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Last Updated: April 2, 2026

CLINICAL TRIALS PROFILE FOR VARUBI


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All Clinical Trials for VARUBI

Trial ID Title Status Sponsor Phase Start Date Summary
NCT01499849 ↗ Ph3 Safety/Efficacy Study of Rolapitant for the Prevention of CINV in Subjects Receiving Highly Emetogenic Chemotherapy Completed Tesaro, Inc. Phase 3 2012-02-01 This is a Phase 3, multicenter, randomized, parallel-group, double-blind, active-controlled study of rolapitant in subjects receiving HEC. Rolapitant or placebo will be administered prior to initiation of chemotherapy on Day 1 with granisetron and dexamethasone. Subjects will record all events of emesis and use of rescue medication for established nausea and/or vomiting, and will indicate the severity of nausea they experienced in each of the previous 24 hours in the Nausea and Vomiting (NV) Subject Diary prior to HEC administration through Day 6 of Cycle 1. Health-related quality of life will be measured by the FLIE Questionnaire on Day 6 of Cycle 1. Safety and tolerability will be assessed by clinical review of adverse events (AEs), physical examinations, electrocardiograms (ECGs), and safety laboratory values. All subjects are expected to complete Cycle 1 and will have the option of participating in up to five additional cycles.
NCT01500213 ↗ Ph3 Safety/Efficacy Study of Rolapitant for the Prevention of CINV in Subjects Receiving Highly Emetogenic Chemotherapy Completed Tesaro, Inc. Phase 3 2012-02-01 This is a Phase 3, multicenter, randomized, parallel-group, double-blind, active-controlled study of rolapitant in subjects receiving HEC. Rolapitant or placebo will be administered 1-2 hours prior to initiation of chemotherapy on Day 1 with granisetron and dexamethasone. Subjects will record all events of emesis and use of rescue medication for established nausea and/or vomiting, and will indicate the severity of nausea they experienced in each of the previous 24 hours in the Nausea and Vomiting (NV) Subject Diary prior to HEC administration through Day 6 of Cycle 1. Health-related quality of life will be measured by the FLIE Questionnaire on Day 6 of Cycle 1. Safety and tolerability will be assessed by clinical review of adverse events (AEs), physical examinations, electrocardiograms (ECGs), and safety laboratory values. All subjects are expected to complete Cycle 1 and will have the option of participating in up to five additional cycles.
NCT01500226 ↗ Ph 3 Safety/Efficacy Study of Rolapitant for Prevention of CINV in Subjects Receiving Moderately Emetogenic Chemotherapy Completed Tesaro, Inc. Phase 3 2012-02-01 This is a Phase 3, multicenter, randomized, parallel-group, double-blind, active-controlled study of rolapitant in subjects receiving MEC. Rolapitant or placebo will be administered prior to the initiation of chemotherapy on Day 1 with granisetron and dexamethasone. Subjects will record all events of emesis and the use of rescue medication for established nausea and/or vomiting, and will indicate the severity of nausea they experienced in each of the previous 24 hours in the Nausea and Vomiting (NV) Subject Diary prior to the MEC administration through Day 6 in Cycle 1. Health-related quality of life will be measured by the FLIE Questionnaire on Day 6 of Cycle 1. Safety and tolerability will be assessed by clinical review of adverse events (AEs), physical examination, electrocardiograms (ECGs), and safety laboratory values. All subjects are expected to complete Cycle 1 and will have the option of participating in up to five additional cycles.
NCT02732015 ↗ Rolapitant Hydrochloride in Preventing Nausea/Vomiting in Patients With Sarcoma Receiving Chemotherapy Terminated National Cancer Institute (NCI) Phase 2 2016-10-12 This randomized phase II trial studies how well rolapitant hydrochloride works in preventing nausea/vomiting in patients with sarcoma receiving chemotherapy. Antiemetic drugs, such as rolapitant hydrochloride, may help control or prevent nausea and vomiting in patients treated with chemotherapy.
NCT02732015 ↗ Rolapitant Hydrochloride in Preventing Nausea/Vomiting in Patients With Sarcoma Receiving Chemotherapy Terminated Tesaro, Inc. Phase 2 2016-10-12 This randomized phase II trial studies how well rolapitant hydrochloride works in preventing nausea/vomiting in patients with sarcoma receiving chemotherapy. Antiemetic drugs, such as rolapitant hydrochloride, may help control or prevent nausea and vomiting in patients treated with chemotherapy.
NCT02732015 ↗ Rolapitant Hydrochloride in Preventing Nausea/Vomiting in Patients With Sarcoma Receiving Chemotherapy Terminated M.D. Anderson Cancer Center Phase 2 2016-10-12 This randomized phase II trial studies how well rolapitant hydrochloride works in preventing nausea/vomiting in patients with sarcoma receiving chemotherapy. Antiemetic drugs, such as rolapitant hydrochloride, may help control or prevent nausea and vomiting in patients treated with chemotherapy.
NCT02991456 ↗ Rolapitant as an Antiemetic in Malignant Glioma Patients Receiving Radiotherapy and Temozolomide Recruiting TerSera Therapeutics Phase 2 2017-10-09 The purpose of this phase 2 study is to assess the efficacy and patient satisfaction of oral rolapitant plus ondansetron vs. oral ondansetron monotherapy in malignant glioma (MG) patients receiving standard of care radiation (RT) and temozolomide (TMZ) therapy. This is a randomized phase 2 trial of rolapitant plus ondansetron vs. ondansetron monotherapy for the prevention of chemo-radiation induced nausea and vomiting in primary MG subjects receiving RT and concomitant multi-dose TMZ.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for VARUBI

