Efficacy benefit of an NK1 receptor antagonist (NK1RA) in patients receiving carboplatin

supportive evidence with NEPA (a fixed combination of the NK1 RA, netupitant, and palonosetron) and aprepitant regimens

Karin Jordan, Richard J. Gralla, Giada Rizzi, Kimia Kashef

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: Antiemetic guideline recommendations are inconsistent as to whether a neurokinin-1 receptor antagonist (NK1 RA) should be administered with a 5-hydroxytryptamine-3 (5HT3) RA + dexamethasone (DEX) in patients receiving carboplatin. Patients receiving cisplatin routinely receive an NK1 RA-containing regimen with a resulting 14–22 % benefit in no emesis rates over a 5-HT3 RA/DEX control. Recent studies suggest a similar benefit in patients receiving carboplatin. NEPA is the first fixed antiemetic combination agent and comprises the highly selective NK1 RA, netupitant, and pharmacologically distinct 5-HT3 RA, palonosetron (PALO). This paper presents the efficacy of NEPA in the subset of patients receiving carboplatin in a phase 3 trial (NCT01376297), in the context of aprepitant (APR) data in the carboplatin setting. Methods: One hundred ninety-six patients (47 % of all study patients: n = 145 NEPA + DEX; n = 51 APR + PALO + DEX) received carboplatin in a multinational, double-blind, randomized phase 3 study. Complete response (CR: no emesis/rescue) and no significant nausea (NSN: score ≤25 on 100 mm visual analog scale) rates were calculated. Results: Cycle 1–4 overall (0–120 h) CR rates were similar for NEPA (80, 91, 92, and 93 %) and APR (82, 88, 88, and 90 %). Overall NSN rates were also similar (NEPA 84–96 %; APR 82–90 %). Conclusions: Response rates for NEPA and APR regimens were similar and consistent with prior studies evaluating the contribution of adding NK1 RAs in patients receiving carboplatin. Considering such evidence, guideline groups/practitioners should consider giving a NK1 RA antiemetic triplet in patients receiving carboplatin.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalSupportive Care in Cancer
DOIs
StateAccepted/In press - Jun 22 2016

Fingerprint

aprepitant
Neurokinin-1 Receptor Antagonists
Carboplatin
Dexamethasone
Antiemetics
Vomiting
Guidelines
netupitant
palonosetron
Visual Analog Scale
Nausea
Cisplatin

Keywords

  • Aprepitant
  • Carboplatin
  • CINV
  • NEPA
  • Netupitant
  • Palonosetron

ASJC Scopus subject areas

  • Oncology

Cite this

@article{ad58228c51884dc88eca3d4506c6cbcd,
title = "Efficacy benefit of an NK1 receptor antagonist (NK1RA) in patients receiving carboplatin: supportive evidence with NEPA (a fixed combination of the NK1 RA, netupitant, and palonosetron) and aprepitant regimens",
abstract = "Purpose: Antiemetic guideline recommendations are inconsistent as to whether a neurokinin-1 receptor antagonist (NK1 RA) should be administered with a 5-hydroxytryptamine-3 (5HT3) RA + dexamethasone (DEX) in patients receiving carboplatin. Patients receiving cisplatin routinely receive an NK1 RA-containing regimen with a resulting 14–22 {\%} benefit in no emesis rates over a 5-HT3 RA/DEX control. Recent studies suggest a similar benefit in patients receiving carboplatin. NEPA is the first fixed antiemetic combination agent and comprises the highly selective NK1 RA, netupitant, and pharmacologically distinct 5-HT3 RA, palonosetron (PALO). This paper presents the efficacy of NEPA in the subset of patients receiving carboplatin in a phase 3 trial (NCT01376297), in the context of aprepitant (APR) data in the carboplatin setting. Methods: One hundred ninety-six patients (47 {\%} of all study patients: n = 145 NEPA + DEX; n = 51 APR + PALO + DEX) received carboplatin in a multinational, double-blind, randomized phase 3 study. Complete response (CR: no emesis/rescue) and no significant nausea (NSN: score ≤25 on 100 mm visual analog scale) rates were calculated. Results: Cycle 1–4 overall (0–120 h) CR rates were similar for NEPA (80, 91, 92, and 93 {\%}) and APR (82, 88, 88, and 90 {\%}). Overall NSN rates were also similar (NEPA 84–96 {\%}; APR 82–90 {\%}). Conclusions: Response rates for NEPA and APR regimens were similar and consistent with prior studies evaluating the contribution of adding NK1 RAs in patients receiving carboplatin. Considering such evidence, guideline groups/practitioners should consider giving a NK1 RA antiemetic triplet in patients receiving carboplatin.",
keywords = "Aprepitant, Carboplatin, CINV, NEPA, Netupitant, Palonosetron",
author = "Karin Jordan and Gralla, {Richard J.} and Giada Rizzi and Kimia Kashef",
year = "2016",
month = "6",
day = "22",
doi = "10.1007/s00520-016-3304-1",
language = "English (US)",
pages = "1--9",
journal = "Supportive Care in Cancer",
issn = "0941-4355",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Efficacy benefit of an NK1 receptor antagonist (NK1RA) in patients receiving carboplatin

T2 - supportive evidence with NEPA (a fixed combination of the NK1 RA, netupitant, and palonosetron) and aprepitant regimens

AU - Jordan, Karin

AU - Gralla, Richard J.

