{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T17:02:14Z","timestamp":1791133334278,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"vor","delay-in-days":183,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Neurokinin (NK) 1 receptor antagonists (RAs), administered in combination with a 5-hydroxytryptamine-3 (5-HT3) RA and dexamethasone (DEX), have demonstrated clear improvements in chemotherapy-induced nausea and vomiting (CINV) prevention over a 5-HT3RA plus DEX. However, studies comparing the NK1RAs in the class are lacking. A fixed combination of a highly selective NK1RA, netupitant, and the 5-HT3RA, palonosetron (NEPA), simultaneously targets two critical antiemetic pathways, thereby offering a simple convenient antiemetic with long-lasting protection from CINV. This study is the first head-to-head NK1RA comparative study in patients receiving anthracycline cyclophosphamide (AC) and non-AC moderately emetogenic chemotherapy (MEC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>This was a pragmatic, multicenter, randomized, single-cycle, open-label, prospective study designed to demonstrate noninferiority of single-dose NEPA to a 3-day aprepitant regimen in preventing CINV in chemotherapy-naive patients receiving AC\/non-AC MEC in a real-life setting. The primary efficacy endpoint was complete response (no emesis\/no rescue) during the overall (0\u2013120 hour) phase. Noninferiority was achieved if the lower limit of the 95% confidence interval (CI) of the difference between NEPA and the aprepitant group was greater than the noninferiority margin set at \u221210%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Noninferiority of NEPA versus aprepitant was demonstrated (risk difference 9.2%; 95% CI, \u22122.3% to 20.7%); the overall complete response rate was numerically higher for NEPA (64.9%) than aprepitant (54.1%). Secondary endpoints also revealed numerically higher rates for NEPA than aprepitant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This pragmatic study in patients with cancer receiving AC and non-AC MEC revealed that a single dose of oral NEPA plus DEX was at least as effective as a 3-day aprepitant regimen, with indication of a potential efficacy benefit for NEPA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications for Practice<\/jats:title>\n                  <jats:p>In the absence of comparative neurokinin 1 (NK1) receptor antagonist (RA) studies, guideline committees and clinicians consider NK1RA agents to be interchangeable and equivalent. This is the first head-to-head study comparing one NK1RA (oral netupitant\/palonosetron [NEPA]) versus another (aprepitant) in patients receiving anthracycline cyclophosphamide (AC) and non-AC moderately emetogenic chemotherapy. Noninferiority of NEPA versus the aprepitant regimen was demonstrated; the overall complete response (no emesis and no rescue use) rate was numerically higher for NEPA (65%) than aprepitant (54%). As a single-dose combination antiemetic, NEPA not only simplifies dosing but may offer a potential efficacy benefit over the current standard-of-care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/onco.13888","type":"journal-article","created":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T10:24:04Z","timestamp":1625307844000},"page":"e1870-e1879","source":"Crossref","is-referenced-by-count":26,"title":["A Pragmatic Study Evaluating NEPA Versus Aprepitant for Prevention of Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Moderately Emetogenic Chemotherapy"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7455-2009","authenticated-orcid":false,"given":"Laurent","family":"Zelek","sequence":"first","affiliation":[{"name":"H\u00f4pital Avicenne, Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Debourdeau","sequence":"additional","affiliation":[{"name":"Institut Sainte-Catherine, Avignon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugues","family":"Bourgeois","sequence":"additional","affiliation":[{"name":"Clinique Victor Hugo, Le Mans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Philippe","family":"Wagner","sequence":"additional","affiliation":[{"name":"Institut Andr\u00e9e Dutreix and Clinique de Flandre, Dunkerque, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Brocard","sequence":"additional","affiliation":[{"name":"Polyclinique De Gentilly, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Lefeuvre-Plesse","sequence":"additional","affiliation":[{"name":"Centre Eug\u00e8ne Marquis, Rennes Cedex, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Chauffert","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire Amiens, Amiens, 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