Peer-Reviewed Publication
Support Care Cancer2026;34(10)September 5, 2026Journal Article
Netupitant versus aprepitant: model-predicted neurokinin-1 receptor occupancy and implications for long-delayed nausea and vomiting prevention.
Hirotoshi Iihara1,2, Giampaolo Bianchini3,4, Matti Aapro5, Luca Licata3, Alberto Bernareggi6, Rudolph M Navari7, Yeon Hee Park8, Karin Jordan9,10, María Vidal11, Florian Scotté12, Eric J Roeland13, Lee Schwartzberg14, Hope S Rugo15
1Department of Pharmacy, Gifu University Hospital, Gifu, Japan. iihara.hirotoshi.p7@f.gifu-u.ac.jp.
2Cancer Center, Gifu University Hospital, Gifu, Japan. iihara.hirotoshi.p7@f.gifu-u.ac.jp.
3Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy.
4School of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.
5Genolier Cancer Center, Clinique de Genolier, Genolier, Switzerland.
6Clinical Pharmacology Consultant, Concorezzo, Italy.
7World Health Organization, Mount Olive, AL, USA.
8Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
9Department of Hematology, Oncology and Palliative Medicine, Ernst Von Bergmann Hospital, Potsdam, Germany.
10Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany.
11Department of Medical Oncology, Hospital Clinic; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS; Department of Medicine, University of Barcelona, Barcelona, Spain.
12Interdisciplinary Cancer Course Department, Gustave Roussy Cancer Institute, Villejuif, France.
13Oregon Health and Science University, Knight Cancer Institute, Portland, OR, USA.
14Renown Health-Pennington Cancer Institute, University of Nevada, Reno, NV, USA.
15Department of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
Abstract
PURPOSE: Nausea and vomiting beyond 5 days after emetogenic chemotherapy or antibody-drug conjugate (ADC) therapy are common, yet the role of neurokinin-1 (NK1) receptor antagonists in this setting remains underrecognized. We used pharmacokinetic/pharmacodynamic (PK/PD) modeling to estimate the NK1 receptor occupancy (RO), a proxy for clinical efficacy, for up to 20 days after a single 300 mg dose…
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