XML Template (2015) [23.4.2015–12:03pm] //blrnas3.glyph.com/cenpro/ApplicationFiles/Journals/SAGE/3B2/OPPJ/Vol00000/150024/APPFile/SG-OPPJ150024.3d
(OPP)
[1–8] [INVALID Stage]
Review Article
The role of netupitant and palonosetron in chemotherapy-induced nausea and vomiting
J Oncol Pharm Practice 0(0) 1–8 ! The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1078155215581525 opp.sagepub.com
Rebecca Briana Abramovitz and Kelly Marie Gaertner
Abstract The combination of netupitant and palonosetron was approved by the Food and Drug Administration in October 2014 for the prevention of acute and delayed chemotherapy-induced nausea and vomiting associated with initial and repeat courses of moderately and highly emetogenic chemotherapy. Netupitant and palonosetron is available as a single capsule to be administered prior to each cycle of chemotherapy. The approval was based on phase II and III data in patients undergoing treatment with moderately and highly emetogenic chemotherapy. Netupitant and palonosetron’s benefits include a convenient dosage form, dual-targeted mechanism, and favorable side effect profile, while its main limitations are cost and potential logistical issues surrounding administration. More studies are needed to adequately determine its role in therapy as well as which patients will derive the most benefit from its use.
Keywords Netupitant, palonosetron, chemotherapy, NEPA, nausea
Introduction Chemotherapy-induced nausea and vomiting (CINV) is a common and dreaded side effect of cancer treatment that continues to present a challenge to practitioners.1,2 CINV has been shown to significantly impact a patient’s quality of life, especially in the delayed setting.3–6 Direct costs related to CINV are attributed to medication use, office visits, and hospitalizations.7 There remains opportunity for improvement with regard to control of nausea and vomiting related to chemotherapy. CINV can be categorized according to the time at which it occurs. Acute nausea and vomiting presents within 24 h of chemotherapy, while the delayed phase can persist for up to five to seven days following treatment.8,9 Each phase is predominantly driven by different mechanisms. The administration of chemotherapy triggers the process of CINV, which occurs via several pathways and involves key neurotransmitters such as serotonin (5-HT), dopamine, and substance P.9 While serotonin plays a large role in acute nausea and vomiting, the activation of neurokinin 1 (NK1) receptors by
substance P is primarily implicated in emesis occurring in the delayed setting.9 Chemotherapy itself is classified as carrying high (>90%), moderate (30–90%), low (10–30%), or minimal (
(OPP)
[1–8] [INVALID Stage]
Review Article
The role of netupitant and palonosetron in chemotherapy-induced nausea and vomiting
J Oncol Pharm Practice 0(0) 1–8 ! The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1078155215581525 opp.sagepub.com
Rebecca Briana Abramovitz and Kelly Marie Gaertner
Abstract The combination of netupitant and palonosetron was approved by the Food and Drug Administration in October 2014 for the prevention of acute and delayed chemotherapy-induced nausea and vomiting associated with initial and repeat courses of moderately and highly emetogenic chemotherapy. Netupitant and palonosetron is available as a single capsule to be administered prior to each cycle of chemotherapy. The approval was based on phase II and III data in patients undergoing treatment with moderately and highly emetogenic chemotherapy. Netupitant and palonosetron’s benefits include a convenient dosage form, dual-targeted mechanism, and favorable side effect profile, while its main limitations are cost and potential logistical issues surrounding administration. More studies are needed to adequately determine its role in therapy as well as which patients will derive the most benefit from its use.
Keywords Netupitant, palonosetron, chemotherapy, NEPA, nausea
Introduction Chemotherapy-induced nausea and vomiting (CINV) is a common and dreaded side effect of cancer treatment that continues to present a challenge to practitioners.1,2 CINV has been shown to significantly impact a patient’s quality of life, especially in the delayed setting.3–6 Direct costs related to CINV are attributed to medication use, office visits, and hospitalizations.7 There remains opportunity for improvement with regard to control of nausea and vomiting related to chemotherapy. CINV can be categorized according to the time at which it occurs. Acute nausea and vomiting presents within 24 h of chemotherapy, while the delayed phase can persist for up to five to seven days following treatment.8,9 Each phase is predominantly driven by different mechanisms. The administration of chemotherapy triggers the process of CINV, which occurs via several pathways and involves key neurotransmitters such as serotonin (5-HT), dopamine, and substance P.9 While serotonin plays a large role in acute nausea and vomiting, the activation of neurokinin 1 (NK1) receptors by
substance P is primarily implicated in emesis occurring in the delayed setting.9 Chemotherapy itself is classified as carrying high (>90%), moderate (30–90%), low (10–30%), or minimal (
