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

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

Prevention of CINV in Patients with Multiple Myeloma or Lymphoma Undergoing Hematopoietic Stem Cell Transplantation: NEPA Versus Ondansetron. a Monocentric Real-Life Experience (ASH 2023) - "Polychemotherapy regimens, used as conditioning regimens for ASCT in lymphomas, and high-dose melphalan (≥140 mg/mq), used in multiple myeloma (MM), have high emetogenic risk...Antiemetic guidelines recommend, for prophylaxis, co-administration of a triplet regimen of a serotonine (5-HT3) receptor antagonist (RA), as Ondansetron, a neurokinin-1 RA, and dexamethasone. Netupitant-Palonosetron (NEPA), an oral formulation derived from the combination of Netupitant (NK1-RA) and Palonsetron, has been approved as prophylaxis of CINV but its experience in the stem cell transplant setting is still limited... In our experience, NEPA has shown superiority in the prevention of CINV, in highly emetogenic regimens in both patients with myeloma or lymphoma, with advantages on the severity and the duration of CINV. Given the high burden of CINV in the whole population analyzed in the study, regardless of the antiemetic used, it would be useful to identify patients at greatest risk and..."

CINV • Clinical • Bone Marrow Transplantation • Chemotherapy-Induced Nausea and Vomiting • Hematological Malignancies • Lymphoma • Mucositis • Multiple Myeloma • Oncology • Transplantation

Virtual screening of drugs against multiple targets of Alzheimer's disease. (PubMed, J Alzheimers Dis) - "BackgroundDrug repurposing offers a rapid, cost-effective approach for discovering therapies against multiple targets.ObjectiveHere, we screen virtual ligand libraries consisting of 3468 approved drugs against 11 protein targets associated with Alzheimer's disease (AD).MethodsWe employ blind molecular docking, and target amyloid-β (Aβ), microtubule-associated protein tau (MAPT), Apolipoprotein E4 (APOE4), acetylcholinesterase (AChE), butyrylcholinesterase (BChE), amyloid-β protein precursor (AβPP), β-secretase (BACE1), brain-derived neurotrophic factor (BDNF), presenilin 1 (PSEN1) and 2 (PSEN2), and α-synuclein (SNCA) proteins using AutoDock Vina.ResultsNotably, multitarget binding recurs among the top-10 ligands with Ergotamine and Dihydroergotamine potentially binding 8; Dutasteride 7; Drospirenone and Nilotinib 6; Adapalene and Conivaptan 5; Bromocriptine 4; and Rolapitant, Irinotecan, Plerixafor, Saquinavir, and Telmisartan 3, out of 11 protein targets. Likewise,..."

Journal • Alzheimer's Disease • Cardiovascular • CNS Disorders • Hypertension • Inflammation • Pain • APOE • BDNF • MAPT • SNCA

Personalizing antiemetic prophylaxis for patients at high emetic risk: Results from the MyRisk Trial (ESMO 2025) - P4 | "Adult patients scheduled to receive 3 cycles of MEC with a high risk score were randomized to NEPA (a fixed combination of an NK 1 RA, netupitant, and 5-HT 3 RA, palonosetron) + DEX or SOC...The most common cancers were colorectal (42%) and lung (19%); oxaliplatin (64%) and carboplatin (30%) were the most common MEC...Table: 2801O Response Endpoint Over 3 Cycles of MEC NEPA(n = 189) SOC (n = 199) Odds Ratio 95% CI p-value Complete response (no emesis, no rescue) 81.0% 71.8% 1.67 1.12 to 2.49 0.012 Complete protection (no emesis, no rescue, no nausea) 71.8% 62.4% 1.53 1.06 to 2.21 0.022 No emesis 95.4% 86.7% 3.18 1.62 to 6.22 <0.001 No nausea 63.7% 54.9% 1.45 1.01 to 2.06 0.042 No rescue medication 82.4% 76.5% 1.43 0.94 to 2.18 0.091 Conclusions This novel trial integrating pre-treatment individual risk factors with planned MEC found NEPA to be superior to SOC in preventing CINV in patients at increased emetic risk, highlighting the benefit of a personalized..."

Clinical • Chemotherapy-Induced Nausea and Vomiting • Colorectal Cancer • Oncology

Personalised Antiemetic Prophylaxis with NEPA for Patients at High-Risk of Chemotherapy-induced Nausea and Vomiting Receiving Moderately Emetogenic Chemotherapy: Results from the Randomised, Multinational MyRisk Trial. (PubMed, Ann Oncol) - "When individual risk factors are considered prior to MEC, a 3-drug regimen including NEPA provides superior CINV prevention across multiple cycles compared to the standard 2-drug approach. These findings underscore the value of personalised risk-adapted antiemetic strategies and have practice-changing potential for optimizing antiemetic control."

