NEPA (netupitant/palonosetron) for the antiemetic prophylaxis of nausea and vomiting induced by chemotherapy (CINV) with Folfirinox and Folfoxiri even during the COVID-19 pandemic: a real-life study.

OBJECTIVE: The outbreak of coronavirus disease 2019 (COVID-19) has affected the treatment of cancer patients, with particular regard to the management of both chemotherapy and side effects. Chemotherapy-induced nausea and vomiting (CINV) are amongst the most troublesome side effects that impair patients' adherence to treatments and their quality of life (QoL). NEPA (Akynzeo®), is an oral fixed-dose combination of netupitant [a neurokinin-1 receptor antagonist (NK1RA), 300 mg] and palonosetron [(5-hydroxytryptamine (serotonin or 5HT) type3 receptor antagonist (5HT3RA), 0.5 mg] which has been shown to be effective in preventing CINV. PATIENTS AND METHODS: This prospective study started before the outbreak of COVID-19 and was carried out during the pandemic period. The aim was to evaluate the efficacy and safety of a single oral dose NEPA plus 12 mg of dexamethasone (DEX) in patients treated with Folfoxiri plus Bevacizumab and Folfirinox. The patients were diagnosed with advanced colorectal cancer (CRC) or advanced pancreatic ductal adenocarcinoma (PDAC). They were divided into two groups: naïve patients and patients previously treated with serotonin receptor antagonists (5HT3-RA) and neurokin-1 receptor antagonists (NK1-RA). RESULTS: During the overall phase, the complete response (CR) rate was 96.8% in naïve patients treated with Folfoxiri plus Bevacizumab, and 94.6% in patients treated with Folfirinox. During the acute and delayed phases, the CR rate was 92.8% and 94.2%, with Folfoxiri and Bevacizumab, as well as 96.2% and 94.6%, with Folfirinox. There was no adequate control of CINV events in patients on antiemetic prophylaxis with 5HT3-RA or NK1-RA associated with cortisone. During the overall phase, the CR rate was 74.6% with Folfoxiri plus Bevacizumab and 75.8% with Folfirinox. During the acute and delayed phases, the CR rate was 72.5% and 74.8% with Folfoxiri plus Bevacizumab, as well as 75.2% and 74.6% with Folfirinox. CONCLUSIONS: This study has shown the therapeutic benefits of NEPA in the management and prophylaxis of CINV events, both in naive patients and patients previously treated with 5HT3-RA and NK1-RA. In addition, NEPA has been shown to be safe, both before and during the COVID-19 pandemic.

Making the elusive more tangible: Remote tools & techniques for teaching web development to screen reader users

The COVID-19 pandemic exacerbated the lack of accessible tech skills training for screen reader users. To address this gap, we developed remote tools and techniques to support screen reader users in learning web development. In this paper, we describe our design and implementation of a free, remote web development workshop, designed to introduce 12 screen reader users to HTML, CSS, and JavaScript. We taught the workshop remotely using synchronous lectures followed by 1-on-1 time with teaching assistants (TAs), and included a resource-rich website, tactile diagrams, and discussion forum. We evaluated the impact of the workshop, as well as techniques and tools using pre- and post-workshop surveys, observational field notes, exit interviews, and unit quizzes. At the end of the workshop, all students demonstrated their knowledge of web development basics by creating and publishing their own websites;showed an increase in self-efficacy;and maintained a high level of interest in the subject. Participating in this workshop benefited our TAs who reported increased confidence in understanding accessibility concepts, increased interest in pursuing work related to accessibility, and plans to apply what they learned. Based on these findings, we recommend techniques and tools to support remote screen reader users learning web development;and suggestions for engaging with post-secondary institutions to pair service learning with tech skills training. We close with recommendations for implementing and adapting the workshop using our open-educational materials. © 2021 ACM.