Anticancéreux hautement et modérément émétisants: Place du rolapitant, un nouvel anti-NK-1, dans la prise en charge des nausées et vomissements chimio-induits

Background: Feared by the patients, chemotherapy induced nausea and vomiting (CINV) jeopardize their health and quality of life. The combination of anti-5HT3, anti-NK1 and dexamethasone is recommended by current guidelines for the prevention of CINV. Rolapitant, a novel anti-NK1 is marketed since 2017 in France. Objectives: To present and place rolapitant into the pharmacists' clinical practice. Results: Three randomized phase-III studies evidenced the efficacy and good tolerance of rolapitant, a new highly selective anti-NK1 active especially in delayed NVCI, thanks to its prolonged half-live (7 days) after a single 180 mg oral administration. Rolapitant has no effect on CYP3A4 cytochrome, which limits the risk of drug-drug interaction. Dispensed in retail pharmacies, rolapitant is to be administered within 2 hours before chemotherapy. Conclusion: With an easy administration (single dose) and a prolonged half-life, rolapitant improves compliance in the prevention of CINV; the pharmacist should be involved in patient education.