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Journal of Oncology Pharmacy Practice

Varinder Kaur, Arjun Swami
Mantle cell lymphoma accounts for 5-7% of all non-Hodgkin's lymphomas. Under the current WHO classification, it is categorized as an indolent B cell lymphoma, but has an aggressive clinical course. New insights into leukemogenic molecular pathways of mantle cell lymphoma have uncovered unique therapeutic targets. Ibrutinib, a Bruton's tyrosine kinase inhibitor, is the newest drug in the arsenal that has shown promising efficacy in relapsed mantle cell lymphoma. Long-term studies have shown that grade 3 or 4 adverse events are infrequent...
April 2017: Journal of Oncology Pharmacy Practice
Constantin A Dasanu, Tiffany Jen, Ryszard Skulski
While an important agent in the contemporary anti-melanoma armamentarium, ipilimumab is associated with serious immune reactions including late immune-mediated side effects. Recently, a case of late-onset acute pericarditis with tamponade was reported at 12 weeks after the last dose of ipilimumab. While polyarthralgia rheumatica has been previously documented with ipilimumab, we were not able to find any reports of recurrent monoarthritis with the use of this agent. Therefore, we present herein a unique case featuring a patient with late-onset autoimmune pleuropericarditis leading to cardiac tamponade at 24 weeks post-ipilimumab and recurrent late immune knee arthritis at 8 and 32 weeks, respectively...
April 2017: Journal of Oncology Pharmacy Practice
Krista G Ramirez, Marla D Koch, William J Edenfield
Irinotecan-induced dysarthria has been reported in the literature, but the underlying mechanism of this neurotoxicity remains unclear. Here, we present a 35-year-old female with metastatic colon cancer who experienced dysarthria during irinotecan infusion. Her symptoms were decreased and eventually eliminated with subsequent increases in infusion time. When the patient returned to original 90 min infusion time, symptoms were significantly reduced in both severity and duration as compared to the first infusion...
April 2017: Journal of Oncology Pharmacy Practice
Brian S Bogdanowicz, Matthew A Hoch, Megan E Hartranft
Purpose The approval history, pharmacology, pharmacokinetics, clinical trials, efficacy, dosing recommendations, drug interactions, safety, place in therapy, and economic considerations of gefitinib are reviewed. Summary Lung cancer is one of the most commonly diagnosed cancers and is the leading cause of cancer death. Platinum-based chemotherapy and tyrosine kinase inhibitors, such as erlotinib and afatinib, are recommended therapies for nonsmall cell lung cancer. The European Medicines Association based their approval of gefitinib on the randomized, multicenter Iressa Pan-Asia Study (IPASS, NCT00322452) and a single-arm study showing effectiveness in Caucasians (IFUM, NCT01203917)...
April 2017: Journal of Oncology Pharmacy Practice
Yi Qian, Jorge Arellano, Debajyoti Bhowmik, Erin Thomson, David M Smith, Guy Hechmati, Xue Song
Introduction During cancer progression, more than half of patients develop renal insufficiency, including chronic kidney disease. The primary and secondary objectives of this study were to estimate healthcare resource use and costs, respectively, associated with renal impairment in patients with bone metastases from solid tumors in the United States. Methods and materials This was a retrospective, observational cohort study conducted using administrative claims data for individuals with solid tumors and bone metastases...
April 2017: Journal of Oncology Pharmacy Practice
Lisa M Holle, Christy S Harris, Alexandre Chan, Rebecca J Fahrenbruch, Bonnie A Labdi, Jocelyn E Mohs, Leann B Norris, Janelle Perkins, Cory M Vela
Background Oncology pharmacists are capable of providing medication therapy management (MTM) because of their level of training, practice experiences, and responsibilities. Very little data exist about their current practice, including changing roles in the multidisciplinary team, overall impact, and effects in the education of patients and healthcare professionals. Methods A 70-item survey about oncology pharmacists' activities in oral chemotherapy programs, MTM, and collaborative practice agreements (CPAs) was deployed using a web survey tool (Qualtrics, Provo, UT, USA), targeting pharmacist members of American College of Clinical Pharmacy (ACCP) Hematology/Oncology Practice and Research Network (PRN)...
April 2017: Journal of Oncology Pharmacy Practice
Peter M Campbell, Cindy Ippoliti, Sapna Parmar
The incidence of venous thromboembolism is greater among cancer patients than the general patient population, with recurrence rates also much higher in patients with cancer diagnoses. Patients with hematologic malignancies often experience prolonged periods of thrombocytopenia throughout their disease course, making therapeutic anticoagulation a challenge. We describe 13 cases of patients with hematologic malignancies that were therapeutically anticoagulated with either low-molecular-weight heparin or unfractionated heparin during periods of severe thrombocytopenia (platelet counts < 50 × 10(9)/µL)...
