New IV combo aims to stop chemo sickness in kids
NCT ID NCT06904235
First seen Jun 27, 2026 · Last updated Sep 16, 2026 · Updated 2 times
Summary
Chemotherapy often causes nausea and vomiting, which is especially hard for children. This study tests a new IV drug called NEPA (fosnetupitant/palonosetron) to prevent these side effects in kids with cancer. The trial has two parts: first, an open-label phase to find the right dose and check safety, then a double-blind phase comparing NEPA to standard anti-nausea drugs. About 95 children from birth to under 18 years old will take part.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- IV NEPA (fosnetupitant/palonosetron)
- What this could lead to
- If successful, this could provide a more effective way to prevent chemotherapy-induced nausea and vomiting in children, improving their quality of life during cancer treatment.
- What could go wrong
- This is an early-phase study with only 95 participants, so results may not apply to all children. The drug may cause side effects or not work better than existing treatments.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 2
Tests whether the treatment actually works, and watches for side effects, in a larger group.
- Participants
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About 95 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Jul 2025
- Expected to finish
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Dec 2027
An estimate. End dates often move.
- Lead sponsor
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A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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0 months to 18 years
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: The following inclusion criteria must be checked prior to study inclusion: 1. 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. 2. Male or female in- or out-patient from 0 months (newborns) to \<18 years on the date of enrolment (Day 1). 3. Cohort 1: Patient \< 6 months weighing at least 4 kg or patient ≥ 6 months weighing at least 6 kg. Cohort 2: Patient weighing at least 4 kg. 4. Patient with a predicted life expectancy ≥3 months according to Investigator's opinion. 5. Patient naïve or non-naïve to chemotherapy, with histologically and/or cytologically (or imaging in the case of brain tumours and nephroblastomas) confirmed malignant disease. 6. Cohort 1: Patient scheduled and eligible to receive at least 1 cycle of single-day HEC. Cohort 2: Patient scheduled and eligible to receive at least 1 cycle of multi-day HEC. (For the level of emetogenicity of the chemotherapeutic agents, refer to the POGO January 2021 guideline). 7. For patients aged ≥10 years: Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≤2. 8. For patient with known hepatic impairment: the patient may be enrolled provided the serum ALT and AST are ≤2.5 ULN, the total bilirubin is ≤1.5 ULN, and in the Investigator's opinion the impairment is not expected to jeopardize the patient's safety during the study. 9. For patient with known renal impairment: the patient may be enrolled provided the estimated glomerular filtration rate (eGFR) is ≥70 mL/min/1.73m2 (≥50 mL/min/1.73m2 for children \<3 months old) (the eGFR should be calculated using the modified Schwartz equation) and in the Investigator's opinion the impairment is not expected to jeopardize the patient's safety during the study. 10. For patient with known history or predisposition to cardiac abnormalities: as per the Investigator's opinion, the history/predisposition should not jeopardize patient's safety during the study. 11. Patient with non-clinically significant abnormal laboratory values or with clinically relevant abnormal laboratory values may be enrolled if in the Investigator's opinion the patient's safety is not expected to be jeopardized. 12. Female patient shall: a) not have attained menarche yet or b) have attained menarche and have a negative serum pregnancy test at the Screening Visit and a negative urine pregnancy test at Day 1. 13. Male or female fertile patient using reliable contraceptive measures. Such measures, for patient and sexual partner, include: implants, injectables, combined oral contraceptives, intrauterine devices, vasectomized/sterilized partner, use of a double barrier method, or sexual abstinence. The patient and his/her parent(s)/legal guardian must be counselled on the importance of avoiding pregnancy before and during the study. Exclusion Criteria: 1. The patient and/or parent(s)/legal guardian are expected by the Investigator to be non compliant with the study procedures. 2. 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. 3. Known history of allergy to any component of the study treatments or other contraindications to any NK1-RAs or 5-HT3-RAs. 4. Active infection. 5. Any illness or condition that, in the opinion of the Investigator, may pose unwarranted risks in administering the investigational product to the patient. 6. Uncontrolled medical condition (e.g., uncontrolled insulin-dependent diabetes mellitus). 7. Patient experiencing ongoing vomiting from any organic aetiology (including patients with history of gastric outlet obstruction or intestinal obstruction due to adhesions or volvulus), or patient with hydrocephalus. 8. Patient who experienced any vomiting, retching, or nausea within 24 h prior to the administration of the study treatment on Day 1 (Note: functional vomiting for infants, which is normally seen during the first 3 months of life, is not to be considered as vomiting). 9. Patient who received any drug with potential antiemetic effect within 24 h prior to administration of study treatment on Day 1, including but not limited to the following: * NK1-RAs (e.g., (fos)aprepitant or any other drug of this class) * 5-HT3-RAs (e.g., ondansetron, granisetron, dolasetron, tropisetron, ramosetron) * Benzamides (e.g., metoclopramide, alizapride) * Phenothiazines (e.g., prochlorperazine, promethazine, perphenazine, fluphenazine, chlorpromazine, thiethylperazine) * Benzodiazepines initiated 48 h prior to study treatment administration on Day 1 or expected to be administered within the efficacy assessment period, except for single doses of midazolam, temazepam, or triazolam * Butyrophenones (e.g., droperidol, haloperidol) * Anticholinergics (e.g., scopolamine, except the inhaled anticholinergics for respiratory disorders e.g., ipratropium bromide) * Antihistamines (e.g., diphenhydramine, cyclizine, hydroxyzine, chlorphenhyramine, dimenhydrinate, meclizine) * Domperidone * Mirtazapine * Olanzapine * Prescribed cannabinoids (e.g., tetrahydrocannabinol, nabilone) * Over-the-counter (OTC) antiemetics, OTC cold medications, or OTC allergy medications * Herbal preparations containing ephedra or ginger 10. Patient who received palonosetron within 1 week prior to administration of study treatment on Day 1. 