Oral combination of netupitant and palonosetron for the of nausea and vomiting induced by chemotherapy

Nausea and vomiting are the most frequent and painful adverse event of chemotherapy. Uncontrolled nausea and vomiting lead to a significant decrease in the quality of life of patients, nutritional insufficiency, breaking of the chemotherapy therapy regimen. Nausea and vomiting worsen the result of chemotherapy and the prognosis of the disease. In clinical studies of antiemetic drugs the “complete response” is used as the primary endpoint. The complete redponse is the absence of nausea and vomiting and the need for additional antiemetic drugs. The oral combination of netupitant and palonosetron is a modern drug for the prevention of nausea and vomiting induced by chemotherapy. This combination includes a highly selective anatagonist of NK1-receptors netupitant at a dose of 300 mg and an antagonist of 5-HT3 receptors palonosetron at a dose of 0.5 mg. The combination of net-upitant and palonosetron has high compliance, it is prescribed once before chemotherapy. The combination of netupitant and palonosetron makes it possible to achieve complete control of acute (0-24 hours) and delayed (24-120 hours) nausea and vomiting with highly emetogenic chemotherapy. In a randomized trial (n = 1455) with AC chemotherapy (doxorubicin + cyclophosphamide), the combination of netupitant and palonosetron resulted in a complete response during the general phase (0-120 hours) in 73.3% of patients. 78.4% of patients with the combination of netupitant and palonosteron experienced “no effect on daily life” due to nausea and vomiting. In an observational study of real clinical practice (n = 1197), the combination of netupitant and palonosetron in the AC chemotherapy regimen (doxorubicin + cyclophosphamide) had a complete response during the general phase (0-120 hours) in 81% of patients. Adverse events when using the combination of netupitant and palonosetron are minimal, constipation was noted in 1-8% of cases, headache in 1.4-3.6% of cases.