Abstract 556P
Background
With the availability of fosnetupitant palonosetron (FP), there are several pharmacological advantages with the combined injection. This has been accessible to our patients from September 2023. In this study we compare the anti-emetic efficacy of patients receiving fosnetupitant + palonosetron (FP) vs Oral aprepitant + palonosetron (AP) in patient receiving highly and moderately emetogenic chemotherapy (HEC and MEC).
Methods
150 patients were included in this observational study done from January 2024 to June 2024. 75 patients who received FP as a part of their antiemetic regimen were matched to AP w.r.t factors: age, gender, smoking status. FP was 235 mg fosnetupitant/0.25 mg palonosetron. AP included Aprepitant given as 125mg on D1 and 80 mg on D2 and D3 and palonosetron 0.25mg i.v injection given > 60 minutes before chemotherapy. The primary endpoint of measurement was occurrence of grade ≥2 nausea or vomiting. Visits to emergency for nausea and vomiting weight loss >10%, requirement of change in antiemetic regimen were all defined as events.
Results
150 patients in age range median 58.5 years (27-85 years). 54 (36%) were females and 96 (64%) were males. Baseline characters like age gender smoking status were evenly matched. Grade ≥2 nausea or vomiting occurred in 32(21.3%) patients of which 27 (18%) were in the AP cohort and 5 (3.3%) in the FP cohort. There were total 28 events and 17 emergency visits. The number of events were 23 (82.1%) in the AP cohort and 5 in the FP cohort. Similarly 14 (82%) out of the 17 casualty visits were of the AP cohort.
Conclusions
Patients receiving FP had statistically significant lesser number of events compared to AP. With increasing access to FP, the combination must be the preferred anti-emetic regimen in HEC and MEC regimens.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.