CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 205718Orig1s000 ENVIRONMENTAL ASSESSMENT Helsinn Healthcare SA submitted a claim of categorical exclusion from the requirement to prepare an environmental assessment (EA) for AKYNZEO. AKYNZEO is a ?xed dose combination of netupitant, a substance P/neurokinin 1 receptor antagonist, and palonosetron, a serotonin subtype 3 receptor antagonist. I have reviewed the claim and determined that the application quali?es-for a categorical exclusion under 21 CFR 2531 No extraordinary circumstances are indicated. No further action is required. Raanan A. Bloom, Staff Reference ID: 3596493 This is a representation of an electronic record that was signed electronically and this page is the manifestation of the electronic signature. Isl RAANAN A BLOOM 07/21/2014 Reference ID: 3596493