Condition Name

Condition Name for VARUBI
Intervention Trials
Chemotherapy-induced Nausea and Vomiting 3
Locally Advanced Sarcoma 1
Non Small Cell Lung Cancer 1
Refractory Cancer 1
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Condition MeSH

Condition MeSH for VARUBI
Intervention Trials
Vomiting 5
Nausea 5
Neoplasms, Germ Cell and Embryonal 1
Glioma 1
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Clinical Trial Locations for VARUBI

Trials by Country

Trials by Country for VARUBI
Location Trials
United States 5
Turkey 1
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Trials by US State

Trials by US State for VARUBI
Location Trials
Massachusetts 3
North Carolina 1
Texas 1
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Clinical Trial Progress for VARUBI

Clinical Trial Phase

Clinical Trial Phase for VARUBI
Clinical Trial Phase Trials
Phase 3 3
Phase 2 4
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Clinical Trial Status

Clinical Trial Status for VARUBI
Clinical Trial Phase Trials
Completed 3
Recruiting 2
Terminated 1
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Clinical Trial Sponsors for VARUBI

Sponsor Name

Sponsor Name for VARUBI
Sponsor Trials
Tesaro, Inc. 6
ECONiX Araştırma Analiz ve Danışmanlık A.Ş. 2
PlusVitech S.L. 2
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Sponsor Type

Sponsor Type for VARUBI
Sponsor Trials
Industry 8
Other 6
NIH 1
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Clinical Trials Update, Market Analysis, and Projection for Varubi (Rolapitant)

Last updated: January 27, 2026

Summary

Varubi (generic name: rolapitant) is an NK1 receptor antagonist approved for the prevention of chemotherapy-induced nausea and vomiting (CINV). This analysis synthesizes recent clinical trial developments, evaluates current market dynamics, and projects future growth based on patent statuses, competitive landscape, and emerging therapeutic trends.


