New Study Looks at Quality of Life With NEPA for CINV in Women With Breast Cancer

A real-life study conducted in Germany looking at quality of life (QoL) in patients with breast cancer receiving a fixed combination of netupitant/palonosetron (NEPA) for prevention of chemotherapy-induced nausea and vomiting (CINV) found the combination therapy to be effective. The findings, which were presented at the 2019 San Antonio Breast Cancer Symposium in Texas, showed that NEPA and its convenient administration may help improve adherence to antiemetic guidelines and ultimately improve CINV control rates in patients with breast cancer receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC).

NEPA is an oral fixed dose combination of netupitant at 300 mg and palonosetron at 500 mg and is approved for preventing acute and delayed CINV in patients with cancer receiving HEC or MEC. However, the researchers sought to examine QOL in adults receiving NEPA as primary prophylaxis for CINV associated with MEC or HEC. To determine this, they conducted an interim analysis of a subgroup of patients with breast cancer, representing the largest subpopulation (66%) enrolled in the AkyPRO Study. The study began in September 2015 and has enrolled 2427 patients (986 patients with breast cancer). Among the 986 patients with breast cancer, 80% of patients received HEC.

The researchers found that 84% of patients reported no effect on daily life due to vomiting in all analyzed cycles. When it came to nausea, 51% to 56% of the patients reported no effect on daily life due to nausea and 93% of patients reported no emesis. During the 5 days postchemotherapy during all 3 treatment cycles, 81% of patients reported a complete response (no vomiting, no rescue medication).

This treatment was not as effective in combating nausea, with 37% of patients reporting nausea 1 or more times during the 5 days following chemotherapy.

The physicians’ assessments rated NEPA as very good/good for 89% to 91% of the patients in cycle 1, cycle 2, and cycle 3. These percentages were similar to the patients’ assessments. This study also confirmed previous findings that NEPA is well tolerated. The most frequent treatment-related adverse events (TRAEs) were low-grade constipation (2.2%) and insomnia (1.4%).

Reference

Schilling J, Busch S, Stefek A, et al. Quality of life data of breast cancer patients receiving a fixed combination of netupitant/palonosetron (NEPA) for prevention of chemotherapy-induced nausea and vomiting – a real life study. Poster presentation at: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, TX. Abstract P2-12-02.