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Clinical Trial
. 2022 Feb;30(2):1521-1527.
doi: 10.1007/s00520-021-06495-0. Epub 2021 Sep 17.

Efficacy and safety of netupitant/palonosetron combination (NEPA) in preventing nausea and vomiting in non-Hodgkin's lymphoma patients undergoing to chemomobilization before autologous stem cell transplantation

Nicola Di Renzo  1 , Maurizio Musso  2 , Rosanna Scimè  3 , Alessandra Cupri  4 , Tommasina Perrone  5 , Clara De Risi  6 , Domenico Pastore  7 , Attilio Guarini  8 , Andrea Mengarelli  9 , Fabio Benedetti  10 , Patrizio Mazza  11 , Saveria Capria  12 , Patrizia Chiusolo  13 , Luca Cupelli  14 , Vincenzo Federico  15 , Valentina Bozzoli  15 , Anna Rita Messa  15 , Rosella Matera  15 , Davide Seripa  15 , Paolo Codega  16 , Erminio Bonizzoni  17 , Giorgina Specchia  5
Affiliations
Clinical Trial

Efficacy and safety of netupitant/palonosetron combination (NEPA) in preventing nausea and vomiting in non-Hodgkin's lymphoma patients undergoing to chemomobilization before autologous stem cell transplantation

Nicola Di Renzo et al. Support Care Cancer. 2022 Feb.

Abstract

Purpose: Prevention of chemotherapy-induced nausea and vomiting (CINV) is particularly challenging for patients receiving highly emetogenic preparative regimens before autologous stem cell transplantation (ASCT) due to the daily and continuous emetogenic stimulus of the multiple day chemotherapy. While studies have shown effective prevention of CINV during the conditioning phase with NK1 receptor antagonist (NK1RA)-containing regimens, there have been no studies evaluating antiemetic use during chemomobilization prior to ASCT.

Methods: This multicenter, open-label, phase IIa study evaluated the efficacy of every-other-day dosing of NEPA administered during chemomobilization in patients with relapsed-refractory aggressive non-Hodgkin's lymphoma. Eighty-one patients participated.

Results: Response rates were 77.8% for complete response (no emesis and no rescue use), 72.8% for complete control (complete response and no more than mild nausea), 86.4% for no emesis, and 82.7% for no rescue use during the overall phase (duration of chemomobilization through 48 h after). NEPA was well tolerated with no treatment-related adverse events reported.

Conclusion: NEPA, administered with a simplified every-other-day schedule, show to be very effective in preventing CINV in patients at high risk of CINV undergoing to chemomobilization of hematopoietic stem cells prior to ASCT.

Keywords: ASCT; CINV; Multiday chemotherapy; NEPA; Netupitant; Palonosetron.

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Conflict of interest statement

Dr. Paolo Codega is an employee of Italfarmaco SpA. Other authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
The histograms show the proportions of patients with complete response (no emesis and no rescue medication), complete control (complete response with no more than mild nausea), no emesis, and no rescue medication during the acute (from Day 1 until last day of chemotherapy), delayed (from last day of chemotherapy until 48 h after last dose of chemotherapy), and overall (from Day 1 until 48 h after last dose of chemotherapy) phases during mobilization
Fig. 2
Fig. 2
The histograms show the proportions of patients with no, mild, moderate or severe nausea during the acute (from Day 1 until last day of chemotherapy), delayed (from last day of chemotherapy until 48 h after last dose of chemotherapy), and overall (from Day 1 until 48 h after last dose of chemotherapy) phases of the mobilization period
See this image and copyright information in PMC

References

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