Dexamethasone-sparing regimens with oral NEPA for the prevention of emesis caused by high-dose cisplatin: A randomized non-inferiority study

CONCLUSIONS: A simplified regimen of NEPA plus single-dose DEX offers comparable CINV prevention throughout 5 days post-chemotherapy with the advantage of sparing patients additional doses of DEX in the high emetic risk setting of cisplatin-based chemotherapy.IMPLICATIONS FOR PRACTICE: Dexamethasone (DEX) has traditionally played an integral role in the management of chemotherapy-induced nausea and vomiting (CINV). While generally considered safe, even short-term DEX use is associated with various side effects, and some evidence suggests that steroids may reduce the efficacy of immunotherapies and cellular therapies, if used concurrently. Our study demonstrates, for the first time, comparable antiemetic control during the 5-days post-chemotherapy with a simplified three-drug regimen of NEPA (netupitant/palonosetron) plus single-dose DEX versus the standard 4-day DEX reference treatment in patients undergoing high-dose cisplatin. This represents a clinically relevant achievement as it not only simplifies antiemetic prophylaxis but also offers an opportunity to minimize DEX-related side effects and appropriately use in patients where caution with corticosteroid use is advised.PMID:34101934 | DOI:10.1002/onco.13851

Source: The Oncologist - June 8, 2021 Category: Cancer & Oncology Authors: Luigi Celio Diego Cortinovis Alessio Aligi Cogoni Luigi Cavanna Olga Martelli Simona Carnio Elena Collov à Federica Bertolini Fausto Petrelli Alessandra Cassano Rita Chiari Francesca Zanelli Salvatore Pisconti Isabella Vittimberga Antonietta Letizia Andr Source Type: research