NEPA and Managing Nausea from Lung Cancer Treatment

Scientists are making breakthroughs in preventing nausea and vomiting from chemotherapy. One medicine, called NEPA, shows promise in warding off these side effects in people receiving chemo for lung cancer.

What is NEPA?

NEPA is a combination of 2 prescription drugs called netupitant (NETU) and palonosetron (PALO). You take NEPA by mouth as a single dose each time you get chemo. The medicines target critical pathways in your body that cause you to throw up.¹

What does research reveal about NEPA?

In 2014, researchers published the results of 2 clinical trials studying NEPA. They looked at how well the medicine works to prevent nausea and vomiting during chemotherapy for lung cancer. Those who took part in the study had different types of lung cancer.¹

Researchers compared a combination of NEPA and a steroid with another drug combo. They found that the NEPA works better at curbing a feeling of sickness and throwing up. It may also help with both sudden and delayed symptoms over multiple rounds of chemo. Study participants also had few side effects from NEPA. The most common was a low white blood cell count.¹

The future of NEPA

Nausea and vomiting are serious reactions to chemo that diminish your quality of life. They sometimes cause people with cancer to delay or stop treatment. Right now, NEPA is not widely available to people undergoing chemotherapy. But in the future, it could be another option to prevent these common side effects.¹

Managing nausea from cancer treatment

In the meantime, your doctor may prescribe other medicines to help control nausea and vomiting. Ondansetron (Zofran) is a common prescription drug for these symptoms. If you are still having trouble, you could also take prochlorperazine (Compazine) or promethazine (Phenergan).²

Acupuncture is another option. It involves stimulating specific areas of the body using needles. Besides nausea, it may work to ease pain, nerve damage (neuropathy), and extreme tiredness.²

Other ways to control nausea include:²

• Eat several small meals a day. Smaller portions spread out over a day are less demanding on your stomach than a few big meals.
• Try different tastes and textures. Try tart foods, ginger root, cold foods, or meal replacement shakes. They can help to settle a queasy stomach or better tolerate food.
• Drink lots of fluids. Staying hydrated relieves nausea and other cancer treatment side effects. If water is too bland, try clear beverages with a little fizz, like ginger ale or lemon-lime soda. Beware of dark-colored soda. The caffeine in them can upset your stomach.
• Steer clear of fatty food. This includes spicy, fried, or greasy dishes. It takes longer for your body to break down fat than carbs and protein. This means it will linger in your stomach, which makes you more likely to throw up.

If you are concerned about nausea from cancer treatment, talk to your cancer care team. They may refer you to a nutritionist or dietitian. Once an expert learns about your specific symptoms, they could have more ideas to help you feel better on your cancer journey.