Antiemetic guidelines recommend proactive protection
The National Comprehensive Cancer Network® (NCCN), American Society of Clinical Oncology (ASCO), and Multinational Association of Supportive Care in Cancer (MASCC) guidelines all recommend prevention from chemotherapy-induced nausea and vomiting (CINV) rather than reactive treatment for breakthrough emesis.1-3
Rolapitant now included as a category 1 neurokinin 1 receptor antagonist (NK-1 RA) for both highly and moderately emetogenic chemotherapy (HEC and MEC) in the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Antiemesis
Category 1: based on high-level evidence and uniform NCCN consensus1
Several options including a 5-hydroxytryptamine-3 (serotonin) (5-HT3) RA, dexamethasone, and an NK-1 RA
Several options including a 5-HT3 RA and dexamethasone; NK-1 RA for patients who failed antiemetic treatment in a previous chemotherapy cycle or if patients have risk factors that increase the likelihood of getting CINV
Warnings and Precautions
Interaction with CYP2D6 substrate
VARUBI is a moderate inhibitor of CYP2D6 and significantly increases the plasma concentrations of CYP2D6 substrates for at least 28 days, with inhibitory effects expected to persist for an unknown duration.
Monitor for adverse reactions when VARUBI is coadministered with CYP2D6 substrates without a narrow therapeutic index (avoid coadministration with CYP2D6 substrates with a narrow therapeutic index, thioridazine and pimozide; see Contraindication). Consider interactions with CYP2D6 substrates before starting treatment with VARUBI.
Select tumor type to see the emetogenic potential of common regimens
Adapted from NCCN Guidelines®.
|Common HEC Agents|
|Common MEC Agents|
|a May be highly emetogenic for certain patients.|
|Common HEC regimens|
|Common MEC regimens|