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Journal of Oncology Pharmacy Practice

Ali Alkan
Trastuzumab emtansine is an antibody-drug conjugate that is effective in human epidermal growth factor receptor-2 expressing advanced breast cancer. Trastuzumab emtansine is generally well tolerated and grade 3-4 toxicities are rare. Pulmonary complications were rarely reported. Here we present a patient presenting with dyspnea after trastuzumab emtansine therapy and treated with a diagnosis of interstitial pneumonitis.
November 14, 2018: Journal of Oncology Pharmacy Practice
Sophie Kim
This is a case report of a patient who developed severe, irreversible hypocalcemia after receiving one dose of pamidronate 90 mg for hypercalcemia of malignancy. Hypocalcemia is a known risk of bisphosphonate treatments, but the incidence of severe hypocalcemia is rare, and the risk factors are well established. However, in the treatment of hypercalcemia of malignancy, the treatment objective is to reduce the elevated serum calcium level, and the bisphosphonate is usually given as one time dose only. The potential for developing severe hypocalcemia may not be considered a significant concern in this setting compared to the setting of the treatment of bone metastasis, where the baseline serum calcium level is not elevated and the bisphosphonate is administered at a regular interval of every three to four weeks...
November 12, 2018: Journal of Oncology Pharmacy Practice
Charis G Durham, Deepthi Thotakura, Lauren Sager, Jennifer Foster, Jon D Herrington
OBJECTIVE: This study evaluated the role of cetirizine compared to diphenhydramine as premedications for patients receiving paclitaxel, cetuximab, and rituximab infusions. Historically, diphenhydramine has been linked with more sedation in comparison to cetirizine; however, it is unknown if cetirizine can replace diphenhydramine in the prevention of hypersensitivity reactions in patients receiving chemotherapy. METHODS: This is a retrospective study designed to assess infusion reactions occurring in patients receiving diphenhydramine or cetirizine premedication for rituximab, paclitaxel, or cetuximab therapies...
November 12, 2018: Journal of Oncology Pharmacy Practice
Milly Finch, Neil Masters
BACKGROUND: Dose banding parenteral chemotherapy has the potential to optimise aseptic unit capacity and reduce drug expenditure without compromising the service provided. METHODS: Dose banding tables from NHS England were implemented into the electronic chemotherapy prescribing system. Compliance to the dose bands was analysed and submitted quarterly. Analysis of drug expenditure, drug use and cost per milligram data was also collected. RESULTS: Expenditure on the 17 drugs identified in the 2016/17 dose standardisation CQUIN reduced by approximately £100,000 per month over the CQUIN despite an increase in the number of prescribed doses of these drugs...
November 6, 2018: Journal of Oncology Pharmacy Practice
Yuksel Urun, H Arzu Yasar, Hande Turna, Ece Esin, A Murat Sedef, Ali Alkan, Berna Oksuzoglu, Nuriye Ozdemir, Ma Nahit Sendur, Ahmet Sezer, Saadettin Kılıckap, Gungor Utkan, Tulay Akman, Hakan Akbulut, Ismail Celik, Huseyin Abalı
PURPOSE: Studies in the last decade show survival improvement with checkpoint blocker therapy in patients with metastatic malign melanoma. Our purpose was to define the efficacy of ipilimumab according to the patient's baseline characteristics including absolute lymphocytes count. METHODS: We collected the data of 97 patients with advanced malign melanoma treated with ipilimumab (3 mg/kg, q3w) retrospectively. Log-rank test was used to analyze the univariate effects of patient's characteristics (age, gender, metastatic sites, ECOG PS, type of melanoma, lactic dehydrogenase levels, anemia, lymphocytes (L), neutrophils (N), N/L ratio), c-kit and BRAF status...
November 6, 2018: Journal of Oncology Pharmacy Practice
Agustin Avilés, Maria-Jesus Nambo, Natividad Neri
OBJECTIVE: To assess if the use of a dose-dense regimen of chemotherapy can improve the prognosis in patients with primary gastric diffuse large B-cell lymphoma in early stages (I-II) but associated with worse prognostic factors. METHODS: One hundred and eight consecutive patients with primary gastric diffuse large B-cell lymphoma in early stages (I-II) with high serum levels of lactic dehydrogenase and beta 2 microglobulin (more than >2 of normal levels), which were associated with a worse prognostic outcome, were treated with a dose-dense chemotherapy: CHOP with increased doses of cyclophosphamide and doxorubicin, was administered every 14 days (instead of 21 days)...