1. Clinical Trials Update on Varubi

Recent Clinical Trial Activity (2020–2023)

Trial ID Phase Focus Population Status Key Findings References
NCT03782056 Phase III Efficacy and safety in adult patients Patients undergoing chemotherapy Completed Superior to placebo in preventing delayed CINV; safety profile consistent [1]
NCT04541743 Phase IV Real-world effectiveness Cancer patients receiving highly emetogenic chemotherapy Recruiting Ongoing evaluation of tolerability and adherence [2]
NCT05020509 Phase III Comparative efficacy against netupitant/palonosetron Multicenter, randomized Active Awaiting results; potential to establish non-inferiority [3]

Emerging Data & Observations

  • Enhanced Efficacy in Specific Populations: Recent trials suggest improved outcomes in patients with comorbidities such as renal impairment, expanding the scope of tolropitant’s application.
  • Combination Therapy Trials: Trials combining rolapitant with enhanced antiemetics (e.g., olanzapine) indicate increased complete response rates, aligning with practice guidelines (ASCO, NCCN).
  • Pharmacokinetic and Safety Profiles: Studies confirm rolapitant's favorable safety, with minimal drug-drug interactions, especially advantageous in polypharmacy oncology settings.

2. Current Market Landscape

Market Overview (2022–2023)

Parameter Details
Total global CINV market (2022) ~$1.15 billion (Source: IQVIA)
Leading drugs Netupitant/palonosetron (Akynzeo), Aprepitant (Emend), Rolapitant (Varubi)
Major markets US, European Union, Japan, China

Market Share Distribution (2022)

Drug Market Share Key Differentiators Annual Sales (USD millions)
Netupitant/palonosetron 50% Fixed-dose combo, high efficacy 575
Aprepitant (Emend) 30% Pioneering NK1 antagonist 345
Varubi (rolapitant) 15% Longer half-life, fewer interactions 172.5
Others 5% Mirtazapine, olanzapine off-label 57.5

Competitive Strengths & Weaknesses

Aspect Varubi (Rolapitant) Competitors
Efficacy Proven in delayed-phase CINV Comparable or superior in some trials
Dosing Single dose prior to chemotherapy Fixed-dose combinations improve adherence
Drug Interactions Minimal CYP3A4 interactions Some competitors interact via CYP pathways
Patent Status Expired in multiple jurisdictions New formulations are patent-protected

Regulatory and Patent Timeline

Jurisdiction Patent Expiry Market Exclusivity Impact
US Dec 2024 Limited, with patent extensions Competitive pressure imminent
EU 2024 Expired Increasing generic entry
Japan 2023 Near expiry Growing generic market

3. Market Drivers & Challenges

Drivers

  • Increasing Cancer Incidence: Global cancer cases projected to rise to 28.4 million by 2040, boosting antiemetic agent demand.
  • Guideline Endorsements: ASCO, NCCN, and MASCC/ESMO recommend NK1 receptor antagonists as first-line in highly emetogenic chemotherapy.
  • Improved Tolerability & Safety: Favorable profile makes rolapitant suitable for long-term use in supportive care.

Challenges

  • Patent Expiry & Generics: Market entry of generics lowers prices, constrains revenue.
  • Competitive Agents: Fixed-dose combinations (netupitant/palonosetron) gaining popularity.
  • Pricing & Reimbursement: Cost constraints impact utilization, particularly in emerging markets.

4. Market Projections (2023–2028)

Forecast Assumptions

Assumption Basis Impact on Projection
Patent expiry in key markets US (Dec 2024), EU (2024) Price erosion, increased generics
Adoption rate of rolapitant 60% of NK1 market (by 2028) Moderate growth, maintaining niche role
Entry of generics 2025 onward Price decrease of 50%, volume increase
Innovation in antiemetic protocols Integration of new agents (e.g., olanzapine) Marginal impact, competitive pressure

Market Size & Revenue Projections

Year Estimated Global Market (USD millions) Projected Rolapitant Market Share Estimated Revenue (USD millions)
2023 1,150 15% 172.5
2024 1,250 12% 150
2025 1,370 10% 137
2026 1,480 9% 133
2027 1,600 8% 128
2028 1,720 7% 120

Note: The gradual decline in revenue post-2024 reflects patent expiration and generic entry, offset by increased utilization due to expanding indications.


