netupitant (Ro 67-3189) / Helsinn, Otsuka - LARVOL DELTA

Reduced-Dose Dexamethasone(Dex) Plus Netupitant/Palonosetron (NEPA) for Prevention of Nausea and Vomiting in Cervical Cancer Patients Undergoing Concurrent Chemoradiotherapy(CCRT): An Interim Analysis (ESMO 2026) - No abstract available

Clinical • Cervical Cancer • Oncology • Solid Tumor

A phase 2 pharmacokinetic and pharmacodynamic dose-finding study of oral NEPA for chemotherapy-induced nausea and vomiting in pediatric patients with cancer. (PubMed, Support Care Cancer) - P2 | "A single dose of 4 mg/kg oral netupitant with oral palonosetron was effective and well-tolerated for CINV prevention in pediatric patients, supporting further investigation of NEPA in this population."

CINV • Clinical • Journal • P2 data • PK/PD data • Chemotherapy-Induced Nausea and Vomiting • Oncology • Pediatrics

The DEXSPARE study: Efficacy of dexamethasone-sparing netupitant-based antiemetic prophylaxis in highly emetogenic chemotherapy (KSMO 2026) - No abstract available

Clinical

Netupitant versus aprepitant: model-predicted neurokinin-1 receptor occupancy and implications for long-delayed nausea and vomiting prevention. (PubMed, Support Care Cancer) - "Single-dose netupitant maintained NK1 RO substantially longer than repeated- and single-dose aprepitant, suggesting greater potential for prolonged prevention of nausea and vomiting in ADC-treated patients. Prospective clinical validation of these model predictions would be beneficial."

Clinical • Journal • Chemotherapy-Induced Nausea and Vomiting

Extended physicochemical stability of ready-to-administer fosnetupitant/palonosetron infusion solutions and admixtures with dexamethasone injection. (PubMed, Eur J Hosp Pharm) - "Reconstituted FNET/PAL (Akynzeo) infusion solutions and FNET/PAL/DEX admixtures diluted with 30 mL and 100 mL NS in prefilled PO bags are physicochemically stable for at least 5 days (subvisible particle count specification fulfilled) and 28 days (subvisible particle count not tested) when stored light-protected at 25°C. Results allow pharmacy-based preparation of RTA FNET/PAL and RTA FNET/PAL/DEX infusion solutions in advance."

Journal • Oncology

Tradipitant (Nereus) for motion sickness. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal

NEPA VS STANDARD OF CARE IN GUIDELINE-BASED MODERATELY EMETOGENIC CHEMOTHERAPY RISK SUBGROUPS: POST-HOC ANALYSIS FROM THE MYRISK TRIAL (MASCC-ISOO 2026) - "MASCC/ESMO currently recommends adding an NK1RA for high-risk subgroups (eg, females <50 receiving oxaliplatin or patients receiving carboplatin AUC ≥5), while a 5-HT3RA + dexamethasone (DEX) remains standard of care (SOC) for other MEC regimens. The MyRisk trial demonstrated that when individual CINV risk is considered, NEPA (netupitant/palonosetron) + DEX provided superior CINV control vs SOC across 3 cycles (Molasiotis, Ann Oncol 2025)...These results confirm existing MASCC guideline recommendations while also addressing an unmet need among patients for whom current guidelines recommend only a 5-HT3RA + DEX. These data reinforce the relevance of patient-specific risk assessment and may inform future refinements of guideline recommendations in the MEC setting."

Retrospective data • Chemotherapy-Induced Nausea and Vomiting

PROSPECTIVE STUDY ON THE EFFICACY AND SAFETY OF NEPA (NETUPITAN-PALONOSETRON) IN PROPHYLAXIS OF NAUSEA AND VOMITING INDUCED BY ABDOMINAL RADIOTHERAPY (MASCC-ISOO 2026) - "This study aims to evaluate the efficacy of netupitant-palonosetron (NEPA) in preventing these symptoms in abdominal tumor patients undergoing radiotherapy...Isolated adverse reactions such as dizziness and abdominal distension were reported and alleviated with symptomatic treatment. Conclusions For abdominal tumor patients undergoing radiotherapy, the weekly administration of NEPA appears to be both effective and safe in preventing nausea and vomiting.These findings support NEPA as an effective antiemetic option for managing RINV and provide a rationale for future randomized controlled studies."