CINV • Journal • Chemotherapy-Induced Nausea and Vomiting • Colorectal Cancer • Oncology

Breast Cancer‒Associated Allergy Caused by Fosnetupitant-A Report of Four Cases (PubMed, Gan To Kagaku Ryoho) - "We describe the cases of 4 patients with breast cancer who developed an allergy to fosnetupitant (Pro‒NETU). The patients in cases 2, 3, and 4 had known allergies to docetaxel, and the cause of allergy in case 4 was unknown. Polysorbate 80, contained in docetaxel, fosaprepitant, and Pro‒NETU, was suspected to be the cause of allergy in cases 1, 2, and 3."

Journal • Allergy • Breast Cancer • Cardiovascular • Immunology • Oncology • Pulmonary Disease • Solid Tumor

Single-Agent Netupitant/Palonosetron for Antiemetic Prophylaxis in Autologous Hematopoietic Cell Transplant Recipients (SOHO 2025) - "Patients with multiple myeloma received pretransplant conditioning with melphalan 200 mg/m² (MEL200), while patients with lymphomas received lomustine, etoposide, cytarabine, and melphalan (LEAM) conditioning. Single-agent NEPA is a highly effective and simple antiemetic prophylaxis strategy in patients receiving highly emetogenic conditioning prior to auto-HCT."

Clinical • Chemotherapy-Induced Nausea and Vomiting • Hematological Malignancies • Lymphoma • Multiple Myeloma • Oncology

Efficacy and safety of netupitantpalonosetron in colorectal cancer patients receiving moderate-emetogenic chemotherapy: An interim analysis (KSMO 2025) - No abstract available

Clinical • Colorectal Cancer • Oncology • Solid Tumor

Individual patient data meta-analysis of NEPA versus aprepitant-based antiemetic regimens for preventing chemotherapy-induced nausea and vomiting. (PubMed, Future Oncol) - "This individual patient data (IPD) meta-analysis compared the efficacy of NEPA (netupitant/fosnetupitant) and aprepitant/fosaprepitant-based regimens in preventing chemotherapy-induced nausea and vomiting (CINV)...A total of six studies involving 2,767 patients were included evaluating NEPA plus dexamethasone versus aprepitant/fosaprepitant plus any 5-HT3RA plus dexamethasone for patients with cancer receiving HEC/MEC. Complete response and no significant nausea rates were similar during the acute (0-24 h) phase but NEPA showed significantly higher rates than aprepitant during the delayed ( > 24-120 h) and overall (0-120 h) phases and on Days 3-5 following chemotherapy. Improved CINV prevention was observed with NEPA-based regimens, particularly during Days 3-5, highlighting its potential for managing prolonged nausea and vomiting associated with emerging anticancer targeted therapies."

CINV • Journal • Retrospective data • Review • Chemotherapy-Induced Nausea and Vomiting • Oncology

Netupitant Exhibits Potent Activity on Mycobacterium tuberculosis Persisters. (PubMed, ACS Infect Dis) - "In combination with isoniazid (INH) and rifampicin (RIF), NTP eliminated viable Mtb cells, achieving a >6-log reduction in colony-forming units (CFUs), compared to the 2.5-log reduction observed with INH-RIF alone. NTP also demonstrated broad-spectrum efficacy, enhancing the activity of multiple TB drugs, including ethambutol, moxifloxacin, amikacin, and bedaquiline...To begin assessing this possibility, we performed transcriptomics and found that NTP significantly upregulates multiple oxidative stress response-associated genes, while downregulating pathways linked to protein synthesis, electron transport chain activities, and ATP synthesis. While further studies are required to decipher mechanisms of action and the resistance profile of NTP, and to assess its in vivo efficacy, these findings underscore its potential as a promising adjunct to existing TB therapies."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis • B3GAT1

Neurokinin-1 receptor antagonists in the current management of chemotherapy-induced nausea and vomiting. (PubMed, Front Med) - "This article summarizes the available clinical and real-world data on the use of NK1RAs in CINV prophylaxis, with a focus on evidence from China, where three NK1RAs, aprepitant, fosaprepitant and netupitant, are currently approved. NK1RAs have demonstrated efficacy and favorable safety in the prevention of acute and delayed CINV. Further research is required to determine the optimal use of these drugs and to identify strategies for CINV management in specific patient populations."

CINV • Journal • Review • Chemotherapy-Induced Nausea and Vomiting

Identification of FDA-Approved Drugs That Inhibit SARS-CoV-2 and Human Norovirus Replication. (PubMed, Biol Pharm Bull) - "Among the hit compounds, 5 compounds (auranofin, endoxifen, netupitant, pimozide, and regorafenib) were selected for further analysis. Interestingly, 4 of them, except for auranofin, significantly suppressed human norovirus (HuNoV) replication in human intestinal organoids. In brief, we identified several FDA-approved drugs that inhibit SARS-CoV-2 and HuNoV replication, which warrant further investigation."

