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
Signed written Informed Consent Form (ICF) by parent(s)/legal guardian of the paediatric patient in compliance with the local laws and regulations. In addition, the signed children's Assent Form according to local requirements.
Male or female in- or out-patient from 0 months (newborns) to <18 years on the date of enrolment (Day 1).
Cohort 1: Patient < 6 months weighing at least 4 kg or patient ≥ 6 months weighing at least 6 kg.
Patient with a predicted life expectancy ≥3 months according to Investigator's opinion.
The patient and/or parent(s)/legal guardian are expected by the Investigator to be non compliant with the study procedures.
Patient has received or is scheduled to receive total body irradiation; total nodal irradiation; upper abdomen radiotherapy; half or upper body irradiation; or radiotherapy of the cranium, craniospinal regions, head and neck, lower thorax region, or the pelvis within 1 week prior to study entry (Day 1) or within 120 h after start of chemotherapy on Day 1 (Cohort 1 patients) or within 168 h (for Cohort 2 patients receiving the last IV NEPA on Day 3) or 216 h (for Cohort 2 patients receiving the last IV NEPA on Day 5) from start of chemotherapy on Day 1.
Known history of allergy to any component of the study treatments or other contraindications to any NK1-RAs or 5-HT3-RAs.
Active infection.