(HealthDay News) — For patients receiving chemotherapy, the use of the oral combination of netupitant (a neurokinin 1 receptor antagonist) and palonosetron (a 5-hydroxytryptamine-3 receptor antagonist) is beneficial for prevention of acute and delayed nausea and vomiting, according to a focused guideline update published online Nov. 2 in the Journal of Clinical Oncology.
Paul J. Hesketh, M.D., from the Lahey Hospital and Medical Center in Burlington, Mass., and colleagues conducted a targeted systematic literature review to update guidelines on use of the oral combination of netupitant and palonosetron for prevention of acute and delayed nausea and vomiting among patients receiving chemotherapy.
The researchers identified two phase III clinical trials and a randomized phase II dose-ranging study. For patients treated with anthracycline plus cyclophosphamide chemotherapy, the oral combination of netupitant and palonosetron correlated with higher complete response rates (no emesis and no rescue medications) versus palonosetron alone (74 versus 67 percent; P = 0.001). The oral combination was found to be safe and effective across multiple cycles of moderately or highly emetogenic chemotherapies in another phase III trial. Among patients receiving cisplatin-based chemotherapy, each dose of netupitant coadministered with palonosetron produced higher complete response rates than palonosetron alone in the dose-ranging study; the highest netupitant dose (300 mg) was most effective.
“The oral combination of netupitant and palonosetron plus dexamethasone is an additional treatment option in this setting,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.