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Journal of Oncology Pharmacy Practice

Meghan Lynch
Whole brain radiotherapy is the mainstay of treatment for patients suffering from stage IV malignancies that have metastasized to the brain. Although this therapy is often effective at reducing tumor size and burden, it is associated with a spectrum of toxicities that often result in irreversible cognitive decline. Various drug and non-drug therapies have been evaluated to treat this neurotoxicity after whole brain radiotherapy is administered; however, currently available options have shown little benefit or come with side effects themselves that may outweigh the benefits of their use...
September 10, 2018: Journal of Oncology Pharmacy Practice
Kathy Vu, Philip Emberley, Erika Brown, Rick Abbott, Justin Bates, Venetia Bourrier, Kathryn Djordjevic, Julie Greenall, Mova Leung, Mark Pasetka, Louise Paquet, Heather Logan
Purpose To create a set of consensus-based and evidence-informed recommendations to provide guidance around the safe dispensing and handling of oral anti-cancer drugs in low-volume settings unique to the community pharmacy setting. Methods A review of published and grey literature (published in non-commercial domains such as national organizations and associations) documents and nine key informant interviews were conducted and a modified Delphi approach was taken to achieve consensus. The final list of 47 candidate recommendations was reviewed by a task force and validated by multi-disciplinary stakeholders...
September 10, 2018: Journal of Oncology Pharmacy Practice
Hassam Baig, Barbara Somlo, Melissa Eisen, Scott Stryker, Mark Bensink, Phuong K Morrow
Objective Inappropriate granulocyte colony-stimulating factor use with myelosuppressive chemotherapy has been reported. Using the Oncology Services Comprehensive Electronic Records electronic medical record database, prophylactic granulocyte colony-stimulating factor (pegfilgrastim/filgrastim) use in cancer patients was assessed by febrile neutropenia risk level. Methods Patients with nonmetastatic or metastatic breast, head/neck, colorectal, ovarian/gynecologic, lung cancer, or non-Hodgkin's lymphoma who received myelosuppressive chemotherapy from June 2013 to May 2014 were included...
September 10, 2018: Journal of Oncology Pharmacy Practice
Guy Van Schandevyl, Tiene Bauters
Thiotepa, a highly lipophilic, alkylating agent, and/or its active metabolites may be excreted in part via skin in patients receiving high-dose therapy. We present a case of cutaneous toxicity observed in a 4.5-year-old girl patient with medulloblastoma treated with a high-dose thiotepa conditioning regimen before autologous stem cell transplantation. Skin lesions, as well as their pattern and locations, were evocative of thiotepa toxidermia. After the case herein described, preventive care guidelines were implemented in our unit as from 2014...
September 5, 2018: Journal of Oncology Pharmacy Practice
Hidetaka Suzuki, Shinya Suzuki, Hayato Kamata, Yuka Sugama, Ken Demachi, Kiwako Ikegawa, Takashi Igarashi, Masakazu Yamaguchi
Background Collaboration between pharmacists, doctors, and nurses in outpatient treatment is beneficial; however, such services are limited in Japan due to the lack of a healthcare reimbursement fee for outpatient pharmacy services at outpatient clinic. Objective We evaluated the impact of a service in which clinical pharmacists collaborated with an oncologist at an outpatient clinic in the treatment of adverse drug reactions in outpatient cancer chemotherapy. Methods We performed a retrospective cohort study using patients' medical records and treatment diaries...
September 4, 2018: Journal of Oncology Pharmacy Practice
Christan M Thomas, Chung-Shien Lee
The brain is a common metastatic site in lung cancer. Approximately one-third of patients will develop brain metastases during the course of their disease. Median overall survival has been reported between 3 and 14.8 months in patients with brain metastases compared to other metastatic sites. In addition, the lifetime incidence of brain metastases is increasing due to prolonged survival seen in non-small cell lung cancer (NSCLC) patients due to new systemic therapies and improved neuro-imaging techniques. Several targeted therapies-such as tyrosine kinase inhibitors targeting epidermal growth factor receptors and anaplastic lymphoma kinase-are active in NSCLC and have data to suggested possible effectiveness against brain metastases in these patients...
