Chemotherapy induced nausea and vomiting is the among most feared and debilitating adverse events experienced by the cancer patients. Left unaddressed, CINV symptoms not only decrease quality of life, but may also affect patients’ willingness to continue chemotherapy treatment. However, adherence to guideline recommendations continues to be suboptimal therapy, and many patients still suffer unnecessarily from CINV. In addition, breakthrough/refractory CINV continues to present particular challenges. The development of effective CINV treatments with diverse mechanisms of action has expanded the options available for preventing symptoms. The US Food and Drug Administration have recently approved several new therapies for the management of CINV. NEPA is a fixed-dose combination of Netupitant (300 mg) plus Palonosetron (0.5 mg). In combination with Dexamethasone, NEPA has demonstrated superior efficacy to Palonosetron alone in patients receiving highly or moderately emetogenic chemotherapy. Rolapitant is a nextgeneration neurokinin-1receptor antagonist. Both palonosetron and rolapitant have proven particularly effective in controlling delayed CINV. Regimens that combine a serotonin 5-hydroxytryptamine–3 receptor antagonist, an NK1 receptor antagonist, and a corticosteroid now represent the standard of care for managing both acute and delayed CINV in patients receiving highly emetogenic chemotherapy.
Keywords: CINV, Seratonin, Dopamine, Neurokinin, Antiemetics.
Prevention of Chemotherapy-Induced Nausea and Vomiting with a Fixed-Dose Combination of Netupitant and Palonosetron (Nepa) Following Highly Emetogenic Chemotherapy: Evaluation of Response Based on Gender and Age