&lt;p&gt;Management of Chemotherapy-Induced Nausea and Vomiting (CINV): A Short Review on the Role of Netupitant-Palonosetron (NEPA)&lt;/p&gt;

Lorusso, Vito; Russo, Anna Lo; Giotta, Francesco; Codega, Paolo

doi:10.2147/ce.s203634

Cited by 14 publications

(20 citation statements)

References 45 publications

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“…33 Although a high dose of radiation has been shown to disrupt the BBB, 65 our imaging and functional studies revealed that 5 Gy radiation therapy enhanced transportation of SLN to glioblastomas and led to an increase in therapeutic effect and mouse survival. Targeted SLN through iRGD showed the most therapeutic effect in preirradiated mice (as compared to nontargeted SLN, or targeted SLN with no radiation), despite previous studies claiming that active targeting does not show drastic improvement, [66][67][68] and proving further that the observed effect is not due to potential BBB disruption by radiation. Hence, combining nanoparticle-based targeted delivery systems with radiation may lead to promising therapy in a clinical setting.…”

Section: Discussionmentioning

confidence: 81%

Radiation-Induced Targeted Nanoparticle-Based Gene Delivery for Brain Tumor Therapy

et al. 2019

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Targeted therapy against the programmed cell death ligand-1 (PD-L1) blockade holds considerable promise for the treatment of different tumor types; however, little effect has been observed against gliomas thus far. Effective glioma therapy requires a delivery vehicle that can reach tumor cells in the central nervous system, with limited systemic side effect. In this study, we developed a cyclic peptide iRGD (CCRGDKGPDC)-conjugated solid lipid nanoparticle (SLN) to deliver small interfering RNAs (siRNAs) against both epidermal growth factor receptor (EGFR) and PD-L1 for combined targeted and immunotherapy against glioblastoma, the most aggressive type of brain *

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Section: Discussionmentioning

confidence: 81%

Radiation-Induced Targeted Nanoparticle-Based Gene Delivery for Brain Tumor Therapy

et al. 2019

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“…This suggests that TRPV1-mediated CGRP and SP release from nerve terminals play a role in emesis [ 53 ]. NK1-receptor antagonists have been successfully used along with 5-HT3-receptor antagonists to treat chemotherapy-induced emesis [ 183 , 184 ]. Morphine and 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) act as antiemetics [ 185 ].…”

Section: Role Of Trpv1 In Cannabinoid-induced Antiemesismentioning

confidence: 99%

TRPV1: A Common Denominator Mediating Antinociceptive and Antiemetic Effects of Cannabinoids

Louis-Gray

Tupal

Premkumar

2022

IJMS

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The most common medicinal claims for cannabis are relief from chronic pain, stimulation of appetite, and as an antiemetic. However, the mechanisms by which cannabis reduces pain and prevents nausea and vomiting are not fully understood. Among more than 450 constituents in cannabis, the most abundant cannabinoids are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Cannabinoids either directly or indirectly modulate ion channel function. Transient receptor potential vanilloid 1 (TRPV1) is an ion channel responsible for mediating several modalities of pain, and it is expressed in both the peripheral and the central pain pathways. Activation of TRPV1 in sensory neurons mediates nociception in the ascending pain pathway, while activation of TRPV1 in the central descending pain pathway, which involves the rostral ventral medulla (RVM) and the periaqueductal gray (PAG), mediates antinociception. TRPV1 channels are thought to be implicated in neuropathic/spontaneous pain perception in the setting of impaired descending antinociceptive control. Activation of TRPV1 also can cause the release of calcitonin gene-related peptide (CGRP) and other neuropeptides/neurotransmitters from the peripheral and central nerve terminals, including the vagal nerve terminal innervating the gut that forms central synapses at the nucleus tractus solitarius (NTS). One of the adverse effects of chronic cannabis use is the paradoxical cannabis-induced hyperemesis syndrome (HES), which is becoming more common, perhaps due to the wider availability of cannabis-containing products and the chronic use of products containing higher levels of cannabinoids. Although, the mechanism of HES is unknown, the effective treatment options include hot-water hydrotherapy and the topical application of capsaicin, both activate TRPV1 channels and may involve the vagal-NTS and area postrema (AP) nausea and vomiting pathway. In this review, we will delineate the activation of TRPV1 by cannabinoids and their role in the antinociceptive/nociceptive and antiemetic/emetic effects involving the peripheral, spinal, and supraspinal structures.

