This paper presents an overview of the efficacy of intravenous (IV) NEPA (fixed combination of the NKRA, fosnetupitant, and 5-HTRA, palonosetron) relative to oral NEPA and also to historical data for other NKRA regimens. Data is compiled from 5 pivotal NEPA studies in adult chemotherapy-naïve patients with solid tumors undergoing either cisplatin- or anthracycline cyclophosphamide (AC)-based chemotherapy. Additionally, data was reviewed from 10 pivotal Phase 3 studies utilizing other NKRA regimens approved for clinical use. The overall (0-120 h) complete response (no emesis, no rescue use), no emesis, and no significant nausea rates for IV NEPA were similar to that of oral NEPA and were consistently numerically higher than historical NKRA regimens. As a single-dose prophylactic antiemetic combination given with dexamethasone, IV NEPA is a highly effective and convenient guideline-compliant antiemetic agent which may offer a safety benefit over other IV NKRA regimens due to its lack of associated hypersensitivity and injection-site reactions.
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