September 4, 2018: Journal of Oncology Pharmacy Practice
Cristina Cuesta Grueso, Amparo Burgos San José, Gerardo Cajaraville Ordoñana, Jaime E Poquet Jornet, Irene Mangues Bafalluy, María S Díaz Carrasco
Objective To describe and analyze the variability in carboplatin dosing strategies in Spanish hospitals. Methods We designed a questionnaire consisting of 19 multiple-choice items structured in two sections (hospital characteristics and carboplatin dosing data). The questionnaire was sent by e-mail to all the oncology pharmacists included in the register of the Spanish Oncology Pharmacy Group (GEDEFO), and we analyzed the completed questionnaires. Results Response rate was 33.5% from a total of 185 pharmacy services invited to take part in the survey...
September 4, 2018: Journal of Oncology Pharmacy Practice
Hiu-Lok Wu
When encountering a hypersensitivity reaction to chemotherapy, a dilemma arises whether to continue the current regimen. In our institution, a standardized protocol has been developed. This study evaluated the effectiveness and safety of our rechallenge protocol in rechallenging patients with previous hypersensitivity reactions of grades 1 to 2 to paclitaxel, docetaxel, carboplatin and oxaliplatin. The protocol consisted of intensification of premedication and lengthening of infusion time. A retrospective review of electronic medical records was conducted...
September 4, 2018: Journal of Oncology Pharmacy Practice
Emily Wang, Anna S Jan, Vi P Doan, Jill B Ferguson, Jason C Yeh
Background Currently, there are no prospective, randomized trials analyzing leflunomide for the treatment of cytomegalovirus infection or disease in allogeneic stem cell transplant patients. Objective The primary objective of this case series was to determine the clinical and virological responses of utilizing leflunomide as therapy for refractory cytomegalovirus infections, unresponsive to first-line therapy in allogeneic stem cell transplant patients. Additionally, patient and leflunomide specific characteristics were identified and determined in this descriptive case series...
August 31, 2018: Journal of Oncology Pharmacy Practice
Kristyn E Yemm, Laura M Alwan, A Bilal Malik, Lupe G Salazar
There is no preferred treatment option for metastatic breast cancer; therefore, treatment should provide palliation, prolong survival, control symptoms, and improve quality of life. Liposomal doxorubicin formulations have been shown to have less alopecia, nausea, vomiting, and myelosuppression than traditional doxorubicin, but more skin toxicities and infusion reactions. Prolonged use of liposomal doxorubicin may be associated with unrecognized or less well-defined toxicities. We report a case of acute kidney injury and progressively worsening chronic kidney disease necessitating dialysis in a patient who received prolonged therapy with liposomal doxorubicin for treatment of metastatic breast cancer...
August 31, 2018: Journal of Oncology Pharmacy Practice
Jenna M Solomon, Veronica B Ajewole, Amy M Schneider, Manvi Sharma, Eric H Bernicker
Purpose Although oral chemotherapy offers advantages over intravenous chemotherapy, it creates a unique set of challenges. Potential barriers include treatment complexity, patient responsibility for medication adherence and monitoring, reduced healthcare contact, and increased financial burden. The purpose of this study is to estimate the prevalence of drug-related problems among a sample of patients treated with oral chemotherapy agents. Methods A single-center, retrospective chart review was conducted on patients prescribed oral chemotherapy at our institution between 1 January 2017 and 31 August 2017...
August 31, 2018: Journal of Oncology Pharmacy Practice
Mohammad Solduzian, Saeed Anvari, Hamidreza Taghvaye Masoumi, Farhad Shahi, Zahra Jahangard-Rafsanjani
Background Severe hypersensitivity reaction is a dangerous adverse drug reaction in patients receiving cetuximab. It requires drug discontinuation and medical management. Case description A 48-year-old man, previously diagnosed with metastatic colorectal cancer, was admitted for therapy continuation. During the first infusion of cetuximab, the patient experienced acute signs of hypersensitivity reactions. The treatment team decided to administer cetuximab employing the desensitization protocol. Conclusions This study reports a severe hypersensitivity reaction to cetuximab in an adult patient with colorectal cancer...
August 24, 2018: Journal of Oncology Pharmacy Practice
Shizuo Machida, Shigeki Matsubara, Hiroyuki Fujiwara, Yuji Takei
No abstract text is available yet for this article.
