Effectiveness of the combination of netupitant and palonosetron in the prevention of nausea and vomiting during anthracycline-containing chemotherapy in patients with breast cancer

The incidence of early-stage breast cancer among young patients has shown a significant increase over the past twenty years, with a substantial portion of these patients requiring chemotherapy. Most treatment regimens used in both neo-adjuvant and adjuvant settings are characterized as moderately or highly emetogenic. Young patients typically lead socially active lives, balancing work and childcare, and strive to remain indistinguishable from healthy women. However, one of the most pronounced adverse effects of chemotherapy is nausea and vomiting, which significantly impair quality of life. One modern method for the prevention of nausea and vomiting involves the use of a combined NK1-receptor and 5-HT3-receptor antagonist, comprising the drugs netupitant and palonosetron (NEPA). This medication is administered as a single dose on the first day in conjunction with dexamethasone, without the need for additional medication on subsequent days. This review discusses the mechanisms of action of NEPA and pres ents studies focused on the effectiveness of the combination of netupitant and palonosetron in patients undergoing moderately and highly emetogenic therapy. According to literature the efficacy of NEPA in combination with dexamethasone reached 70.5% for complete response in the first cycle of treatment. A retrospective analysis involving 2,173 patients confirmed the high efficacy of NEPA, particularly in patients under 60 years of age. Data from real clinical practice further support the results of studies on the effectiveness of NEPA, demonstrating a complete control rate of nausea and vomiting ranging from 74 to 90%.