netupitant + palonosetron + ondansetron

This is a triple combination antiemetic regimen consisting of netupitant, palonosetron, and ondansetron. All three agents are used to prevent nausea and vomiting associated with cancer chemotherapy. Netupitant is a neurokinin 1 (NK1) receptor antagonist that blocks the action of substance P in the brain, reducing both acute and delayed emesis. Palonosetron and ondansetron are both serotonin (5-HT3) receptor antagonists; they block serotonin receptors in the gut and central nervous system to prevent chemotherapy-induced nausea and vomiting. While fixed-dose combinations of netupitant plus palonosetron (marketed as Akynzeo) are approved for this indication, there is no single marketed product containing all three agents together; however, these drugs may be co-administered as part of guideline-recommended antiemetic regimens for highly or moderately emetogenic chemotherapy[1][4][5][6].