A Review of NEPA, a Novel Fixed Antiemetic Combination with the Potential for Enhancing Guideline Adherence and Improving Control of Chemotherapy-Induced Nausea and Vomiting

Table 3

Cycle 1 Efficacy of NEPA + DEX compared with oral palonosetron + DEX.

Patients (%)	Study 1 (Cisplatin HEC)			Study 2 (AC)
	NEPA + DEX; ()	Oral PALO + DEX; ()	value^1	NEPA + DEX; ()	Oral PALO + DEX; ()	value^2
No emesis
Acute (0–24 h)	98.5	89.7	0.007	90.9	87.3	0.025
Delayed (25–120 h)	91.9	80.1	0.006	81.8	75.6	0.004
Overall (0–120 h)	91.1	76.5	0.001	79.8	72.1	<0.001
No significant nausea
Acute	98.5	93.4	0.050	87.3	87.9	0.747
Delayed	90.4	80.9	0.027	76.9	71.3	0.014
Overall	89.6	79.4	0.021	74.6	69.1	0.020
Complete protection
Acute	97.0	87.5	0.006	82.3	81.1	0.528
Delayed	84.4	73.5	0.027	67.3	60.3	0.005
Overall	83.0	69.9	0.010	63.8	57.9	0.020

 ¹ value from logistic regression versus oral palonosetron; not adjusted for multiple comparisons.
² value from two-sided Cochran-Mantel-Haenszel test including treatment, age class, and region as strata.
HEC: highly emetogenic chemotherapy; AC: anthracycline cyclophosphamide; NEPA: netupitant/palonosetron; PALO: palonosetron; DEX: dexamethasone.