Rudolph M Navari, Timothy Tyler, Naoki Inui, Hirotoshi Iihara, Erminio Bonizzoni, Yeon Hee Park, Hope S Rugo, Eric J Roeland
{"title":"Individual patient data meta-analysis of NEPA versus aprepitant-based antiemetic regimens for preventing chemotherapy-induced nausea and vomiting.","authors":"Rudolph M Navari, Timothy Tyler, Naoki Inui, Hirotoshi Iihara, Erminio Bonizzoni, Yeon Hee Park, Hope S Rugo, Eric J Roeland","doi":"10.1080/14796694.2025.2542108","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>Because no conclusive data demonstrate superiority among NK<sub>1</sub> receptor antagonists (RA), existing antiemetic guidelines regard them as interchangeable. This individual patient data (IPD) meta-analysis compared the efficacy of NEPA (netupitant/fosnetupitant) and aprepitant/fosaprepitant-based regimens in preventing chemotherapy-induced nausea and vomiting (CINV).</p><p><strong>Materials & methods: </strong>Head-to-head comparative studies published between 2003 and 2022 that evaluated antiemetic prophylaxis of aprepitant or fosaprepitant versus oral or intravenous (IV) NEPA in patients with various cancers receiving highly (HEC) or moderately emetogenic chemotherapy (MEC) were identified through a literature search. We combined individual patient data to assess complete response (no emesis/no rescue medication) and no significant nausea using a two-stage approach.</p><p><strong>Results: </strong>A total of six studies involving 2,767 patients were included evaluating NEPA plus dexamethasone versus aprepitant/fosaprepitant plus any 5-HT<sub>3</sub>RA plus dexamethasone for patients with cancer receiving HEC/MEC. Complete response and no significant nausea rates were similar during the acute (0-24 h) phase but NEPA showed significantly higher rates than aprepitant during the delayed ( > 24-120 h) and overall (0-120 h) phases and on Days 3-5 following chemotherapy.</p><p><strong>Conclusion: </strong>Improved CINV prevention was observed with NEPA-based regimens, particularly during Days 3-5, highlighting its potential for managing prolonged nausea and vomiting associated with emerging anticancer targeted therapies.</p>","PeriodicalId":12672,"journal":{"name":"Future oncology","volume":" ","pages":"2823-2833"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407638/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Future oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14796694.2025.2542108","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/9 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: Because no conclusive data demonstrate superiority among NK1 receptor antagonists (RA), existing antiemetic guidelines regard them as interchangeable. This individual patient data (IPD) meta-analysis compared the efficacy of NEPA (netupitant/fosnetupitant) and aprepitant/fosaprepitant-based regimens in preventing chemotherapy-induced nausea and vomiting (CINV).
Materials & methods: Head-to-head comparative studies published between 2003 and 2022 that evaluated antiemetic prophylaxis of aprepitant or fosaprepitant versus oral or intravenous (IV) NEPA in patients with various cancers receiving highly (HEC) or moderately emetogenic chemotherapy (MEC) were identified through a literature search. We combined individual patient data to assess complete response (no emesis/no rescue medication) and no significant nausea using a two-stage approach.
Results: A total of six studies involving 2,767 patients were included evaluating NEPA plus dexamethasone versus aprepitant/fosaprepitant plus any 5-HT3RA plus dexamethasone for patients with cancer receiving HEC/MEC. Complete response and no significant nausea rates were similar during the acute (0-24 h) phase but NEPA showed significantly higher rates than aprepitant during the delayed ( > 24-120 h) and overall (0-120 h) phases and on Days 3-5 following chemotherapy.
Conclusion: Improved CINV prevention was observed with NEPA-based regimens, particularly during Days 3-5, highlighting its potential for managing prolonged nausea and vomiting associated with emerging anticancer targeted therapies.
期刊介绍:
Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community.
The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.