April 2017: Journal of Oncology Pharmacy Practice
Prakirthi Yerram, Shraddha Kansagra, Osama Abdelghany
Background Denosumab therapy is commonly used for the prevention of skeletal-related events in patients with bone metastasis. However, a common side effect of denosumab is hypocalcemia. Objective The aim of the study is to determine the incidence of hypocalcemia in patients receiving denosumab for prevention of skeletal-related events in bone metastasis and evaluate risk factors for developing hypocalcemia. Methods This was a retrospective medication use evaluation reviewing the incidence of hypocalcemia in patients receiving outpatient denosumab for prevention of skeletal-related events at Yale-New Haven Hospital...
April 2017: Journal of Oncology Pharmacy Practice
Shebli Atrash, Issam Makhoul, Jason S Mizell, Laura Hutchins, Fade Mahmoud
Immune therapy with checkpoint inhibitors has revolutionized the management of metastatic melanoma. Ipilimumab, nivolumab, and pembrolizumab are all FDA-approved immune checkpoint inhibitors to treat metastatic melanoma. Responses to immune checkpoint inhibitors are usually delayed. An interim progression on restaging computed tomography scans "pseudo-progression" may be observed before response to treatment occur. In this case, we report a significant interim progression of metastatic mucosal melanoma before meaningful responses to immunotherapy occurred...
April 2017: Journal of Oncology Pharmacy Practice
Jana Reynolds, April Chamberland-Tremblay, Jon D Herrington, Yolanda Munoz Maldonado, Lucas Wong
Background In response to the national leucovorin shortage in 2008, our institution adjusted the modified FOLFOX6 (leucovorin, fluorouracil, and oxaliplatin) protocol to utilize a lower dose of leucovorin (20 mg/m(2)). This adjustment was based on prospective studies suggesting that lower doses of leucovorin may be equally effective in other fluorouracil containing regimens. This retrospective study evaluates outcomes in metastatic colorectal cancer (mCRC) patients treated with low- (20 mg/m(2)) vs. high-dose (400 mg/m(2)) leucovorin in the FOLFOX6 regimen for mCRC...
April 2017: Journal of Oncology Pharmacy Practice
Brandon R Shank, Amy H Seung, Katharine Kinsman, Matthew J Newman, Ross C Donehower, Bradley Burton
Purpose As a result of the leucovorin shortage, we switched from BSA-adjusted to low fixed-dose leucovorin in patients with colon cancer receiving fluorouracil-containing therapy. Methods A retrospective, pilot study of adults receiving intravenous leucovorin as part of a fluorouracil-containing treatment was conducted including individuals with stage II or III colon or newly diagnosed metastatic colorectal cancer. One low fixed-dose (leucovorin 50 mg) patient was matched by the investigator to one BSA-adjusted (leucovorin 200-500 mg/m(2)/dose) patient on disease stage and age...
April 2017: Journal of Oncology Pharmacy Practice
M G Rajanandh, S Suresh, K Manobala, R Nandhakumar, G Jaswanthi, S Neha
Objective Despite the fact that cancer and heart diseases are interconnected, there is lack of information about the prevalence of cardiovascular risk in cancer patients in the South Indian population. With this background, the present study sought to predict the cardiovascular disease in cancer patients. Methods A prospective, cross-sectional study was conducted in the Department of Medical Oncology, Sri Ramachandra University and Hospital, India. Patients' demographic details, medical information, height, weight, body mass index, blood pressure, total cholesterol and HDL-cholesterol were measured...
January 1, 2017: Journal of Oncology Pharmacy Practice
M Crul, K Simons-Sanders
Background To prevent occupational exposure of hospital staff to cytostatics, a mandatory national guideline describing a set of safety measures was issued in the Netherlands in 2004. The guideline includes, among other directives, obligatory annual wipe testing to assess the efficacy of the local cleaning protocol. Full implementation of this guideline was executed in all Dutch hospital pharmacies over the next couple of years. Objective We aimed to investigate the effect of the national guideline on contamination levels, and specifically on the phenomenon of carry-over of traces of antineoplastic drugs through contact with surfaces, since this is a potential route of exposure...