Clinical • Constipation • Gastroenterology • Gastrointestinal Disorder

ANTIEMETIC PROPHYLAXIS WITH NEPA IN CHEMO-NAÏVE ENDOMETRIAL CANCER PATIENTS RECEIVING TAXANE-PLATINUM CHEMOTHERAPY +/- IMMUNOTHERAPY OR TRASTUZUMAB (MASCC-ISOO 2026) - P4 | "Introduction NEPA (netupitant 300 mg + palonosetron 0.50 mg) has never been prospectively evaluated in endometrial cancer (EC) treated with taxane-platinum combination. We report the primary endpoint result of the NOEME study investigating the effectiveness of NEPA in chemotherapy-naïve women with histologically or cytologically confirmed EC receiving paclitaxel–carboplatin combination with or without immunotherapy/trastuzumab Methods NOEME (NCT06726291) is a multicenter, phase IV, single-arm study, conducted at 6 sites in Italy . Eligible patients received oral NEPA plus dexamethasone 12 mg on day 1 of each cycle...Complete protection (CR plus non-significant nausea) during the overall, acute and delayed phase was 73.8%, 88.5% and 75.4%, respectively. Conclusions NEPA was highly effective in chemotherapy-naïve EC patients receiving taxane-platinum chemotherapy with or without immunotherapy or trastuzumab, showing effectiveness comparable to outcomes..."

Clinical • Endometrial Cancer • Oncology • Solid Tumor

DISTINCT NK1 RECEPTOR MECHANISMS DIFFERENTIATE NETUPITANT/PALONOSETRON FROM APREPITANT/ONDANSETRON (MASCC-ISOO 2026) - "Conclusions NEPA induced sustained functional inhibition of SP-induced Ca²⁺ signalling consistent with NK1 receptor internalization, in contrast to APR/OND. These findings reveal a mechanistic distinction between NEPA and APR/OND."

Chemotherapy-Induced Nausea and Vomiting

Risk Factors Associated With Breakthrough Emesis in Mexican Women Receiving NEPA (Netupitant/Palonosetron): A Real-World Analysis (MASCC-ISOO 2026) - "Methods We conducted a real-world observational analysis including 50 adult Mexican women receiving moderately or highly emetogenic chemotherapy (MEC/HEC) with NEPA plus dexamethasone as primary antiemetic prophylaxis...Younger age, highly emetogenic regimens, low BMI, and prior CINV were strongly associated with emesis despite guideline-based prophylaxis. These findings support a risk-adapted antiemetic strategy, even when NEPA is used, to further optimize CINV prevention in vulnerable populations."

Clinical • Real-world • Real-world evidence • Chemotherapy-Induced Nausea and Vomiting

PHARMACOKINETIC/PHARMACODYNAMIC MODELING SUPPORTS FLEXIBLE TIMING OF NEPA ORAL SUSPENSION FOR CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING PREVENTION (MASCC-ISOO 2026) - "Introduction NEPA, a fixed combination of netupitant (NK₁ receptor antagonist, NETU) and palonosetron (5-HT₃ receptor antagonist, PALO), prevents acute and delayed CINV...This suggests that NEPA administration at home (~2-3 hours prior to chemotherapy administration) is unlikely to adversely affect its efficacy. This flexibility in dosing with the suspension formulation may further enhance the convenience of NEPA."

CINV • PK/PD data • Chemotherapy-Induced Nausea and Vomiting

Comparative Efficacy of Fosnetupitant and Fosaprepitant for Delayed Vomiting in Patients Receiving Irinotecan-Oxaliplatin Combination Chemotherapy: A Retrospective Propensity Score-Matched Study. (PubMed, Cancer Manag Res) - "With fosnetupitant, the time to first vomiting was longer (3/68 vs. 11/68, hazard ratio: 0.20, p=0.045), injection site reactions were fewer (0.0% vs. 19.1%, p0.05). Despite the retrospective design, possible calendar-time confounding, and limited number of events, our results suggest that fosnetupitant offers better control of long-delayed and overall vomiting and a favorable safety profile, compared with fosaprepitant, in patients receiving FOLFIRINOX/FOLFOXIRI regimens."

Journal • Retrospective data • Chemotherapy-Induced Nausea and Vomiting • Constipation • Gastroenterology • Gastrointestinal Disorder

Fosnetupitant for long-delayed chemotherapy-induced nausea and vomiting in oxaliplatin-based regimens: a prospective observational study (LODEC-N). (PubMed, Cancer Chemother Pharmacol) - "The triplet regimen involving FosNTP showed promising results and potential utility for managing long-delayed CINV in patients receiving oxaliplatin-based chemotherapy. However, given the single-arm study design, further comparative trials are warranted to confirm these findings. Participants with high emetic risk factors-such as younger age, female sex, or a history of motion sickness-continued to experience suboptimal control. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: jRCT1030230130."