August 23, 2018: Journal of Oncology Pharmacy Practice
M Alexandra Schickli, Michael J Berger, Maryam Lustberg, Marilly Palettas, Craig A Vargo
Purpose The management of endocrine therapy resistance is one of the most challenging facets of advanced breast cancer treatment. Palbociclib is an inhibitor of cyclin-dependent kinases 4 and 6 approved for the treatment of hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced or metastatic breast cancer in combination with fulvestrant in postmenopausal women with disease progression following endocrine therapy. However, treatment responsiveness of tumors to palbociclib after multiple lines of endocrine therapy is not clearly established...
August 22, 2018: Journal of Oncology Pharmacy Practice
Abdulkerim Yıldız, Hacer Ba Öztürk, Murat Albayrak, Çiğdem Pala, Osman Şahin, Senem Maral, Harika Okutan
Background Prophylaxis is strongly recommended in patients with hematological malignancy who are usually at higher risk for infection and neutropenic fever. It is still unclear whether or not there is a definite need for antimicrobial prophylaxis in intermediate-risk hematology patients such as those with lymphoma. Methods A retrospective analysis was made of patients admitted from January 2009 to December 2017 to the Hematology Department of Diskapi Yildirim Beyazit Training and Research Hospital, a tertiary referral hospital in Ankara, Turkey...
August 22, 2018: Journal of Oncology Pharmacy Practice
Marine Deppenweiler, Marc Debled, Jean-Luc Robquin, Barbara Lortal-Canguilhem
Trastuzumab is a monoclonal antibody used to treat human epidermal growth receptor 2 positive (HER2+) breast cancers either by itself or in combination with other chemotherapy medication. Marketing authorization was granted for a subcutaneous form of the antibody in 2014. In this case report, we discuss our experience with a patient who took part in a therapeutic education program on self-administration of trastuzumab. We demonstrate that these types of self-administered injections are not only possible but also are toxicity-free...
August 20, 2018: Journal of Oncology Pharmacy Practice
Maria Teresa Bejarano Varas, Scott Gould, Marjory Charlot
The emergence of oral targeted therapy in the management of non-small cell lung cancer with targetable oncogenes has led to significant improvements in progression-free survival, toxicity profile, and quality of life compared to intravenous chemotherapy. However, patients unable to swallow or with exclusive enteral feeding are left without alternative formulations for these targeted therapies given their availability only in tablet or capsule formulations. We report a case of a woman with metastatic anaplastic lymphoma kinase-positive non-small cell lung cancer who was unable to swallow and was successfully treated with an oil-based alectinib liquid suspension...
August 19, 2018: Journal of Oncology Pharmacy Practice
Tyler Beardslee, Amber Draper, Ragini Kudchadkar
Immunotherapy treatments in oncology have garnered much attention and use throughout the past several years. With increased use and new approvals in many different types of solid tumors and hematological malignancies, practitioners in oncology should have an appreciation and understanding of the potential adverse effects of these unique treatment approaches. The most common adverse effects with immunotherapy treatment are immune-related adverse effects with activation of patients' immune systems against a wide array of tissues and organ systems...
August 19, 2018: Journal of Oncology Pharmacy Practice
Andrew R Zullo, Uvette Lou, Sarah E Cabral, Justin Huynh, Christine M Berard-Collins
Introduction Guidelines recommend pegfilgrastim for primary prophylaxis of febrile neutropenia after highly myelosuppressive chemotherapy. While deviations from guidelines could result in overuse and increased costs, underuse is also a concern and could compromise quality of care. Our objectives were to evaluate guideline adherence and quantify the extent to which physician heterogeneity may influence pegfilgrastim use. Methods We randomly sampled 550 patients from a retrospective cohort of those who received infusions at an academic cancer center between 1 September 2013 and 1 September 2014...
August 19, 2018: Journal of Oncology Pharmacy Practice
Roland Coppens, Johanna Yang, Sunita Ghosh, John Gill, Carole Chambers, Jacob C Easaw
Background Cotrimoxazole is associated with the development of hyponatremia, hyperkalemia and elevated serum creatinine, especially when combined with inhibitors of the renin-angiotensin-aldosterone system (RAAS). Pneumocystis jirovecii pneumonia (PJP) prophylaxis is the standard of care for high-grade glioma (HGG) patients receiving temozolomide concurrently with radiotherapy, low-dose cotrimoxazole being the preferred agent. Many of these patients are also taking renin-angiotensin-aldosterone system inhibitors, however the risk of significant laboratory disturbance in these patients remains undescribed...
August 19, 2018: Journal of Oncology Pharmacy Practice
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