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Lorusso V, Russo A, Giotta F, Codega P. Management of Chemotherapy-Induced Nausea and Vomiting (CINV): A Short Review on the Role of Netupitant-Palonosetron (NEPA). CORE EVIDENCE 2020; 15:21-29. [PMID: 32802009 PMCID: PMC7394513 DOI: 10.2147/ce.s203634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/18/2020] [Indexed: 11/23/2022]
Abstract
Introduction Antineoplastic drugs may induce several side effects, including chemotherapy-induced nausea and vomiting (CINV). Two neurotransmitters play a central role in mediating the emetic response: serotonin acting on the 5HT3 receptor and the substance P targeting the NK1 receptor. Indeed, a combination of a 5HT3 receptor antagonist (5HT3-RA) and a NK1 receptor antagonist (NK1-RA) together with dexamethasone has been shown to be very effective. In fact, this combination is actually widely used and recommended for CINV prophylaxis for highly emetogenic cisplatin-based adriamycin/cyclophosphamide (AC) and carboplatin-based regimens. NEPA (netupitant/palonosetron) is the only fixed combination antiemetic available and it is composed by the long-lasting second-generation 5HT3-RA palonosetron and the highly selective NK1-RA netupitant. Aim The aims of this short review were to analyze the role of NEPA in CINV prophylaxis and management taking in account the risk factors related to the patient and to the antineoplastic treatment. Evidence Review CINV development is not only correlated to the emetogenic potential of the antineoplastic drugs but is also very influenced by the patient characteristics and history, such as gender, age, alcohol intake, nausea during pregnancy and motion sickness. In pivotal and post-registration studies, NEPA has demonstrated to be effective and safe in both highly and moderately emetogenic chemotherapy. Conclusion A proper assessment of both chemotherapy- and patient-related risk factors is paramount to properly evaluate an appropriate prophylaxis of CINV and NEPA by simplifying the therapy, guarantees fully adherence to antiemetic guidelines, and consequently improves the control of CINV, especially in high risk patients.
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Affiliation(s)
- Vito Lorusso
- Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Anna Russo
- Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Francesco Giotta
- Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Paolo Codega
- Medical Affairs Department, Italfarmaco SpA, Cinisello Balsamo, Italy
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Lorusso V. Management of chemotherapy-induced nausea and vomiting by risk profile: role of netupitant/palonosetron. Ther Clin Risk Manag 2016; 12:917-25. [PMID: 27354807 PMCID: PMC4907706 DOI: 10.2147/tcrm.s89215] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
As recommended by most recent antiemetic guidelines, the optimal prophylaxis of chemotherapy-induced nausea and vomiting (CINV) requires the combination of 5-HT3 receptor antagonist (RA) with an NK1-RA. Moreover, the major predictors of acute and delayed CINV include: young age, female sex, platinum- or anthracycline-based chemotherapy, nondrinker status, emesis in the earlier cycles of chemotherapy, and previous history of motion/morning sickness. Despite improved knowledge of the pathophysiology of CINV and advances in the availability of active antiemetics, an inconsistent compliance with their use has been reported, thereby resulting in suboptimal control of CINV in several cases. In this scenario, a new anti-emetic drug is now available, which seems to be able to guarantee better prophylaxis of CINV and improvement of adherence to guidelines. In fact, netupitant/palonosetron (NEPA) is a ready-to-use single oral capsule, combining an NK1-RA (netupitant) and a 5-HT3-RA (palonosetron), which is to be taken 1 hour before the administration of chemotherapy, ensuring the coverage from CINV for 5 days. We reviewed the role of NEPA in patients at high risk of CINV receiving highly emetogenic chemotherapy. In these patients, NEPA plus dexamethasone, as compared to standard treatments, achieved superior efficacy in all primary and secondary end points during the acute, delayed, and overall phases, including nausea assessment. Moreover, these results were also achieved in female patients receiving anthracycline plus cyclophosphamide-based chemotherapy. NEPA represents a real step forward in the prophylaxis of CINV.