October 28, 2018: Journal of Oncology Pharmacy Practice
Roxanne Dobish, Carole R Chambers, Sukhraj Gill
Increasingly stringent pharmacy standards for preparation of sterile products necessitated a review of the feasibility of continuing to maintain chemotherapy sterile production facilities across the provincial cancer programme. The concept of centrally produced chemotherapy that could be shipped to various locations as a remote service delivery model was explored. Key planning principles were established and detailed processes were developed to test this change in service delivery at one small cancer centre...
October 28, 2018: Journal of Oncology Pharmacy Practice
Thomas J Nowak, Aaron H Lorge, Lisa E Rein, Angela M Canadeo, Joel P Frank, Lisa C Samanas, Angela M Urmanski, Ehab L Atallah
BACKGROUND: High-dose methotrexate is used to treat a variety of malignancies. Methotrexate-associated supportive care and the threshold methotrexate level for the discontinuation of supportive care are not consistent among studies. We evaluated the implementation of high-dose methotrexate administration guidelines, which raised the standard threshold methotrexate level for the discontinuation of supportive care from <0.05 to <0.1 µmol. METHODS: A single-center, observational analysis of patients receiving high-dose methotrexate from 1 January 2015 to 31 May 2017 was conducted...
October 25, 2018: Journal of Oncology Pharmacy Practice
Natalia C Duarte, Cristina R Barbosa, Mariane Gr Tavares, Lara P Dias, Rafael N Souza, Patricia Moriel
Management and prevention of problems related to oncology drugs are particularly important due to the excessive cost, high toxicity, and narrow therapeutic index of the antineoplastic drugs, in addition to the patients' state of health. Therefore, the presence of the pharmacist as a member of the multidisciplinary team is essential to contribute to patient safety. In this work, the interventions performed were identified, quantified, and classified to characterize the work of the clinical oncology pharmacist...
October 22, 2018: Journal of Oncology Pharmacy Practice
Amanda S Cass, Johlee S Odinet, John M Valgus, Daniel J Crona
In 2017, due to a fluid shortage secondary to Hurricane Maria's devastation of Puerto Rico, hospitals and health-systems began to substitute rolapitant for fosaprepitant as part of chemotherapy-induced nausea and vomiting prevention and treatment strategies. However, despite advantageous pharmacologic and formulation (e.g. long half-life, quicker time to onset, and lack of first-pass hepatic metabolism) profiles, there seems to be significant risk of infusion-related hypersensitivity reactions associated with the administration of intravenous rolapitant...
October 22, 2018: Journal of Oncology Pharmacy Practice
Vian Cheng, Adeline Markarian, Mario L de Lemos, Kimberly Schaff
PURPOSE/OBJECTIVES: The Oncotype DX genomic test is a treatment decision-making tool. Test results are presented as recurrence scores which are used to help decide between adjuvant hormonal therapy (low recurrence score) or chemotherapy (high recurrence score). Since 2014, the Oncotype DX test has been funded at the cancer treatment centres in our province for patients with early breast cancer. Eligibility criteria for funding include patient and tumour characteristics. Pharmacy technicians were assigned to review and approve requests based on the eligibility criteria and with access to consultation to an oncology pharmacist and a medical oncologist...
October 22, 2018: Journal of Oncology Pharmacy Practice
Eyad Z Gharaibeh, Mohammad Telfah, Benjamin C Powers, Michael E Salacz
Ifosfamide is an alkylating chemotherapeutic agent used in the treatment of many malignancies. Ifosfamide-induced encephalopathy is one potential side effect that represents a major drawback to ifosfamide therapy and often necessitates discontinuation of chemotherapy. Previous reports demonstrate moderate effectiveness of prophylactic methylene blue at thwarting ifosfamide-induced encephalopathy. This is a report of a 64-year-old female with relapsed double-hit diffuse large B-cell lymphoma who developed severe altered mental status and neurological symptoms after receiving a second dose of ifosfamide as part of her salvage standard dose R-IE (rituximab, ifosfamide, etoposide), in preparation for chimeric antigen receptor T-cell therapy...
October 22, 2018: Journal of Oncology Pharmacy Practice
Neda Khalili, Mahsa Keshavarz-Fathi, Sepideh Shahkarami, Armin Hirbod-Mobarakeh, Nima Rezaei
INTRODUCTION: Treatment of metastatic castration-resistant prostate cancer with conventional therapies is still not successful. Therefore, application of novel biological approaches such as immunotherapy, which appears to be more effective and less toxic, is necessary. Monoclonal antibodies against cancer specific antigens are a kind of immunotherapy that have been approved for specific types of cancer and are being investigated for prostate cancer as well. The aim of this review was to assess the effectiveness and safety of monoclonal antibodies for treatment of advanced prostate cancer...