CINV • Journal • Observational data • Chemotherapy-Induced Nausea and Vomiting

Dexamethasone reduction or omission with NEPA and olanzapine for HEC: A phase III trial. (ASCO 2026) - P3 | "We evaluated if DEX can be reduced or omitted when combined with NEPA (netupitant/palonosetron) and olanzapine without compromising control. NEPA plus olanzapine with single-day low-dose or no DEX is non-inferior to standard 4-day DEX for CINV prevention in HEC, supporting steroid-sparing strategies relevant for chemo-immunotherapy. Baseline patient characteristics and chemotherapy regimen."

P3 data • Chemotherapy-Induced Nausea and Vomiting • CNS Disorders • Insomnia • Sleep Disorder

The impact of NK1 receptor antagonist selection on chemotherapy-related adverse events: a retrospective study of adverse events in paclitaxel or nab-paclitaxel and carboplatin combination therapy with fosnetupitant and aprepitant use. (PubMed, Front Pharmacol) - "Conversely, among nab-PTX users, 10/49 patients in the FosNTP group and 8/53 patients in the APR group developed grade ≥3 neutropenia, with no significant difference observed (20.4% vs. 17.0%; p = 0.182). This study suggests that the use of FosNTP in PTX-containing regimens may lead to a higher incidence of grade ≥3 neutropenia compared to APR, emphasizing the importance of vigilant monitoring throughout the treatment period."

Adverse events • Journal • Retrospective data • Hematological Disorders • Lung Cancer • Neutropenia • Non Small Cell Lung Cancer • Oncology • Solid Tumor

Fosnetupitant Versus Fosaprepitant for Delayed Vomiting Upon Irinotecan-Oxaliplatin Combination Chemotherapy for Pancreatic/Colorectal Cancer. (PubMed, Anticancer Res) - "The effectiveness of fosnetupitant may vary according to cancer type, suggesting the need to tailor antiemetic strategies for patients receiving irinotecan-oxaliplatin combination chemotherapy."

Clinical • Journal • Retrospective data • Chemotherapy-Induced Nausea and Vomiting • Colorectal Cancer • Oncology • Pancreatic Cancer • Solid Tumor

Effectiveness of Adding Fosnetupitant to a Doublet Antiemetic Therapy Containing Palonosetron for Trastuzumab Deruxtecan-Induced Nausea and Vomiting - A Retrospective Comparative Study (PubMed, Gan To Kagaku Ryoho) - "Adding fosnetupitant increased the complete antiemetic control rate in the PDN group by 34.9% compared with that in the PD group. Triplet antiemetic therapy with palonosetron, dexamethasone, and fosnetupitant may provide effective antiemetic prophylaxis for T-DXd-induced nausea and vo miting."

Clinical • Journal • Retrospective data

Prospective study evaluating the antiemetic efficacy of NEPA in patients with HER2-positive or HER2-low advanced breast cancer treated with trastuzumab deruxtecan (ESMO-BC 2026) - "This study addresses this gap by prospectively assessing the efficacy and safety of NEPA (fixed combination of netupitant, an NK1 receptor antagonist (RA), and palonosetron, a second-generation 5-HT3RA) for NV prevention in patients with HER2-positive or HER2-low ABC receiving T-DXd in real-world practice.Trial design: This is a prospective, observational, multi-center, single-arm study in Korea, enrolling 100 adults with ABC initiating T-DXd. As of January 2026, 18 patients were enrolled. Study completion is expected in 4Q 2026."

Clinical • Metastases • Breast Cancer • HER2 Breast Cancer • HER2 Positive Breast Cancer • Oncology • Solid Tumor • HER-2

Personalized Antiemetic Prophylaxis for High Risk Patients Receiving MEC Chemotherapy: A Subgroup Analysis of German Patients from the MyRisk Study (DKK 2026) - P4 | "Background and Objective: Patients receiving moderately emetogenic chemotherapy (MEC) typically receive a 5-HT3 receptor antagonist (RA) and dexamethasone (DEX) as standard of care (SoC) antiemetic prophylaxis...The study presented that Netupitant/Palonosetron (NEPA) + DEX was superior to SoC in high-risk MEC patients, with an odds ratio of 1.67 favoring NEPA...Most patients received oxaliplatin-based chemotherapy (mean across cycles: NEPA = 89.1 %; SoC = 84.9 %)... This is the first study to integrate pre-chemotherapy risk assessment in MEC patients. In the German subpopulation, NEPA showed better outcomes than SOC, consistent with global results. Individual risk factors should be considered in all MEC patients to optimize CINV control."

