug of choice for delayed chemotherapy-induced vomiting? ›Studies have shown that dexamethasone is the most potent antiemetic for prevention of delayed nausea and vomiting.
Is delayed nausea and vomiting a chemotherapy treatment? ›Acute and delayed nausea and vomiting with chemotherapy or radiation therapy are usually treated with drugs. Drugs may be given before each treatment, to prevent nausea and vomiting. After chemotherapy, drugs may be given to prevent delayed vomiting.
What is the long acting anti nausea medication for chemo? ›
Granisetron extended-release (long-acting) injection is used with other medications to prevent nausea and vomiting caused by cancer chemotherapy that may occur immediately or several days after receiving chemotherapy medications. Granisetron is in a class of medications called 5-HT3 receptor antagonists.
Which chemotherapy is associated with delayed nausea and vomiting? ›Classifications. Delayed (or late) N&V: N&V that occurs more than 24 hours after chemotherapy administration. Delayed N&V is associated with cisplatin, cyclophosphamide, and other drugs (e.g., doxorubicin and ifosfamide) given at high doses or on 2 or more consecutive days.
How long does delayed nausea from chemo last? ›Delayed nausea and vomiting usually starts more than 24 hours after treatment and can last up to a few days after treatment ends. It's more likely with certain types of chemo or other drug to treat cancer. Ask your doctor if the treatment you're getting is known to cause delayed nausea and vomiting.
What is the difference between acute and delayed CINV? ›CINV is classified as acute, delayed, anticipatory, break- through, or refractory. Acute CINV occurs less than 24 hours after chemotherapy (Jordan, Sippel, & Schmoll, 2007; Schwartz- berg, 2006), whereas delayed CINV is defined as nausea and vomiting occurring 24 hours or more after chemotherapy.
What are the different types of chemotherapy-induced nausea and vomiting? ›Three distinct types of CINV have been defined: acute, delayed, and anticipatory. Recognizing the differences between these types of CINV has important implications for both prevention and management. Acute emesis — Acute emesis is defined as emesis occurring during the first 24 hours after chemotherapy.