Hesketh, P.J., Bohlke, K., Lyman, G.H., Basch, E., Chesney, M., Clark-Snow, R.A., . . . Kris, M.G. (2015). Antiemetics: American Society of Clinical Oncology focused guideline update. Journal of Clinical Oncology. Advance online publication.
DOI Link
Purpose & Patient Population
PURPOSE: To update a specific recommendation in the American Society of Clinical Oncology (ASCO) antiemetic guidelines to incorporate the use of netupitant and palonosetron (NEPA)
TYPES OF PATIENTS ADDRESSED: Adult and pediatric patients
Type of Resource/Evidence-Based Process
RESOURCE TYPE: Evidence-based guideline
PROCESS OF DEVELOPMENT: The identification of the need for an update with a signal strategy caused the authors to review new evidence for NEPA. A literature review was done by a committee.
SEARCH STRATEGY:
DATABASES USED: Not provided; states consistent, ongoing process for updating using signals approach
KEYWORDS: Not provided
INCLUSION CRITERIA: Phase 2 or 3 trials of NEPA
Phase of Care and Clinical Applications
PHASE OF CARE: Active antitumor treatment
Results Provided in the Reference
Three studies were included in the review.
Guidelines & Recommendations
The oral combination of NEPA and dexamethasone is an option for patients receiving highly emetogenic chemotherapy (including anthracycline and cyclophosphamide) to meet recommendations for triple-drug therapy.
Limitations
- Focused guideline update only to include NEPA
- Studies reviewed did not specifically show that pediatric patients were included.
Nursing Implications
NEPA is a new drug that can be combined with NK1 and 5HT3 drugs. This drug provides both recommended agents in a single, oral medication. Patients who take NEPA rather than a typical regimen will not need IV administration, which can result in increased cost to the patient depending on individual insurance coverage.