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Affiliation(s)
- Vito Lorusso
- National Cancer Research Centre, Istituto Tumori Giovanni Paolo II, Bari, Italy
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Moradian S, Howell D. Prevention and management of chemotherapy-induced nausea and vomiting. Int J Palliat Nurs 2015; 21:216, 218-24. [PMID: 26107543 DOI: 10.12968/ijpn.2015.21.5.216] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Nausea and vomiting are among the most frequently experienced toxic side-effects associated with chemotherapy. Although nausea and vomiting can result from surgery or radiotherapy, chemotherapy-induced nausea and vomiting (CINV) is potentially the most severe and most distressing. Estimates regarding the incidence of CINV vary depending on the treatment administered and individual patient characteristics.The impact of CINV on quality of life (QoL) and daily activities is considerable. Pharmacological treatments are considered routine for CINV. Clinical guidelines now recommend that patients receiving moderate emetic chemotherapy (MEC) regimens be preferentially treated with palonosetron, the 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist, in combination with dexamethasone. In addition, it has shown that single-dose fosaprepitant is equivalent to the standard 3-day aprepitant regimen (the neurokinin 1 (NK1) receptor antagonist). Despite these advances in antiemetic management, approximately 50% of patients receiving chemotherapy still experience nausea and/or vomiting. Further improvements are still desirable, particularly in the prevention and treatment of delayed CINV. Non-pharmacological interventions can be possible adjuncts to standard anti-emetic therapy. Using new technologies to collect patient-reported outcomes may improve the accuracy of assessment, provide a better picture of the patient's experience of these symptoms, and provide a means to simultaneously monitor symptoms, educate patients, and collect longitudinal data.
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Affiliation(s)
| | - Doris Howell
- Associate Professor, Lawrence Bloomberg Faculty of Nursing, University of Toronto & University Health Network, Princess Margaret Cancer Care, Toronto, Canada
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De Tursi M, Carella C, Tomao S, Cinieri S, Lorusso V, Marchetti P, Vecchio S, Sansoni E, Contu A, Adamo V, Silvestris N, Nuzzo A, Rosti G, Ravaioli A, Danova M, Tonini G, Passalacqua R, Cruciani G, Faedi M, Spada M, De Laurentiis M, Amoroso D, Tomao F, Sperduti I, Grassadonia A, Tinari N, Natoli C, Iacobelli S. Chemotherapy-Induced Nausea and Vomiting in Italian Cancer Centers: Results of CINVDAY, a Prospective, Multicenter Study. TUMORI JOURNAL 2014. [DOI: 10.1177/1778.19310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Giovanni Rosti
- Medical Oncology, S Maria di Ca' Foncello Hospital, Treviso
| | | | - Marco Danova
- Medical Oncology, Hospital of Vigevano, Vigevano
| | | | | | | | | | | | | | | | | | | | | | - Nicola Tinari
- Medical Oncology, G D'Annunzio University, Chieti-Pescara
| | - Clara Natoli
- Medical Oncology, G D'Annunzio University, Chieti-Pescara
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Bae SH, Park MJ, Lee MM, Kim TM, Lee SH, Cho SY, Kim YH, Kim YJ, Park CK, Kim CY. Toxicity profile of temozolomide in the treatment of 300 malignant glioma patients in Korea. J Korean Med Sci 2014; 29:980-4. [PMID: 25045231 PMCID: PMC4101787 DOI: 10.3346/jkms.2014.29.7.980] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 04/29/2014] [Indexed: 11/26/2022] Open
Abstract
This study evaluated the toxicity profiles of temozolomide in the treatment of malignant glioma as either concurrent or adjuvant chemotherapy. We retrospectively reviewed the medical records of 300 malignant glioma patients treated with temozolomide in two medical institutions in Korea between 2004 and 2010. Two hundred nine patients experienced a total of 618 toxicities during temozolomide therapy. A total of 84.8% of the 618 toxicities were Common Terminology Criteria for Adverse Events (CTCAE) grade 1 or 2, while 15.2% were grade 3 or 4. Among the hematologic toxicities, thrombocytopenia (13.7%), anemia (11.0%), and AST/ALT increases (7.0%) were common. Among the non-hematologic toxicities, nausea (44.3%), vomiting (37.0%), and anorexia (14.3%) were the three most common toxicities. There was no mortality due to temozolomide. Although temozolomide showed many types of toxicities, the majority of the toxicities were tolerable and of lower grade. Gastrointestinal troubles are the most common toxicities in Korean patients treated with temozolomide.
