학술논문
奈妥匹坦帕洛诺司琼预防化疗引起的恶心呕吐:从临床试验到日常临床实践 / Netupitant-palonosetron for Preventing Chemotherapy-induced Nausea and Vomiting:From Clinical Trials to Daily Practice
Document Type
Academic Journal
Source
中国实用医药 / China Practical Medical. 19(1):159-174
Subject
Language
Chinese
ISSN
1673-7555
Abstract
化疗引起的恶心呕吐(CINV)是众多抗癌药物治疗中常见的不良事件,不仅会对患者生活质量带来负面影响,还有可能影响化疗效果.目前,指南建议的止吐方案可以预防大部分癌症患者的CINV.但临床医师并不能始终遵循指南建议,患者也常常难以坚持医师处方的治疗.因此需要采取一些提高指南依从性的方法.奈妥匹坦帕洛诺司琼(NEPA)是首个也是唯一一个固定剂量复方止吐药,由奈妥匹坦(口服)/福奈妥匹坦(静脉给药)与帕洛诺司琼(PALO)组成.NEPA可以联合地塞米松组成三联止吐方案,这是用于高致吐性化疗(HEC)患者和部分中致吐性化疗(MEC)患者预防CINV的推荐方案.因此,NEPA止吐治疗操作简单便捷,可能有助于提高指南依从性.本综述对CINV进行了概括,评价了在临床试验和真实实践中积累的NEPA止吐效果及安全性方面的证据,同时也评价了在关键临床试验之外的环境下,即日常临床环境中使用NEPA进行止吐的初步证据.此外,本文还评述了化疗期间使用NEPA控制恶心症状和提高患者生活质量,这是癌症患者管理中面临的两个大挑战.
Chemotherapy-induced nausea and vomiting(CINV)is a common adverse event associated with many anticancer therapies and can negatively impact patients'quality of life and potentially limit the effectiveness of chemotherapy.Currently CINV can be prevented in most patients with guideline-recommended antiemetic regimens.However clinicians do not always follow guidelines and patients often face difficulties adhering to their prescribed treatments.Therefore approaches to increase guideline adherence need to be implemented.Netupitant-palonosetron(NEPA)is the first and only fixed combination antiemetic composed of netupitant(oral)/fosnetupitant(intravenous)and palonosetron(PALO),which together with dexamethasone constitute a triple antiemetic combination recommended for the preven tion of CINV for patients receiving highly emetogenic chemotherapy(HEC)and for certain patients receiving moderately emetogenic chemotherapy(MEC).Thus NEPA offers a convenient and straightforward antiemetic treatment that could improve adherence to guidelines.This review provides an overview of CINV evaluates the accumulated evidence of NEPA's antiemetic activity and safety from clinical trials and realworld practice and examines the preliminary evidence of antiemetic control with NEPA in daily clinical settings beyond those described in pivotal trials.Moreover this paper reviews the utility of NEPA in controlling nausea and preserving patients'quality of life during chemotherapy,two major concerns in managing patients with cancer.
Chemotherapy-induced nausea and vomiting(CINV)is a common adverse event associated with many anticancer therapies and can negatively impact patients'quality of life and potentially limit the effectiveness of chemotherapy.Currently CINV can be prevented in most patients with guideline-recommended antiemetic regimens.However clinicians do not always follow guidelines and patients often face difficulties adhering to their prescribed treatments.Therefore approaches to increase guideline adherence need to be implemented.Netupitant-palonosetron(NEPA)is the first and only fixed combination antiemetic composed of netupitant(oral)/fosnetupitant(intravenous)and palonosetron(PALO),which together with dexamethasone constitute a triple antiemetic combination recommended for the preven tion of CINV for patients receiving highly emetogenic chemotherapy(HEC)and for certain patients receiving moderately emetogenic chemotherapy(MEC).Thus NEPA offers a convenient and straightforward antiemetic treatment that could improve adherence to guidelines.This review provides an overview of CINV evaluates the accumulated evidence of NEPA's antiemetic activity and safety from clinical trials and realworld practice and examines the preliminary evidence of antiemetic control with NEPA in daily clinical settings beyond those described in pivotal trials.Moreover this paper reviews the utility of NEPA in controlling nausea and preserving patients'quality of life during chemotherapy,two major concerns in managing patients with cancer.