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. 2022 Jan;30(1):585-591.
doi: 10.1007/s00520-021-06472-7. Epub 2021 Aug 4.

Netupitant/palonosetron without dexamethasone for preventing nausea and vomiting in patients with multiple myeloma receiving high-dose melphalan for autologous stem cell transplantation: a single-center experience

Barbara Loteta  1 , Annalisa Paviglianiti  1 , Virginia Naso  1 , Anna Ferreri  1 , Tiziana Moscato  1 , Giuseppe Console  1 , Filippo Antonio Canale  1 , Giuseppe Irrera  1 , Marta Pugliese  1 , Antonella Di Costanzo  2 , Pasquale Fabio Provenzano  1 , Viviana Loddo  3 , Gaetana Porto  1 , Giuseppa Cusumano  1 , Letteria Russo  1 , Nicola Meliambro  1 , Valentina Romeo  1 , Domenico Porcino  1 , Salvatore Gallo  1 , Tiziana Gangemi  1 , Antonio Maria Rossetti  1 , Massimo Martino  4
Affiliations

Netupitant/palonosetron without dexamethasone for preventing nausea and vomiting in patients with multiple myeloma receiving high-dose melphalan for autologous stem cell transplantation: a single-center experience

Barbara Loteta et al. Support Care Cancer. 2022 Jan.

Abstract

Chemotherapy-induced nausea and vomiting (CINV) is one of the most frequent adverse events compromising quality of life (QoL) in patients undergoing autologous stem cell transplantation (ASCT). However, CINV prophylaxis is still lacking uniformity for high-dose melphalan (HDM), which is used to condition patients with multiple myeloma (MM). Netupitant/palonosetron (NEPA) is administered with dexamethasone (DEXA) for CINV prevention in several chemotherapy regimens. Our study aims to assess the efficacy of NEPA, without DEXA, in preventing CINV in 106 adult patients with MM receiving HDM and ASCT. All patients had antiemetic prophylaxis with multiple doses of NEPA 1 h before the start of conditioning and after 72 h and 120 h. A complete response (CR) was observed in 99 (93%) patients at 120 h (overall phase). The percentage of patients with complete control was 93%. The CR rate during the acute phase was 94% (n = 100). During the delayed phase, the CR rate was 95% (n = 101). Grade 1 nausea and vomiting were experienced by 82% and 12% of the patients, respectively. Grade 2 nausea was reported in 18% and vomiting in 10% of patients. Our results showed, for the first time, that NEPA, without DEXA, was a well-tolerated and effective antiemetic option for MM patients receiving HDM followed by ASCT.

Keywords: ASCT; Chemotherapy-induced nausea and vomiting (CINV); High-dose melphalan; Multiple myeloma; Netupitant/palonosetron (NEPA).

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Conflict of interest statement

ADC is an employee of Italfarmaco SpA. Other authors have no conflict of interest to disclose.

Figures

Fig. 1
Fig. 1
Proportions of patients with complete response (no emesis and no rescue medication) and no emesis for the acute (0–24 h), delayed (25–120 h), and overall (0–120 h) phases
Fig. 2
Fig. 2
The histograms show the proportions of patients with grade 1, grade 2, grade 3, and grade 4 of nausea (a) and emesis (b) during overall phase (120 h) according to the Common Terminology Criteria for Adverse Events (CTCAE) 4.03
See this image and copyright information in PMC

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