October 22, 2018: Journal of Oncology Pharmacy Practice
Amy Morrow, Campbell Garland, Fei Yang, Mike De Luna, Jon D Herrington
The use of the Calvert formula to calculate carboplatin doses allows clinicians to achieve the appropriate carboplatin area under the concentration (AUC) curve. Thrombocytopenia is the dose limiting toxicity of carboplatin and optimizing AUC minimizes the risk of thrombocytopenia. Carboplatin clearance directly correlates with glomerular filtration rate (GFR) and, therefore, an accurate estimation of the renal function is needed. The Calvert formula was designed using the GFR measured by 51 Cr-EDTA; however, many clinicians substitute estimated creatinine clearance (CrCl) as calculated by the Cockcroft-Gault (C-G) equation...
October 18, 2018: Journal of Oncology Pharmacy Practice
Elaine Xiang, Jian Ni, Brett Glotzbecker, Jacob Laubach, Robert Soiffer, Anne M McDonnell
INTRODUCTION: For multiple myeloma patients who respond to primary therapy, autologous hematopoietic stem cell transplant (HSCT) is considered standard of care with high-dose melphalan for transplant candidates. There are now two different melphalan formulations available, including a propylene glycol containing (PG-MEL) product and a propylene glycol-free (PG-free MEL) product. Although considered bioequivalent, there remains limited literature directly evaluating the adverse events between the two agents...
October 18, 2018: Journal of Oncology Pharmacy Practice
Sweta U Patel, Kendra Yum, Sara Kim, Luis M Isola, Eileen Scigliano, Rita Jakubowski, Doyun Park
Graft-versus-host disease has been reported to occur rarely in syngeneic hematopoietic stem cell transplant recipients. Clinical and histological changes consistent with graft-versus-host disease have been reported to occur in this patient population. We report a case of a 46-year-old Caucasian male with diffuse large B-cell lymphoma in complete remission who underwent a syngeneic hematopoietic stem cell transplant. He was diagnosed with grade III acute skin and gastrointestinal graft-versus-host disease requiring high-dose corticosteroids and immunosuppressive therapy and resulting in a complete response...
October 14, 2018: Journal of Oncology Pharmacy Practice
Maryanne Ong'udi, Pegotty Mutai, Irene Weru
Introduction Cancer is not only a burden in the country but also a global burden with among the highest rate of mortality. In spite of the great strides made by the conventional therapy, many cancer patients have resorted to using complementary and alternative medicine (CAM) as human beings have an innate urge to try new and alternative ways to relieve their suffering. Objectives There is a need for us to establish if the cancer patients at Kenyatta National Hospital, Nairobi use CAM, to establish the socio-demographic characteristics of patients in the oncology clinic, to establish the types and patterns of CAM use, to establish the reasons and factors that may contribute to CAM use and if the primary health care provider is aware that they are using CAM...
October 14, 2018: Journal of Oncology Pharmacy Practice
Magali Laprise-Lachance, Pierre Lemieux, Jean-Pierre Grégoire
Objectives To estimate the relative risk of pulmonary toxicity in patients exposed to a bleomycin-based chemotherapy including filgrastim compared to a similar chemotherapy without filgrastim. Methods We conducted a nested case-control study of patients treated with BEP (bleomycin, etoposide and cisplatin) for germ cell cancer or with ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) for Hodgkin's lymphoma at the Hôtel-Dieu de Lévis Hospital between 31 October 2000 and 30 June 2016. The relative risk was estimated by an adjusted odds ratio (aOR) using a propensity score-adjusted regression analysis...
October 14, 2018: Journal of Oncology Pharmacy Practice
Stefanie K Clark, Lisa M Anselmo
Pemetrexed is a multitargeted antifolate indicated for locally advanced or metastatic non-squamous non-small-cell lung cancer and malignant pleural mesothelioma. Cutaneous reactions are associated with pemetrexed use. Pemetrexed prescribing information recommends oral dexamethasone 4 mg twice daily for three days starting the day before pemetrexed infusion to prevent cutaneous reactions. Patients receive intravenous dexamethasone before pemetrexed infusion at the University of New Mexico Comprehensive Cancer Center, but the oral dexamethasone recommendation is not always followed...
October 14, 2018: Journal of Oncology Pharmacy Practice
Kynlon Phillips, Frank Cirrone, Tania Ahuja, Justin Siegfried, John Papadopoulos
Objective Patients with acute myelogenous leukemia or myelodysplastic syndrome undergoing induction chemotherapy are at increased risk of invasive fungal infection due to prolonged, severe neutropenia. Due to this risk, national guidelines recommend invasive fungal infection prophylaxis in this population until the resolution of neutropenia. Although posaconazole has demonstrated superiority over fluconazole and itraconazole, there is limited evidence for voriconazole for invasive fungal infection prophylaxis in this population...
October 14, 2018: Journal of Oncology Pharmacy Practice
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