Abstract 2725
Background
The oral, fixed-combination NEPA containing netupitant and palonosetron target crucial pathways involved in both acute and delayed chemotherapy-induced nausea and vomiting (CINV) in patients with highly emetogenic chemotherapy.Hematopoietic stem cell transplantation (HSCT) is associated with infectious complications, especially bloodstream infections (BSI). The risk factors associated with BSI include presence of indwelling vascular catheters. NEPA eliminates accessing intravenous catheters leading to a decreased risk of infection in HSCT recipients.There is a paucity of studies about the management of CINV during preparative regimens for HSCT. The aim of this study was to assess the safety of NEPA during and after HSCT conditioning.
Methods
Patients with chronic myeloid leukemia, multiple myeloma, myelodysplastic syndrome, and acute myeloid leukemia who received an allogeneic HSCT between 2017 and 2018 were retrospective studied. Conditioning regimen consisted of fludarabine and busulfan. Graft versus host disease prophylaxis was done with high-dose cyclophosphamide on days +3 to + 4 post-HSCT. Patients received a single capsule of NEPA prior to conditioning regimen and before cyclophosphamide, both with oral dexamethasone on days 1-3 . Safety was assessed by evaluation of adverse events and use of rescue medications (baclofen for hiccups and lactitol, macrogol and sennosides for constipation).
Results
Six patients were included: 4/6were male and median age was 50 years (IQR: 46-53 years). Two patients reported hiccups needing baclofen and 6 required rescue medications for constipation. Five out of six patients presented neutropenic enterocolitis on day +7, oral intake was stopped in 4 of them, total parenteral nutrition was started in 3 cases, 3 patients required extra antibiotic coverage, and 4 received analgesic therapy. All patients improved with conservative measures.
Conclusions
In this real-world observational study, the incidence of neutropenic enterocolitis was considerably higher than previous reports in HSCT recipients. It may be associated with NEPA administration but future studies will be needed to confirm this relationship.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Hospital Clínic Barcelona.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3611 - Phase II trial of SM 88 in Non-Metastatic Biochemical Recurrent Prostate Cancer.
Presenter: Benjamin Gartrell
Session: Poster Display session 3
Resources:
Abstract
2492 - A phase 1 study of Ad5 PSA/MUC-1/Brachyury Vaccine in Patients with Metastatic Castration Resistant Prostate Cancer (mCRPC)
Presenter: Marijo Bilusic
Session: Poster Display session 3
Resources:
Abstract
3142 - Multicenter Phase I Trial of a DNA Vaccine Encoding the Androgen Receptor Ligand Binding Domain (pTVG-AR, MVI-118) in Patients with Metastatic Prostate Cancer
Presenter: Douglas McNeel
Session: Poster Display session 3
Resources:
Abstract
4327 - Impact of germline mutations in Homologous Recombination (HR) genes on the response to Radium-223 for metastatic castration resistant prostate cancer (mCRPC)
Presenter: Elena Castro
Session: Poster Display session 3
Resources:
Abstract
3600 - Serum biomarkers of bone metabolism in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with Radium-223 (Ra223): Results from a prospective multicentre study
Presenter: Nuria Romero Laorden
Session: Poster Display session 3
Resources:
Abstract
3742 - Prognostic value of tumor suppression genes (TP53, PTEN, Rb) in metastatic hormone sensitive prostate cancer
Presenter: Miguel Gonzalez Velez
Session: Poster Display session 3
Resources:
Abstract
2643 - Germline sequencing of advanced prostate cancer patients in the BARCODE2 trial
Presenter: Sarah Benafif
Session: Poster Display session 3
Resources:
Abstract
4349 - Impact of treatment sequence in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): data from the prospective PROREPAIR-B study.
Presenter: Carlo Cattrini
Session: Poster Display session 3
Resources:
Abstract
3301 - Implications of Single Nucleotide Polymorphisms (SNPs) in Androgen Related-Genes in Outcome of metastatic castration-resistant prostate cancer (mCRPC) patients treated with Abiraterone (Abi) and Enzalutamide (Enza)
Presenter: Isabel Aragon
Session: Poster Display session 3
Resources:
Abstract
2275 - Activating mutations in AKT1/PIK3CA are associated with poor clinical outcomes in metastatic prostate cancer (mPC)
Presenter: Simon Fu
Session: Poster Display session 3
Resources:
Abstract