Nausea and vomiting are among the most problematic symptoms experienced by patients with cancer who are receiving chemotherapy. 5-hydroxytryptamine 3(5-HT3)-receptor antagonists, NK1 receptor antagonists(aprepitant)and dexamethasone are now the standard therapies for preventing chemotherapy-induced nausea and vomiting(CINV)that follow highly emetogenic chemotherapy, such as cisplatin and anthracycline. However, since it is not cleared which 5-HT3-recepter antagonist is a proper treatment for combined use with aprepitant and dexamethasone, we conducted a questionnaire survey, which used the numerical rating scale(NRS), for comparing palonosetron with granisetron in the same patient. Palonosetron showed a significant improvement of nausea for both acute(within 24 hours)and delayed phase(24-120 hours later), regardless of the type of chemotherapy(cisplatin or anthracycline-based regimen). Furthermore, palonosetron had a tolerable safety profile. Our study suggests that palonosetron-based antiemetic treatment will be a preferred choice for preventing CINV following highly emetogenic chemotherapy.

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  • Dexamethasone, commonly used to prevent nausea from chemotherapy, has side effects that prompt the search for alternatives without it.
  • This study tested the efficacy and safety of palonosetron, aprepitant, and olanzapine in chemotherapy-naïve breast cancer patients, assessing their effectiveness in controlling nausea and vomiting.
  • Results showed low total control rates (17.1%) for antiemetic therapies excluding dexamethasone, though olanzapine could be a viable replacement for patients unable to use dexamethasone.
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Article Synopsis
  • * A systematic review and Bayesian network meta-analysis (NMA) were conducted to compare multiple antiemetic treatments, analyzing data from 16 randomized controlled trials involving over 3,000 patients.
  • * Results indicate that NK1 antagonists combined with ondansetron are the most effective option for preventing CINV in children, particularly when given with dexamethasone, while olanzapine also shows significant benefits when added to certain regimens.
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Background And Aims: Postoperative nausea and vomiting (PONV) is a common complication after surgery. Preventing PONV in high-risk patients often requires a multimodal approach combining antiemetic drugs with diverse mechanisms. While aprepitant, a neurokinin-1 receptor antagonist, is recognised as highly effective for PONV prevention, uncertainties remain regarding its effectiveness.

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Background: Despite guidelines for managing chemotherapy-induced nausea and vomiting (CINV), there remains a need to clarify the optimal use of neurokinin-1 (NK1) receptor antagonists. Comparing the effectiveness of NEPA (netupitant-palonosetron) plus dexamethasone with other NK1 antagonist-based regimens combined with a 5HT3 receptor antagonist and dexamethasone is crucial for informed decision-making and improving patient outcomes.

Methods: We conducted a systematic review of the literature to assess randomized controlled trials (RCTs) comparing the efficacy, safety, and cost-effectiveness of NEPA plus dexamethasone and other NK1 antagonist-based regimens combined with a 5HT3 receptor antagonist and dexamethasone.

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