Why you should read this article

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To recognise the potential negative effects of chemotherapy-induced nausea and vomiting (CINV) on people with cancer

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To learn about the findings of a service evaluation that assessed the effectiveness, safety and acceptability of NEPA (netupitant and palonosetron) in the prevention of CINV in patients undergoing multiple cycles of chemotherapy

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To enhance your awareness of the available treatments that can be used to prevent and relieve CINV

Background Chemotherapy-induced nausea and vomiting (CINV) is one of the most feared and difficult side effects of chemotherapy. In clinical trials, the oral fixed-combination drug NEPA (netupitant and palonosetron) has been shown to prevent acute and delayed CINV and to be well-tolerated by patients. However, there is limited real-world UK data concerning the effectiveness, acceptability and potential benefits of a single dose of NEPA per cycle of chemotherapy among patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC).

Aim To assess the effectiveness, safety and patients’ acceptability of NEPA in the prevention of CINV in patients undergoing multiple cycles of chemotherapy (HEC, including anthracycline and cyclophosphamide combination (AC) and cisplatin, or MEC) in a real-world setting.

Method This service evaluation recruited patients from two UK centres who were scheduled for at least three HEC, including AC and cisplatin, or MEC chemotherapy cycles, and taking NEPA as per the UK licence before each cycle. A web-based app was used to register patients, record their baseline characteristics and collect data. Patients used the app to rate their nausea and vomiting, report adverse events and rate their satisfaction with the effectiveness and convenience of NEPA for five days post-chemotherapy.

Results Of the 37 recruited patients, the majority reported ‘no significant nausea’ (nausea score 3 on a numerical rating scale from 0 to 10) (89.1%) and no episodes of vomiting (97.1%) across the three chemotherapy cycles. Patients’ satisfaction with NEPA was high.

Conclusion The results of this service evaluation support the effectiveness and acceptability of NEPA. Healthcare professionals should feel able to reassure patients that there are effective, tolerable and easy-to-use treatments available to prevent and relieve CINV.