FDA event • Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Single-agent netupitant/palonosetron for antiemetic prophylaxis in autologous hematopoietic cell transplantat recipients (MASCC-ISOO 2025) - "Patients with myeloma received high-dose melphalan (HD-MEL), whereas patients with lymphoma – lomustine, etoposide, cytarabine, and melphalan (LEAM)...Metoclopramide was used as rescue medication...Mucositis was registered in 44%, diarrhoea in 54%, febrile neutropenia in 47% of patients. Conclusions Single-agent NEPA is a simple, well-tolerated and effective antiemetic option for patients undergoing auto-HCT."

Bone Marrow Transplantation • Chemotherapy-Induced Nausea and Vomiting • Febrile Neutropenia • Hematological Disorders • Hematological Malignancies • Hodgkin Lymphoma • Lymphoma • Mucositis • Multiple Myeloma • Neutropenia • Non-Hodgkin’s Lymphoma • Oncology • Transplantation

Efficacy of dexamethasone-sparing regimen as CINV prophylaxis in highly and moderately emetogenic chemotherapy: a multicenter, retrospective study (MASCC-ISOO 2025) - "Common chemotherapy regimens included doxorubicin-cyclophosphamide (15.53%) and Docetaxel, Cisplatin and Fluorouracil (10.64%). Complete response rates, Complete Protection rates and Complete Control rates improved with subsequent Chemotherapy cycles (Figure). Conclusions Sparing Dexamethsone dose on day 2nd, 3rd and 4th and administering only Day 1 Dexamethasone with tab Netupitant and tab Palanosetron is an effective antiemetic combination in achieving high response rates, in both acute and delayed phases of CINV."

CINV • Retrospective data • Chemotherapy-Induced Nausea and Vomiting • Oncology

NETUPITANT/PALONOSETRON FOR ANTIEMETIC PROPHYLAXIS IN PATIENTS WITH MULTIPLE MYELOMA AND LYMPHOMAS UNDERGOING HIGH-DOSE INTENSIVE CHEMOTHERPY PRIOR TO AUTOLOGOUS HEMATOPOIETC STEM CELL TRANSPLANTION (EHA 2025) - "Aims: We evaluated the efficacy of single-agent NEPA without any concurrent medication (including dexamethasone) for CINV prophylaxis in patients after auto-HCT...Patients with myeloma received high-dose melphalan (HD-MEL) at the dose of 200mg/m2, whereas patients with lymphoma - combination of lomustine, etoposide, cytarabine, and melphalan (LEAM)...Metoclopramide 10 mg was used as rescue medication... single-agent NEPA is a simple, well-tolerated and effective antiemetic option for patients undergoing auto-HCT."

Clinical • Bone Marrow Transplantation • Chemotherapy-Induced Nausea and Vomiting • Febrile Neutropenia • Hematological Disorders • Hematological Malignancies • Hodgkin Lymphoma • Lymphoma • Mucositis • Multiple Myeloma • Neutropenia • Non-Hodgkin’s Lymphoma • Oncology • Transplantation

Efficacy and safety of oral NEPA versus fosaprepitant combined with palonosetron for preventing highly emetogenic chemotherapy-induced nausea and vomiting in patients with nasopharyngeal carcinoma. (ASCO 2025) - "Funded by Prognostic evaluation and individualized treatment strategies for nasopharyngeal carcinoma based on recursive attention mechanisms (RAMs) and multimodal deep learning, Study of the antitumor effect of marine docosahexaenoic acid on the miR-26a/EZH2 axis in NSCLC, A non-inferiority, parallel design, randomized controlled study of saperine versus dexamethasone nebulized inhalation in the prevention and treatment of radiation oral mucositis in nasopharyngeal carcinoma Background: Oral NEPA, a fixed combination of netupitant (300 mg) and palonosetron (0.5 mg), is a highly effective antiemetic agent used in patients with cancer undergoing highly emetogenic chemotherapy (HEC)...156 patients (Oral NEPA group) received a single dose of NEPA capsules orally 1 hour before each chemotherapy cycle, while 156 patients (APR + PALO group) received once intravenous drip of FosAPR (150 mg) for 30 minutes followed by once intravenous injection of PALO (0.25 mg). In addition,..."