11. Patient receiving systemic corticosteroid therapy above 0.14mg/kg or \>10 mg of prednisone daily or equivalent. Exception: Dexamethasone for the prevention of CINV is permitted in association with the study treatment (Test Treatment and Reference Treatment) as per standard of care and applicable guidelines, provided its dosage is reduced by 50% in consideration of known interactions with various NK1 RAs, including fosaprepitant and fosnetupitant. 12. Patient aged \<6 years who received any investigational drug (defined as a medication with no marketing authorization granted for any age or indication) within 90 days prior to Day 1, or patient aged ≥6 years who received any investigational drug within 30 days prior to Day 1, or patient any age who is expected to receive investigational drugs prior to study completion. 13. Intake of alcohol, food, or beverages (e.g., grapefruit, cranberry, pomegranate, and aloe vera juices; German chamomile) known to interfere with CYP3A4 or CYP2D6 metabolic enzymes within 1 week prior to Day 1 and during the overall study period. 14. Use of any drugs or substances known to be strong inhibitors of CYP3A4 or CYP2D6 enzymes within 1 week prior to Day 1 or planned to be used during the overall study period. 15. Use of any drugs or substances known to be CYP3A4 substrates with narrow therapeutic range within 1 week prior to Day 1 or planned to be used during the overall study period. 16. Use of any drugs or substances known to be strong inducers of CYP3A4 or CYP2D6 enzymes within 4 weeks prior to Day 1 or planned to be used during the overall study period. 17. Lactating female patient. 18. Enrolment in a previous study on netupitant (either administered alone or in combination with palonosetron). 19. Marked baseline prolongation of QTc interval (QTcF\>460 millisecond \[msec\]). At the discretion of the investigator, criterion may be based on automatic interpretation of results.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
17 sites in 4 countries. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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"AHEPA" University General Hospital of Thessaloniki, 2nd Department of Pediatrics
RECRUITINGThessaloniki, Greece
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Aghia Sophia Children's Hospital, Pediatric Hematology/ Oncology Unit (POHemU)
RECRUITINGAthens, Greece
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Ankara University Faculty of Medicine Children's Hospital, Department of Children Oncology and Hematology
RECRUITINGAnkara, Mamak, Turkey (Türkiye)
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Clinic of Pediatrics, Oncology and Hematology University Pediatric Center them M. Konopnicka SP ZOZ Central Clinical Hospital Medical University of Lodz
RECRUITINGLodz, Poland
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Clinical Department of Paediatric Oncology and Haematology VOIVODSHIP SPECIALIST CHILDREN'S HOSPITAL them. prof. dr. Stanisław Popowski in Olsztyn
WITHDRAWNOlsztyn, Poland
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Department of Oncology Institute "Monument - Child Health Center"
RECRUITINGWarsaw, Poland
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Department of Oncology and Surgical Oncology for Children and Youth Institute Mother and Child
RECRUITINGWarsaw, Poland
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Department of Paediatrics and Paediatric Haemato-Oncology University Clinical Hospital No. 1 them. prof. Tadeusz Sokołowski Pomeranian Medical University
WITHDRAWNSzczecin, Poland
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Department of Paediatrics, Haematology, Oncology and Rheumatology Voivodship Children's Hospital them. J. Brudziński
RECRUITINGBydgoszcz, 85-667, Poland
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Department of Paediatrics, Oncology and Paediatric Immunology, University Clinical Hospital No. 1 them. prof. Tadeusz Sokołowski Pomeranian Medical University in Szczecin
RECRUITINGSzczecin, Poland
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Department of Pediatric Oncology, Hematology and Transplantation Clinical Hospital them. Karol Jonscher Medical University them. Karol Marcinkowski in Poznań
RECRUITINGPoznan, Poland
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Department of Pediatrics, Oncology and Hematology University Children's Clinical Hospital them. Ludwik Zamenhof in Bialystok
WITHDRAWNBialystok, Poland
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Emergency Children's Hospital " Louis Turcanu, Oncology-Haematology and BMP department
RECRUITINGTimișoara, Romania
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Erciyes University Hospitals Kanka Children's Hematology Oncology and Bone Marrow Hospital
RECRUITINGKayseri, Melikgazi, Turkey (Türkiye)
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Fundeni Clinical Institute, Pediatric Hematology and BMT
RECRUITINGBucharest, Romania
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Gazi University Gazi Hospital Children Hematology and Oncology
RECRUITINGAnkara, Turkey (Türkiye)
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Hacettepe University Hospitals Oncology Hospital 2nd Floor Children Oncology
RECRUITINGAnkara, Turkey (Türkiye)
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Istanbul University Istanbul Faculty of Medicine Topkapı
NOT_YET_RECRUITINGIstanbul, Faith, Turkey (Türkiye)
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Oncology Institute "Prof. Dr. Al. Trestioreanu", Pediatric Oncology
RECRUITINGBucharest, Romania
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University Children'S Hospital in Lublin, Department of Pediatric Hematology, Oncology, and Transplantology
NOT_YET_RECRUITINGLublin, 20-093, Poland
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