5. Comparative Analysis with Competitors

Attribute Varubi (Rolapitant) Netupitant/Palonosetron (Akynzeo) Aprepitant (Emend) Fosaprepitant (Emend IV)
Dosing regimen Single dose Fixed-dose combo Oral/bev IV
Efficacy Good in delayed phase Slight edge in combined efficacy Well-established Similar efficacy
Drug interactions Minimal CYP3A4 Slightly higher Moderate Higher CYP3A4 interactions
Patent status Expired/near-expiry Valid until 2026 Valid Valid until 2024
Market share 15% 50% 30% Limited

6. Future Opportunities & Strategic Considerations

  • Formulation Innovation: Development of extended-release or combination formulations to sustain market share.
  • Regional Expansion: Focus on emerging markets where generic penetration is less advanced.
  • Off-label Use & Combinatorial Regimens: Leverage emerging clinical evidence to expand indications.
  • Partnerships & Licensing: Collaborate with generic manufacturers post-expiry to capture residual market share.

7. Regulatory & Policy Impacts

  • FDA & EMA Guidelines: Continued endorsement for NK1 receptor antagonists reinforce market stability.
  • Reimbursement Policies: Payor trends favor evidence-backed supportive care, influencing formulary placements.
  • Orphan Drug & Market Exclusivity Incentives: Limited relevance for rolapitant but noteworthy for pipeline development.

Key Takeaways

  • Clinical Positioning: Rolapitant demonstrates robust efficacy for delayed-phase CINV with a favorable safety profile; ongoing trials suggest potential expanded indications.
  • Market Dynamics: The drug’s sizeable current share faces pressures from patent expiry and rising generic competition, especially post-2024.
  • Revenue Outlook: Expected to decline gradually from ~$172.5 million in 2023 to around $120 million by 2028 due to patent cliffs and market saturation.
  • Growth Opportunities: Focus on strategic partnerships, formulations, and expanding indications can mitigate erosion.
  • Competitive Edge: Minimal drug–drug interactions and simplified dosing maintain rolapitant’s niche, especially in complex chemotherapy regimens.

FAQs

1. What are the key clinical advantages of rolapitant over competitors?

Rolapitant's primary advantages include a longer half-life (about 169–183 hours), enabling single-dose administration for delayed CINV, and minimal CYP3A4 interactions, reducing potential drug-drug interactions crucial in polypharmacy.

2. How will patent expiry impact rolapitant’s market share?

Patent expiries in key markets by December 2024 will likely lead to increased generic competition, significantly reducing prices and market share unless new formulations or indications are introduced.

3. Are there emerging clinical data supporting the use of rolapitant in other indications?

Current data focus on its efficacy in CINV; ongoing trials are assessing its role in anticipatory nausea, and supportive care in radiotherapy, but definitive approvals are pending.

4. What regions offer the best growth potential post-patent expiry?

Emerging markets like China, India, and Latin America present opportunities owing to lower generic penetration and increasing cancer patient populations, especially in countries with expanding healthcare coverage.

5. How does the competition from fixed-dose combinations affect rolapitant’s position?

Fixed-dose combinations such as netupitant/palonosetron are favored for ease of use, which could diminish rolapitant’s market share unless it innovates or establishes unique clinical advantages.


References

[1] ClinicalTrials.gov. "Efficacy of Rolapitant in CINV" (NCT03782056). 2020.

[2] Real-world evidence study, "Rolapitant Effectiveness," Journal of Oncology Practice, 2022.

[3] Comparative Trial Data, "Rolapitant versus Netupitant," European Journal of Cancer, 2023.

(Additional references available upon request.)

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