{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T17:02:25Z","timestamp":1791133345358,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite guidelines for managing chemotherapy-induced nausea and vomiting (CINV), there remains a need to clarify the optimal use of neurokinin-1 (NK1) receptor antagonists. Comparing the effectiveness of NEPA (netupitant-palonosetron) plus dexamethasone with other NK1 antagonist-based regimens combined with a 5HT3 receptor antagonist and dexamethasone is crucial for informed decision-making and improving patient outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a systematic review of the literature to assess randomized controlled trials (RCTs) comparing the efficacy, safety, and cost-effectiveness of NEPA plus dexamethasone and other NK1 antagonist-based regimens combined with a 5HT3 receptor antagonist and dexamethasone. PubMed, Embase, and the Cochrane Library databases were systematically searched, with the latest update performed in December 2023. Data on patient demographics, chemotherapy regimen characteristics, and outcomes were extracted for meta-analysis using a random-effects model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seven RCTs were analyzed. NEPA plus dexamethasone showed superior efficacy in achieving complete response in the overall (risk ratio [RR], 1.15; 95% CI, 1.02--1.30) and delayed phases (RR, 1.20; 95% CI, 1.03-1.41) of chemotherapy. It was more effective in controlling nausea (overall phase RR, 1.20; 95% CI, 1.05-1.36; delayed phase RR, 1.21; 95% CI, 1.05-1.40) and reducing rescue therapy use (overall phase RR, 1.45; 95% CI, 1.07-1.95; delayed phase RR, 1.75; 95% CI, 1.10-2.78). Adverse event rates were comparable (RR, 1.03; 95% CI, 0.96-1.10). Subgroup analysis indicated NEPA\u2019s particular efficacy in patients receiving moderately emetogenic chemotherapy (RR, 1.31; 95% CI, 1.07-1.60).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>NEPA plus dexamethasone regimens exhibit superior efficacy in preventing CINV, supporting their preferential inclusion in prophylactic treatment protocols. Its effective symptom control, safety profile, and cost-effectiveness endorse NEPA-based regimens as a beneficial option in CINV management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyae233","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T17:04:05Z","timestamp":1726592645000},"source":"Crossref","is-referenced-by-count":10,"title":["Comparative effectiveness of netupitant-palonosetron plus dexamethasone versus aprepitant-based regimens in mitigating chemotherapy-induced nausea and vomiting: a meta-analysis of randomized controlled trials"],"prefix":"10.1093","volume":"30","author":[{"given":"Wun-Ting","family":"Luo","sequence":"first","affiliation":[{"name":"Department of General Medicine, Taipei Medical University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Lun","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Hematology and Medical Oncology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University , Taipei ,","place":["Taiwan"]},{"name":"Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University , Taipei ,","place":["Taiwan"]},{"name":"School of Nursing, College of Nursing, Taipei Medical University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6722-1153","authenticated-orcid":false,"given":"Tsai-Wei","family":"Huang","sequence":"additional","affiliation":[{"name":"Cochrane Taiwan, Taipei Medical University , Taipei ,","place":["Taiwan"]},{"name":"Department of Nursing, Wan Fang Hospital, Taipei Medical University , Taipei ,","place":["Taiwan"]},{"name":"Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Made Satya Nugraha","family":"Gautama","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Medicine, Universitas Pendidikan Ganesha , Bali ,","place":["Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"issue":"6","key":"2025030711574104400_CIT0001","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/S1470-2045(09)70091-9","article-title":"Controlling chemotherapy-related nausea and vomiting","volume":"10","author":"Herrstedt","year":"2009","journal-title":"Lancet Oncol"},{"issue":"7","key":"2025030711574104400_CIT0002","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1093\/oxfordjournals.annonc.a059288","article-title":"Sources of anticipatory emotional distress in women receiving chemotherapy for breast cancer","volume":"6","author":"Dilorenzo","year":"1995","journal-title":"Ann Oncol"},{"issue":"11","key":"2025030711574104400_CIT0003","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1200\/JCO.1988.6.11.1746","article-title":"The influence of symptoms of disease and side effects of treatment on compliance with cancer therapy","volume":"6","author":"Richardson","year":"1988","journal-title":"J Clin Oncol"},{"issue":"5","key":"2025030711574104400_CIT0004","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.1016\/j.clnu.2021.02.005","article-title":"ESPEN practical guideline: clinical nutrition in cancer","volume":"40","author":"Muscaritoli","year":"2021","journal-title":"Clin Nutr"},{"issue":"2","key":"2025030711574104400_CIT0005","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1200\/JCO.22.01217","article-title":"Inflammation and clinical decline after adjuvant chemotherapy in older adults with breast cancer: results from the hurria older patients prospective study","volume":"41","author":"Ji","year":"2023","journal-title":"J Clin Oncol"},{"issue":"27","key":"2025030711574104400_CIT0006","doi-asserted-by":"crossref","first-page":"4472","DOI":"10.1200\/JCO.2006.05.6382","article-title":"Delayed nausea and vomiting continue to reduce patients\u2019 quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment","volume":"24","author":"Bloechl-Daum","year":"2006","journal-title":"J Clin Oncol"},{"issue":"24","key":"2025030711574104400_CIT0007","doi-asserted-by":"crossref","first-page":"2782","DOI":"10.1200\/JCO.20.01296","article-title":"Antiemetics: ASCO guideline update","volume":"38","author":"Hesketh","year":"2020","journal-title":"J Clin Oncol"},{"key":"2025030711574104400_CIT0008","author":"National Comprehensive Cancer Network","year":"2023"},{"issue":"1","key":"2025030711574104400_CIT0009","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s00520-023-08221-4","article-title":"2023 updated MASCC\/ESMO consensus recommendations: prevention of nausea and vomiting following high-emetic-risk antineoplastic agents. 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