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“…6 On September 28, 2017, Health Canada issued a Notice of Compliance for netupitant/palonosetron (NEPA) -a combination of a highly selective NK 1 RA netupitant (300 mg) and palonosetron (0.5 mg) -in combination with DEX, for once-per-cycle treatment in adult patients for the "prevention of acute and delayed nausea and vomiting associated with HEC and prevention of acute nausea and vomiting associated with MEC therapy that is uncontrolled by a 5-HT 3 RA." 7,8 Over the past decades, the development of new antiemetic drugs has progressed and shown promising results in the prevention of CINV. Particularly, the appearance of second-generation of 5-HT 3 receptor palonosetron and its combination with netupitant in NEPA has urged a literature review on the clinical effectiveness and cost-effectiveness of these drugs relative to other 5-HT 3 RAs.…”

Section: Context and Policy Issuesmentioning

confidence: 99%

Palonosetron for Patients Undergoing High or Moderate Emetogenic Chemotherapy

Tran¹,

Loshak²

2021

cjht

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This report identified high to moderate quality evidence from clinical studies and economic evaluations, as well as high-quality guidelines regarding the use of palonosetron in the prevention of chemotherapy-induced nausea and vomiting in adult and pediatric patients receiving different emetogenic chemotherapies. Interpretations of the findings should be taken with caution because of the presence of some identified limitations in both clinical and economic evidence. In adult patients receiving high emetogenic chemotherapy, a fixed antiemetic combination of netupitant and palonosetron (NEPA) plus dexamethasone demonstrated noninferiority relative to a triple regimen of granisetron-aprepitant-dexamethasone. Similarly, palonosetron had similar efficacy compared to granisetron with the co-administration of neurokinin 1 receptor antagonist (e.g., aprepitant or fosaprepitant) and dexamethasone. However, in the absence of aprepitant, a 2-drug combination of palonosetron-dexamethasone appeared to be significantly more effective than granisetron-dexamethasone for the prevention of both acute and delayed emesis. In adult patients receiving moderate emetogenic chemotherapy, palonosetron plus dexamethasone was found to be noninferior compared with ondansetron plus dexamethasone. Similar efficacy was also observed between palonosetron plus dexamethasone and transdermal granisetron plus dexamethasone. In a mixed population of adult patients receiving high or moderate emetogenic chemotherapy, a palonosetron regimen appeared to have greater efficacy than ondansetron for delayed emesis. The efficacy of triple regimen of palonosetron-aprepitant-dexamethasone and granisetron-aprepitant-dexamethasone was comparable at all phases. In pediatric patients receiving high emetogenic chemotherapy, palonosetron plus dexamethasone had similar efficacy compared with ondansetron plus dexamethasone in the acute phase, but was more effective in delayed and overall phases of chemotherapy-induced nausea and vomiting. In a mixed population of pediatric patients receiving high or moderate emetogenic chemotherapy, palonosetron plus dexamethasone was noninferior to ondansetron plus dexamethasone. There were no significant differences between palonosetron and ondansetron or between palonosetron and granisetron treatment regimens in adverse events or quality of life. A cost-utility analysis revealed that NEPA plus dexamethasone was dominant (i.e., cost less, more effective) relative to granisetron-aprepitant-dexamethasone and ondansetron-aprepitant or fosaprepitant-dexamethasone in adult patients receiving high emetogenic chemotherapy. In contrast, double or triple regimens of palonosetron was not cost-effective compared to granisetron regimens, mainly due to large difference in price and small quality-adjusted life-years gained. These economic evaluations may not be applicable to the Canadian context. The identified high-quality guidelines have recommendations on the use of specific antiemetic regimens for adult and pediatric patients receiving high emetogenic chemotherapy or moderate emetogenic chemotherapy and suggest that palonosetron may be offered as an alternative to other 5-hydroxytryptamine-3 receptor antagonists and that 1 5-hydroxytryptamine-3 receptor antagonist is not preferred over another based on the available evidence.

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<p>Management of Chemotherapy-Induced Nausea and Vomiting (CINV): A Short Review on the Role of Netupitant-Palonosetron (NEPA)</p>

Cited by 14 publications

References 45 publications

Radiation-Induced Targeted Nanoparticle-Based Gene Delivery for Brain Tumor Therapy

Radiation-Induced Targeted Nanoparticle-Based Gene Delivery for Brain Tumor Therapy

TRPV1: A Common Denominator Mediating Antinociceptive and Antiemetic Effects of Cannabinoids

Palonosetron for Patients Undergoing High or Moderate Emetogenic Chemotherapy

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