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Affiliation(s)
- So Hyun Bae
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min-Jung Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Min Mi Lee
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Seoul National University College of Medicine, Seoul National University, Seoul, Korea
| | - Se-Hoon Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Seoul National University College of Medicine, Seoul National University, Seoul, Korea
| | - Sung Yun Cho
- Department of Neurosurgery, Dong-Eui Medical Center, Busan, Korea
| | - Young-Hoon Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Seoul National University College of Medicine, Seoul National University, Seoul, Korea
| | - Yu Jung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Seoul National University College of Medicine, Seoul National University, Seoul, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
- Seoul National University College of Medicine, Seoul National University, Seoul, Korea
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Seoul National University College of Medicine, Seoul National University, Seoul, Korea
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Kwon SJ, Park JS. Effects of Auricular Acupressure on Chemotherapy-induced Nausea, Vomiting, and Serum Serotonin Level. ACTA ACUST UNITED AC 2014. [DOI: 10.7475/kjan.2014.26.3.330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Soon Jo Kwon
- Department of Nursing, Keimyung College University, Daegu, Korea
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Lee EJ, Warden S. The Effect of Acupressure on Chemotherapy-induced Nausea. EVIDENCE-BASED NON-PHARMACOLOGICAL THERAPIES FOR PALLIATIVE CANCER CARE 2013. [DOI: 10.1007/978-94-007-5833-9_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Karagozoglu S, Tekyasar F, Yilmaz FA. Effects of music therapy and guided visual imagery on chemotherapy-induced anxiety and nausea-vomiting. J Clin Nurs 2012; 22:39-50. [PMID: 23134272 DOI: 10.1111/jocn.12030] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2012] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To reveal the effects of music therapy and visual imagery on chemotherapy-induced anxiety and nausea-vomiting. BACKGROUND Behavioural techniques such as music therapy and visual imagery are becoming increasingly important in dealing with chemotherapy-induced anxiety, nausea and vomiting. DESIGN The study is an experimental and cross-sectional one and performed on a single sample group with the pre-post-test design consisting of 40 individuals. The individuals in the sample group comprised both the control and the case group of the study. METHODS To obtain the study data, the following forms were used: the Personal Information Form, Spielberger State-Trait Anxiety Inventory, The Visual Analogue Scale and Individual Evaluation Form for Nausea and Vomiting adapted from The Morrow Assessment of Nausea and Vomiting. RESULTS In the study, the participants' state and trait anxiety levels decreased significantly (p < 0·05). Music therapy and visual imagery reduced the severity and duration of chemotherapy-induced nausea and vomiting significantly (p < 0·05). In our research, 40% of the patients did not have anticipatory nausea and 55% of the patients did not have anticipatory vomiting during the third chemotherapy cycle during which music therapy and guided visual imagery were implemented. CONCLUSIONS It was determined that complementary approaches comprising music therapy and visual imagery had positive effects on chemotherapy-induced anxiety, nausea and vomiting, which are suffered too often and affect the patients' whole lives adversely. RELEVANCE TO CLINICAL PRACTICE This study is worthy of interest as it has revealed that music therapy and visual imagery which have been proven to be effective in many health problems in different areas are also important, and practical complementary approaches that are effective in getting chemotherapy-induced anxiety, nausea and vomiting under control.
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Affiliation(s)
- Serife Karagozoglu
- Department of Fundamentals of Nursing, Division of Nursing, Cumhuriyet University Faculty of Health Science, Sivas, Turkey.
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