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Study With IV NEPA (Fosnetupitant/Palonosetron) for the Prevention of Chemotherapy-induced Nausea and Vomiting in Paediatric Cancer Patients Undergoing Highly Emetogenic Chemotherapy (HEC)
Sponsor: Helsinn Healthcare SA
Summary
Chemotherapy often causes nausea and vomiting (CINV), and this is a major problem for the children being treated for cancer. To prevent this, a combination of two substances in fixed proportion (IV NEPA) was developed. The two substances are: palonosetron, an antagonist of 5 HT3 receptors, and fosnetupitant, an antagonist of NK1 receptors that transforms into netupitant in the body. The medication is administered through intravenous injection (IV- drip). This study is built from 2 parts: Part 1: phase 2, open label Part 2: phase 3 double blind The detailed description, study design, study milestones and eligibility criteria will reflect the Part 1 requirements
Official title: A Multicentre, Multinational, Pharmacokinetic, Safety, and Efficacy Study With IV NEPA (Fosnetupitant/Palonosetron) for the Prevention of Chemotherapy-induced Nausea and Vomiting in Paediatric Cancer Patients Undergoing Highly Emetogenic Chemotherapy (HEC). A 2-part Study With Phase 2, Open-label, Randomised, Single-dose IV NEPA vs Fosaprepitant/Ondansetron in Single-day HEC and Repeated-dose IV NEPA in Multi-day HEC (Part I, Single Cycle) and With Phase 3, Double-blind, Randomised, Repeated-dose IV NEPA vs Fosaprepitant/Ondansetron in Multi-day HEC (Part II, Repeated Cycles)
Key Details
Gender
All
Age Range
0 Months - 18 Years
Study Type
INTERVENTIONAL
Enrollment
95
Start Date
2025-07-07
Completion Date
2027-12
Last Updated
2026-03-31
Healthy Volunteers
No
Interventions
IV NEPA (fosnetupitant/palonosetron)
In NEPA-22-01, different body weight-based dosages of IV NEPA will be applied to patients below and over 3 months of age: Formulation A (for patients ≥3 months of age; 235 mg fosnetupitant/1.5 mg palonosetron per vial) or Formulation B (for patients \<3 months of age; 235 mg fosnetupitant/2.5 mg palonosetron per vial).
Reference Treatment: IV ondansetron infusion
IV Ondansetron Dosing Regimen * Day 1 (before start of chemotherapy): One 30-min infusion of 0.15 mg/kg (ondansetron maximum dose: 8 mg per administration) * Day 1 at 4 h and 8 h after the end of first administration: Two 30-min infusions of 0.15 mg/kg (ondansetron maximum dose: 8 mg per administration)
Reference Treatment: IV fosaprepitant infusion
Fosaprepitant IV Dosing Regimen * Patients aged 12 years to \<18 years: a single dose of IV fosaprepitant 150 mg * Patients aged 2 years to \<12 years: a single dose of IV fosaprepitant 4 mg/kg (maximum dose: 150 mg) * Patients aged 6 months to \<2 years: a single dose of IV fosaprepitant 5 mg/kg (maximum dose: 150 mg)
Locations (20)
Aghia Sophia Children's Hospital, Pediatric Hematology/ Oncology Unit (POHemU)
Athens, Greece
"AHEPA" University General Hospital of Thessaloniki, 2nd Department of Pediatrics
Thessaloniki, Greece
Department of Pediatrics, Oncology and Hematology University Children's Clinical Hospital them. Ludwik Zamenhof in Bialystok
Bialystok, Poland
Department of Paediatrics, Haematology, Oncology and Rheumatology Voivodship Children's Hospital them. J. Brudziński
Bydgoszcz, Poland
Clinic of Pediatrics, Oncology and Hematology University Pediatric Center them M. Konopnicka SP ZOZ Central Clinical Hospital Medical University of Lodz
Lodz, Poland
University Children'S Hospital in Lublin, Department of Pediatric Hematology, Oncology, and Transplantology
Lublin, Poland
Clinical Department of Paediatric Oncology and Haematology VOIVODSHIP SPECIALIST CHILDREN'S HOSPITAL them. prof. dr. Stanisław Popowski in Olsztyn
Olsztyn, Poland
Department of Pediatric Oncology, Hematology and Transplantation Clinical Hospital them. Karol Jonscher Medical University them. Karol Marcinkowski in Poznań
Poznan, Poland
Department of Paediatrics and Paediatric Haemato-Oncology University Clinical Hospital No. 1 them. prof. Tadeusz Sokołowski Pomeranian Medical University
Szczecin, Poland
Department of Paediatrics, Oncology and Paediatric Immunology, University Clinical Hospital No. 1 them. prof. Tadeusz Sokołowski Pomeranian Medical University in Szczecin
Szczecin, Poland
Department of Oncology and Surgical Oncology for Children and Youth Institute Mother and Child
Warsaw, Poland
Department of Oncology Institute "Monument - Child Health Center"
Warsaw, Poland
Fundeni Clinical Institute, Pediatric Hematology and BMT
Bucharest, Romania
Oncology Institute "Prof. Dr. Al. Trestioreanu", Pediatric Oncology
Bucharest, Romania
Emergency Children's Hospital " Louis Turcanu, Oncology-Haematology and BMP department
Timișoara, Romania
Istanbul University Istanbul Faculty of Medicine Topkapı
Istanbul, Faith, Turkey (Türkiye)
Ankara University Faculty of Medicine Children's Hospital, Department of Children Oncology and Hematology
Ankara, Mamak, Turkey (Türkiye)
Erciyes University Hospitals Kanka Children's Hematology Oncology and Bone Marrow Hospital
Kayseri, Melikgazi, Turkey (Türkiye)
Gazi University Gazi Hospital Children Hematology and Oncology
Ankara, Turkey (Türkiye)
Hacettepe University Hospitals Oncology Hospital 2nd Floor Children Oncology
Ankara, Turkey (Türkiye)