Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2017
NEPA, a fixed oral combination of netupitant and palonosetron, improves control of chemotherapy-induced nausea and vomiting (CINV) over multiple cycles of chemotherapy: results of a randomized, double-blind, phase 3 trial versus oral palonosetron.
Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- MASCC antiemetics in advanced cancer updated guideline.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Guideline
- Antiemetics for adults for prevention of nausea and vomiting caused by moderately or highly emetogenic chemotherapy: a network meta-analysis.The Cochrane database of systematic reviews · 2021Pooled it
- The underreporting of phase III chemo-therapeutic clinical trial data of older patients with cancer: A systematic review.Journal of geriatric oncology · 2020Pooled it
- A Pragmatic Study Evaluating NEPA Versus Aprepitant for Prevention of Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Moderately Emetogenic Chemotherapy.The oncologist · 2021Trial
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- A randomized phase III study evaluating the efficacy of single-dose NEPA, a fixed antiemetic combination of netupitant and palonosetron, versus an aprepitant regimen for prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (HEC).Annals of oncology : official journal of the European Society for Medical Oncology · 2018Trial
- Phase III Trial: Single Low-Dose 5 mg Dexamethasone with NEPA for Preventing 168 h Nausea and Vomiting of Diverse Highly or Moderately Emetogenic Chemotherapy (LD-NEPA).Diseases (Basel, Switzerland) · 2026Article
- Impact of antiemetic prophylaxis on reducing trastuzumab deruxtecan dose modifications in HER2+/HER2-low breast cancer.Future oncology (London, England) · 2026Article
- Neurokinin-1 receptor antagonists in the current management of chemotherapy-induced nausea and vomiting.Frontiers of medicine · 2025Review
- Generic Netupitant Plus Palonosetron and Dexamethasone for Prophylaxis of Chemotherapy-Induced Nausea and Vomiting (CINV) in Cancer Patients Receiving Highly or Moderately Emetogenic Chemotherapy: A Retrospective Study.South Asian journal of cancer · 2025Article
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- Risk Factors Associated with Chemotherapy-Induced Nausea and Vomiting Among Women with Breast Cancer Receiving Highly Emetogenic Chemotherapy: Individual Patient-Based Analysis of Three Prospective Antiemetic Trials.Cancer management and research · 2024Article
- Prevention of Chemotherapy-Induced Nausea and Vomiting in the Older Patient: Optimizing Outcomes.Drugs & aging · 2022Review
- Review
- The effectiveness of NEPA in the prevention of chemotherapy-induced nausea vomiting among chemo naive patients in an Indian setting.BMC cancer · 2021Article
- Cost-effectiveness of a fixed combination of netupitant and palonosetron (NEPA) relative to aprepitant plus granisetron (APR + GRAN) for prophylaxis of chemotherapy-induced nausea and vomiting (CINV): a trial-based analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Article
- Getting it right the first time: recent progress in optimizing antiemetic usage.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018Article
Corrections and comments
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Authors and funding
12 authors at 9 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAntiemetic guidelines recommend co-administration of targeted prophylactic medications inhibiting molecular pathways involved in emesis. NEPA is a fixed oral combination of a new NK
methodsThis study is a multinational, double-blind study comparing a single oral dose of NEPA vs oral PALO in chemotherapy-naïve patients receiving anthracycline/cyclophosphamide-based chemotherapy along with dexamethasone 12 mg (NEPA) or 20 mg (PALO) on day 1. The primary efficacy endpoint was delayed (25-120 h) complete response (CR: no emesis, no rescue medication) in cycle 1. Sustained efficacy was evaluated during the multicycle extension by calculating the proportion of patients with overall (0-120 h) CR in cycles 2-4 and by assessing the probability of sustained CR over multiple cycles.
resultsOf 1455 patients randomized, 1286 (88 %) participated in the multiple-cycle extension for a total of 5969 cycles; 76 % completed ≥4 cycles. The proportion of patients with an overall CR was significantly greater for NEPA than oral PALO for cycles 1-4 (74.3 vs 66.6 %, 80.3 vs 66.7 %, 83.8 vs 70.3 %, and 83.8 vs 74.6 %, respectively; p ≤ 0.001 each cycle). The cumulative percentage of patients with a sustained CR over all 4 cycles was also greater for NEPA (p < 0.0001). NEPA was well tolerated over cycles.
conclusionsNEPA, a convenient, guideline-consistent, fixed antiemetic combination is effective and safe over multiple cycles of chemotherapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.