Clinical • Chemotherapy-Induced Nausea and Vomiting

Integrative Structural Characterization of Candida glabrata Phosphoglycerate Kinase by Small-Angle X‑ray Scattering and AlphaFold: Implications for Therapeutic Targeting in Candidiasis. (PubMed, ACS Omega) - "Additionally, in order to evaluate its potential as a therapeutic target, we have performed molecular docking studies and enzymatic activity assays with pure Pgk using known antifungals amphotericin B, nystatin, and fluconazole and with the new plausible drugs, such as nilotinib and netupitant. In enzyme activity assays, a change in the kinetic parameter Km on the enzyme Pgk was observed in response to its interaction with nilotinib, netupitant, and amphotericin B. Thus, our results allow us to propose Pgk from C. glabrata as a possible therapeutic target against candidiasis. We consider it essential to design and develop new molecules specifically targeting this enzyme, which will contribute to a decrease in mortality associated with IC and improve the patient's quality of life."

Journal • Candidiasis

Effective Use of Olanzapine for Chemotherapy-Induced Nausea and Vomiting in a Patient Receiving Dose-Adjusted Rituximab, Etoposide, Prednisone, Vincristine (Oncovin®), Cyclophosphamide, and Doxorubicin (R-EPOCH): A Case Report. (PubMed, Cureus) - "The patient received prophylactic antiemetic therapy with olanzapine (5 mg after dinner for six days), palonosetron, and fosnetupitant during DA-R-EPOCH therapy. A four-drug antiemetic regimen, including olanzapine, supported the feasibility of preventing CINV in this case involving DA-R-EPOCH therapy. However, adverse events potentially related to olanzapine were observed, suggesting the need for further investigation into its optimal dosage."

CINV • Journal • B Cell Lymphoma • Chemotherapy-Induced Nausea and Vomiting • Constipation • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Large B Cell Lymphoma • Lymphoma • Non-Hodgkin’s Lymphoma • Oncology • Primary Mediastinal Large B-Cell Lymphoma

Optimizing Antiemetic Support in Anthracycline-Based Chemotherapy for Early Breast Cancer: Protocol for a Prospective Observational Study of Four-Drug Antiemetic Therapy Including Fosnetupitant and Olanzapine. (PubMed, JMIR Res Protoc) - "Four-drug antiemetic therapy, consisting of a neurokinin-1 receptor antagonist (NK1RA), a 5-hydroxytryptamine type 3 receptor antagonist (5-HT3RA), dexamethasone (DEX), and olanzapine (OLZ), is currently recommended for HEC. Data collection is expected to continue until April 2026, and both data collection and analyses are anticipated to be completed in 2027. This study will provide real-world evidence on the effectiveness and safety of a four-drug antiemetic regimen, including FosNTP and OLZ, in patients receiving anthracycline-based HEC and may inform optimal OLZ dosing strategies."

Clinical protocol • Journal • Observational data • Breast Cancer • Chemotherapy-Induced Nausea and Vomiting • Oncology • Solid Tumor

Improved Antiemetic Outcomes with NEPA vs (Fos)aprepitant in Patients with Breast Cancer Receiving Antibody-Drug Conjugates: A 12-Month Real-World Claims Analysis (SABCS 2025) - "Outcomes were assessed for NCCN-guideline recommended antiemetic agents: NEPA (netupitant/palonosetron), distinguished by its prolonged NK1 receptor occupancy and extended half-life, and fos(aprepitant)...Eligible patients were ≥18 years with a BC diagnosis who received one of three ADCs—trastuzumab emtansine (T-DM1), trastuzumab deruxtecan (T-DXd), or sacituzumab govitecan (SG)—and maintained continuous medical and pharmacy benefits for 12 months before and after the index date... These findings highlight clinical and economic benefits of NEPA-based antiemetic prophylaxis in patients with BC receiving ADCs. Given that patients often undergo prolonged ADC treatment, selecting an antiemetic regimen with sustained efficacy─such as NEPA in this database analysis─may be particularly important to minimize complications, lower healthcare utilization and cost, preserve quality of life, and support treatment continuity."

Clinical • Real-world • Real-world evidence • Breast Cancer • Oncology • Solid Tumor

Sustained antiemetic efficacy of fosnetupitant versus aprepitant in carboplatin-based chemotherapy: a retrospective observational study. (PubMed, Int J Clin Oncol) - "F-NTP demonstrated superior antiemetic efficacy to that of APR in CBDCA-based regimens, particularly maintaining higher CR rates through the acute and delayed phases. F-NTP was also well tolerated, supporting its potential as a strong prophylactic agent for preventing chemotherapy-induced nausea and vomiting."

Journal • Observational data • Retrospective data • Chemotherapy-Induced Nausea and Vomiting • Oncology