AU - Rizzi, Giada

AU - Kashef, Kimia

PY - 2016/6/22

Y1 - 2016/6/22

N2 - Purpose: Antiemetic guideline recommendations are inconsistent as to whether a neurokinin-1 receptor antagonist (NK1 RA) should be administered with a 5-hydroxytryptamine-3 (5HT3) RA + dexamethasone (DEX) in patients receiving carboplatin. Patients receiving cisplatin routinely receive an NK1 RA-containing regimen with a resulting 14–22 % benefit in no emesis rates over a 5-HT3 RA/DEX control. Recent studies suggest a similar benefit in patients receiving carboplatin. NEPA is the first fixed antiemetic combination agent and comprises the highly selective NK1 RA, netupitant, and pharmacologically distinct 5-HT3 RA, palonosetron (PALO). This paper presents the efficacy of NEPA in the subset of patients receiving carboplatin in a phase 3 trial (NCT01376297), in the context of aprepitant (APR) data in the carboplatin setting. Methods: One hundred ninety-six patients (47 % of all study patients: n = 145 NEPA + DEX; n = 51 APR + PALO + DEX) received carboplatin in a multinational, double-blind, randomized phase 3 study. Complete response (CR: no emesis/rescue) and no significant nausea (NSN: score ≤25 on 100 mm visual analog scale) rates were calculated. Results: Cycle 1–4 overall (0–120 h) CR rates were similar for NEPA (80, 91, 92, and 93 %) and APR (82, 88, 88, and 90 %). Overall NSN rates were also similar (NEPA 84–96 %; APR 82–90 %). Conclusions: Response rates for NEPA and APR regimens were similar and consistent with prior studies evaluating the contribution of adding NK1 RAs in patients receiving carboplatin. Considering such evidence, guideline groups/practitioners should consider giving a NK1 RA antiemetic triplet in patients receiving carboplatin.

AB - Purpose: Antiemetic guideline recommendations are inconsistent as to whether a neurokinin-1 receptor antagonist (NK1 RA) should be administered with a 5-hydroxytryptamine-3 (5HT3) RA + dexamethasone (DEX) in patients receiving carboplatin. Patients receiving cisplatin routinely receive an NK1 RA-containing regimen with a resulting 14–22 % benefit in no emesis rates over a 5-HT3 RA/DEX control. Recent studies suggest a similar benefit in patients receiving carboplatin. NEPA is the first fixed antiemetic combination agent and comprises the highly selective NK1 RA, netupitant, and pharmacologically distinct 5-HT3 RA, palonosetron (PALO). This paper presents the efficacy of NEPA in the subset of patients receiving carboplatin in a phase 3 trial (NCT01376297), in the context of aprepitant (APR) data in the carboplatin setting. Methods: One hundred ninety-six patients (47 % of all study patients: n = 145 NEPA + DEX; n = 51 APR + PALO + DEX) received carboplatin in a multinational, double-blind, randomized phase 3 study. Complete response (CR: no emesis/rescue) and no significant nausea (NSN: score ≤25 on 100 mm visual analog scale) rates were calculated. Results: Cycle 1–4 overall (0–120 h) CR rates were similar for NEPA (80, 91, 92, and 93 %) and APR (82, 88, 88, and 90 %). Overall NSN rates were also similar (NEPA 84–96 %; APR 82–90 %). Conclusions: Response rates for NEPA and APR regimens were similar and consistent with prior studies evaluating the contribution of adding NK1 RAs in patients receiving carboplatin. Considering such evidence, guideline groups/practitioners should consider giving a NK1 RA antiemetic triplet in patients receiving carboplatin.

KW - Aprepitant

KW - Carboplatin

KW - CINV

KW - NEPA

KW - Netupitant

KW - Palonosetron

UR - http://www.scopus.com/inward/record.url?scp=84975509053&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84975509053&partnerID=8YFLogxK

U2 - 10.1007/s00520-016-3304-1

DO - 10.1007/s00520-016-3304-1

M3 - Article

SP - 1

EP - 9

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

ER -