CINV • Clinical • Chemotherapy-Induced Nausea and Vomiting • Constipation • Gastroenterology • Gastrointestinal Disorder • Lung Cancer • Mucositis • Nasopharyngeal Carcinoma • Non Small Cell Lung Cancer • Oncology • Pain • Solid Tumor • Stomatitis • MIR26A1

Safety and antiemetic efficacy of weekly administration of netupitant/palonosetron plus dexamethasone during 5 weeks of concomitant chemo-radiotherapy-the DANGER-emesis study. (PubMed, Support Care Cancer) - P2/3 | "Weekly NEPA administration was safe, well-tolerated, and highly effective during concomitant radiotherapy and weekly cisplatin."

Journal • Cervical Cancer • Fatigue • Oncology • Solid Tumor

SINGLE-AGENT NETUPITANT/PALONOSETRON FOR ANTIEMETIC PROPHYLAXIS IN PATIENTS RECEIVING HIGH-DOSE CHEMOTHERAPY PRIOR TO AUTOLOGOUS HEMATOPOIETIC CELL TRANSPLANTATION (EBMT 2025) - "We evaluated the efficacy of single-agent NEPA without any concurrent medication (including dexamethasone) for CINV prophylaxis in patients after auto-HCT...Patients with myeloma received high-dose melphalan (HD-MEL) at the dose of 200mg/m2, whereas patients with lymphoma – combination of lomustine, etoposide, cytarabine, and melphalan (LEAM)...Metoclopramide 10 mg was used as rescue medication... Single-agent NEPA is a simple, well-tolerated and effective antiemetic option for patients undergoing auto-HCT."

Clinical • Bone Marrow Transplantation • Chemotherapy-Induced Nausea and Vomiting • Febrile Neutropenia • Hematological Disorders • Hematological Malignancies • Hodgkin Lymphoma • Lymphoma • Mucositis • Multiple Myeloma • Neutropenia • Non-Hodgkin’s Lymphoma • Oncology • Transplantation

Safety and Feasibility of Outpatient Zolbetuximab Administration in Community Cancer Care: A Mixed-methods Analysis. (PubMed, In Vivo) - "Outpatient zolbetuximab administration proved safe and feasible in a community setting when implemented with appropriate protocols and support systems. This implementation model could serve as a template for delivering complex cancer therapies in resource-limited settings."

Journal • Gastric Cancer • Oncology • Solid Tumor • CLDN18

A Clinical Trial to Assess Safety and Pharmacokinetics of Fosnetupitant 235 Mg and Metabolites in Healthy Volunteers (clinicaltrials.gov) - P1 | N=50 | Terminated | Sponsor: Helsinn Healthcare SA

New P1 trial

Cost-effectiveness analysis of fosnetupitant in patients receiving cisplatin in Japan: analysis based on real-world data. (PubMed, Support Care Cancer) - "F-NTP is more cost-effective than F-APR, but slightly less cost-effective than APR."

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

A systematic review and meta-analysis on evaluating the efficacy and safety of netupitant/palonosetron compared to aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients undergoing emetogenic chemotherapy. (ASCO-GI 2025) - "Our analysis suggests that the use of NEPA results in better control of nausea in overall phases compared to Aprepitant for the prevention of CINV in patients receiving emetogenic chemotherapy. However, NEPA demonstrates comparable efficacy to aprepitant in achieving control of nausea and emesis when the symptoms are stratified in acute and delayed phases. Nevertheless, further studies are warranted for a comprehensive comparison between NEPA and Aprepitant for the prevention of CINV."

CINV • Retrospective data • Review • Esophageal Cancer • Gastrointestinal Cancer • Oncology • Solid Tumor

Impact of antiemetic prophylaxis on maintaining dose intensity of trastuzumab deruxtecan in HER2-positive advanced breast cancer (SABCS 2024) - "The TAR consisted of either the fixed combination of netupitant/palonosetron (NEPA) or the combination of an NK1 receptor antagonist (RA) and a 5-HT3 RA plus dexamethasone. These results highlight the previously unreported finding that administering guideline-recommended TAR prophylaxis facilitates maintaining the dose intensity of TDXd throughout treatment. Using an appropriate upfront antiemetic regimen when initiating T-DXd is critical to optimize patient outcomes."

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

Model-predicted Neurokinin-1 (NK1) Receptor Occupancy of Netupitant versus Aprepitant Over an Extended Time Period: Implications for Controlling Nausea and Vomiting Associated with Antibody-Drug Conjugates (ADCs) (SABCS 2024) - "There was a persistent and gradual decline of % NK1 RO over a period of 20 days following a single dose of NETU compared with a rapid decline in RO for APR after 6 days. These findings suggest that NETU has the potential to prevent NV over a prolonged duration, making it a promising antiemetic for prevention of NV with new anticancer targeted therapy like some ADCs. Preserving patients' quality of life and ensuring uninterrupted treatment is vital to optimizing outcomes and maximizing treatment effectiveness."

Breast Cancer