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Peer-reviewedCC BY-NCMedicine

Risk-tailored antiemetic prophylaxis with NEPA in Chinese cancer patients receiving moderately emetogenic chemotherapy : MyRisk study subgroup analysis

  • Yu Cheng1
  • Xin Lu1
  • Wenyong Tu2
  • Alex Molassiotis3
  • Tingchao Chen4
  • Zhen Zhou5
5 affiliations
  1. 1Department for Gynaecological Oncology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
  2. 2Department for Oral and Maxillofacial Head and Neck Tumors, Shanghai Ninth People’s Hospital, Shanghai, China
  3. 3School of Psychology, Health & Clinical Sciences, Aston University, Birmingham, United Kingdom
  4. 4Helsinn Pharmaceuticals China, Shanghai, China
  5. 5Oncology Department, Shanghai Chest Hospital, Shanghai, China.
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Abstract

Background:: Chemotherapy-induced nausea and vomiting (CINV) remains a key challenge for patients receiving moderately emetogenic chemotherapy (MEC), especially those at high risk. This study is the first to apply a validated risk algorithm to guide antiemetic prophylaxis in Chinese MEC patients.

Methods:: MyRisk was a phase IV, randomized, open-label, multinational trial (NCT04817189) enrolling adult patients with a high-risk CINV score (≥13), scheduled for 3 cycles of MEC. Patients were randomized to oral netupitant–palonosetron (NEPA capsule) + dexamethasone or standard of care (SoC), including a 5-hydroxytryptamine-3 receptor antagonist + dexamethasone. The primary endpoint was model-estimated complete response (no emesis/no rescue medication) during the overall phase (0–120 hours) across 3 consecutive cycles. This report describes a prespecified analysis of the Chinese subgroup in the MyRisk study.

Results:: Of 53 enrolled Chinese patients, 50 were included (NEPA: n = 24; SoC: n = 26). NEPA showed a numerically higher overall complete response rate than SoC (89.1% vs 77.3%; odds ratio = 2.39, 95% confidence interval = 0.57–9.98) as well as higher rates of no emesis (92.2% vs 80.0%) and no significant nausea (80.6% vs 70.7%) across delayed and overall phases across all cycles. However, these differences were not statistically significant. NEPA was well tolerated across all 3 cycles, with no serious adverse events.

Conclusion:: In this Chinese subgroup analysis, risk-tailored prophylaxis with NEPA provided effective and safe control of delayed and overall CINV. Although statistically insignificant, consistent numerical benefits support consideration of neurokinin-1 receptor antagonist-based strategies for high-risk MEC patients. Future studies with larger sample sizes in the Chinese population are warranted to permit statistical evaluation.

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Cite

BibTeXRIS
BibTeX
@article{cheng2026risktailored,
  title = {{Risk-tailored antiemetic prophylaxis with NEPA in Chinese cancer patients receiving moderately emetogenic chemotherapy : MyRisk study subgroup analysis}},
  author = {Yu Cheng and Xin Lu and Wenyong Tu and Alex Molassiotis and Tingchao Chen and Zhen Zhou},
  journal = {Medicine},
  year = {2026},
  month = oct,
  doi = {10.1097/md.0000000000051211},
  url = {https://europepmc.org/article/PMC/PMC13727212},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Risk-tailored antiemetic prophylaxis with NEPA in Chinese cancer patients receiving moderately emetogenic chemotherapy : MyRisk study subgroup analysis
AU  - Yu Cheng
AU  - Xin Lu
AU  - Wenyong Tu
AU  - Alex Molassiotis
AU  - Tingchao Chen
AU  - Zhen Zhou
PY  - 2026
DA  - 2026/10/30
JO  - Medicine
DO  - 10.1097/md.0000000000051211
UR  - https://europepmc.org/article/PMC/PMC13727212
AB  - Background:: Chemotherapy-induced nausea and vomiting (CINV) remains a key challenge for patients receiving moderately emetogenic chemotherapy (MEC), especially those at high risk. This study is the first to apply a validated risk algorithm to guide antiemetic prophylaxis in Chinese MEC patients.  Methods:: MyRisk was a phase IV, randomized, open-label, multinational trial (NCT04817189) enrolling adult patients with a high-risk CINV score (≥13), scheduled for 3 cycles of MEC. Patients were randomized to oral netupitant–palonosetron (NEPA capsule) + dexamethasone or standard of care (SoC), including a 5-hydroxytryptamine-3 receptor antagonist + dexamethasone. The primary endpoint was model-estimated complete response (no emesis/no rescue medication) during the overall phase (0–120 hours) across 3 consecutive cycles. This report describes a prespecified analysis of the Chinese subgroup in the MyRisk study.  Results:: Of 53 enrolled Chinese patients, 50 were included (NEPA: n = 24; SoC: n = 26). NEPA showed a numerically higher overall complete response rate than SoC (89.1% vs 77.3%; odds ratio = 2.39, 95% confidence interval = 0.57–9.98) as well as higher rates of no emesis (92.2% vs 80.0%) and no significant nausea (80.6% vs 70.7%) across delayed and overall phases across all cycles. However, these differences were not statistically significant. NEPA was well tolerated across all 3 cycles, with no serious adverse events.  Conclusion:: In this Chinese subgroup analysis, risk-tailored prophylaxis with NEPA provided effective and safe control of delayed and overall CINV. Although statistically insignificant, consistent numerical benefits support consideration of neurokinin-1 receptor antagonist-based strategies for high-risk MEC patients. Future studies with larger sample sizes in the Chinese population are warranted to permit statistical evaluation.
SN  - 0304-5412
SN  - 1536-5964
SN  - 0025-7974
ER  -