January 1, 2017: Journal of Oncology Pharmacy Practice
Constantin A Dasanu, Juliana A Argote, Scott M Lippman, Steven C Plaxe
While therapy with epidermal growth factor receptor inhibitors leads to meaningful clinical responses in several tumor types, it has also been linked with perplexing toxic effects. Skin effects of these agents such as generalized papulo-pustular rash, trichomegaly, fingertip fissures, xerosis, pruritus and paronichias are now well characterized. Though uncommon, nail atrophic changes have also been described in subjects treated with these classes of agents. We describe herein unusual longitudinal thumbnail fissures caused by erlotinib therapy for metastatic lung cancer...
January 1, 2017: Journal of Oncology Pharmacy Practice
Constantin A Dasanu, David M Hyams, Frank J Senatore
Paclitaxel has been linked with a number of immunosuppressive effects such as decreased numbers and activity of dendritic cells, NK-cells and monocytes, which may in turn lead to defective T-cell activation. In addition, this agent was shown to cause mitotic arrest resembling high-grade dysplasia throughout the gastrointestinal tract, including the appendix. We have previously documented a series of lung cancer patients who developed pre-malignant colonic polyps and/or colon cancer either during or weeks following chemotherapy with paclitaxel, suggesting a potential role of this agent in their pathogenesis...
January 1, 2017: Journal of Oncology Pharmacy Practice
Michael Del Rosario, Henry Tsai, Constantin A Dasanu
Primary myelofibrosis is characterized by bone marrow fibrosis, splenomegaly and presence of JAK-2 V617F mutation in more than 90% of patients. Ruxolitinib is a Janus kinase inhibitor used for the treatment of primary myelofibrosis. We describe herein a persistent foot ulcer development attributed to ruxolitinib therapy. We are unaware of any previous reports of this phenomenon in the scientific literature. A thorough examination of the lower extremities is perhaps necessary before initiating this oral agent...
January 1, 2017: Journal of Oncology Pharmacy Practice
Michio Kimura, Eiseki Usami, Hitomi Teramachi, Tomoaki Yoshimura
Introduction Weekly paclitaxel (PTX), irinotecan (CPT-11) and ramucirumab plus paclitaxel (Ram + PTX) are currently recommended as the standard second-line or later chemotherapies for advanced and recurrent gastric cancer. This study aims to compare the cost-effectiveness of using Ram + PTX vs. PTX or CPT-11. Furthermore, we investigated the safety and treatment continuity of Ram + PTX in Japan. Methods Expected costs were calculated based on data from patients with advanced and recurrent gastric cancer who were treated with PTX, CPT-11 and Ram + PTX...
January 1, 2017: Journal of Oncology Pharmacy Practice
Erin B Bailey, Joseph Merriman, Benjamin Maughan, Austin Poole, Srinivas K Tantravahi, Archana M Agarwal, Julia A Batten, Shiven B Patel, Sumanta K Pal, David D Stenehjem, Neeraj Agarwal
Purpose Hand-foot syndrome is a common dose limiting toxicity of vascular endothelial growth factor receptor tyrosine kinase inhibitors used for treatment of patients with metastatic renal cell carcinoma. The effect of treatment dose reductions, in the context of hand-foot syndrome, on survival outcomes is reported. Methods This was a retrospective case series of patients receiving vascular endothelial growth factor receptor tyrosine kinase inhibitors from 1 January 2004 to 31 October 2013. The main outcomes were progression-free and overall survival in these patients experiencing hand-foot syndrome and undergoing treatment dose reductions...
January 1, 2017: Journal of Oncology Pharmacy Practice
Jacob K Kettle, Puja B Patel
Purpose Denosumab is a crucial supportive care agent for patients with advanced cancers affecting the bone. Despite the importance of treatment, logistical and financial obstacles hinder the ability to maintain long-term adherence. This analysis was designed to provide preliminary data regarding the feasibility of extended denosumab dosing intervals. Methods This retrospective, case cohort study was conducted on patients receiving treatment with denosumab for malignancies with bone involvement. A total of 60 patients were identified for analysis and were divided into cohorts according to the average number of days between denosumab doses...
January 1, 2017: Journal of Oncology Pharmacy Practice
Anupama Divakaruni, Elizabeth Saylor, Alison P Duffy
Rationale Oral anticancer medication adherence is a critical factor in optimizing cancer treatment outcomes and minimizing toxicity. Although potential adherence barriers exist, it is not well understood how these factors impact adherence. Methods This is a prospective, single-center, patient survey-based study conducted at the University of Maryland Greenebaum Comprehensive Cancer Center including 18- to 39-year-old patients who have been actively taking an oral anticancer medication for at least one month from 1 April 2013 to 1 April 2016...
January 1, 2017: Journal of Oncology Pharmacy Practice
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