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Controlling Emesis with Chemotherapy
- New Agents -
•
NEPA
3, 4
• Fixed-dose combination of netupitant (NK
1
receptor antagonist) + palonosetron (5HT
3
receptor antagonist)
• Highly selective agents
• Single oral dosing for both acute and delayed emesis (IV formulation in some countries)
• Multiple positive safety studies
Some references:
1
Rapoport, et al.
Lancet Oncol
2015.
2
Schwarzberg, et al.
Lancet Oncol
2015.
3
Aapro, et al
. Ann Oncol
2014;
4
Gralla, et al.
Ann Oncol
2014;
5
Navari et al.
N Engl J Med
2016
• Olanzapine
5
• A non-specific, non-selective, neuroleptic agent
• Questions persist regarding dose (5 or 10 mg), schedule and role
• Issue: side effect trade-off, sedation vs nausea
• Rolapitant
1,2
• NK
1
receptor antagonist with different metabolic pathway
• Highly selective agent
• Single oral dosing (IV formulation in some countries, but hypersensitivity issues)