Year: 2026 | Month: April | Volume: 16 | Issue: 4 | Pages: 296-305
DOI: https://doi.org/10.52403/ijhsr.20260437
Efficacy Safety and Clinical Outcomes of Netupitant-Palonosetron Based Oral Combination Therapy in the Management of Chemotherapy-Induced Nausea and Vomiting: A tertiary care Centre Analysis
Rachit Ahuja1, Debanjan Sikdar1, Ajeet Tiwari2, Shakti Bala Dutta3, Vipra Kohli, Adil Ali1
1Department of Radiation Oncology, 2Department of Surgical Oncology, 3Department of Pharmacology
Shri Guru Ram Institute of Medical and Health Sciences, Dehradun, India.
Corresponding Author: Dr. Rachit Ahuja
ABSTRACT
Background: Chemotherapy-induced nausea and vomiting (CINV) significantly impact quality of life and treatment continuity. Netupitant/palonosetron (NEPA) is a fixed-dose combination tablet containing Netupitant 300 mg and Palonosetron 0.5 mg, combining a selective neurokinin-1 (NK-1) receptor antagonist with a second-generation 5-HT3 receptor antagonist. Real-world data on generic NEPA across diverse tumor types and emetogenic risk categories in Indian cancer patients remains sparse.
Methods: This retrospective, single-centre study evaluated 131 adult cancer patients at a tertiary cancer hospital in India (January 2024 and December 2025). Patients receiving highly emetogenic chemotherapy (HEC) or moderately emetogenic chemotherapy (MEC) were included. All patients received a fixed dose combination tablet of netupitant 300 mg/palonosetron 0.5 mg as antiemetic prophylaxis.
Primary endpoints were complete response (CR) rates (no emesis and no rescue medication) during acute (0-24 hours), delayed (24-120 hours) and overall (0-120 hours) phases. Secondary endpoints included breakthrough nausea/vomiting incidence and rescue antiemetics.
Results: Of 131 patients (87 males, 44 females; mean age 56.71 ± 13.11 years), 53 (40.5%) received HEC and 78 (59.5%) received MEC. Overall, acute CR was 98.47% (129/131) and delayed CR was 90.84% (119/131). Anticipatory CINV occurred in 2.05%. In HEC, acute and delayed CR rates were 100 % and 73.58%; in MEC, CR was 100% in both phases. No serious drug-related adverse events were recorded.
Conclusion: NEPA demonstrated high antiemetic effectiveness in this real-world study, with excellent acute CINV control across HEC and MEC groups. Although overall delayed CR was high, a lower rate in HEC patients suggests scope for optimization. The regimen was well tolerated with no serious adverse events, supporting its safety and clinical utility in routine oncology practice.
Key words: Chemotherapy-induced nausea and vomiting; Netupitant; Palonosetron; NK-1 receptor antagonist; Complete response; Antiemetic prophylaxis.