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Journal of Oncology Pharmacy Practice

Donald C Moore, Gary Neal McVey
PURPOSE: To evaluate the potential cost savings incurred from a policy to round doses of bevacizumab to the nearest vial size. Secondarily, to determine differences in rates of adverse events between patients who had their doses rounded up compared with those who had doses rounded down. METHODS: This study is a retrospective chart review of all patients who received at least one rounded dose of bevacizumab over a period of 22 months. Doses of bevacizumab were calculated based on actual body weight...
October 19, 2016: Journal of Oncology Pharmacy Practice
Luis Ramudo Cela, Jesús Balea Filgueiras, José Ramón Vizoso Hermida, Isabel Martín Herranz
Abiraterone acetate is a potent and irreversible inhibitor of cytochrome p450 17A1 that suppresses androgen synthesis. It is approved for chemotherapy-naive and docetaxel-treated patients with metastatic castration-resistant prostate cancer. We describe the protocol for use of abiraterone in metastatic castration-resistant prostate cancer chemotherapy naive patients has been implanted in our centre and we review the cases of those patients whose adverse effects have forced the discontinuation of treatment. The side effects fit the safety profile of abiraterone, speed of their appearance and severity indicate that you should perform a thorough follow-up of these patients especially in the early phases of treatment...
October 16, 2016: Journal of Oncology Pharmacy Practice
Trang H Au, Courtney C Cavalieri, David D Stenehjem
Clinical pharmacists are important contributors to the care of patients with cancer; it is therefore critical for oncology clinical pharmacists to stay current with new anticancer therapies. This review summarizes the epidemiology and pathogenesis of non-small cell lung cancer, including the most common genetic alterations, as well as the mechanism of action, clinical development, pharmacodynamics and pharmacokinetics of the anaplastic lymphoma kinase inhibitor ceritinib for the treatment of patients with anaplastic lymphoma kinase-positive non-small cell lung cancer...
October 13, 2016: Journal of Oncology Pharmacy Practice
Brandon Battis, Linda Clifford, Mostaqul Huq, Edrick Pejoro, Scott Mambourg
OBJECTIVES: Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve...
October 12, 2016: Journal of Oncology Pharmacy Practice
Zachary T Rivers, Drew R Oostra, James S Westholder, Gregory M Vercellotti
BACKGROUND: Romidepsin is a novel histone deacetylase inhibitor that is approved for the treatment of cutaneous and peripheral T-cell lymphoma in patients who have had at least one prior therapy. Romidepsin is generally well tolerated, though it comes with a risk of cardiac toxicities. OBJECTIVE: We report a case of electrocardiogram changes in a 64-year-old male with enteropathy-associated T-cell lymphoma, type 2, treated with salvage romidepsin therapy who relapsed after non-myeloablative allogeneic sibling peripheral blood stem cell transplant...
October 5, 2016: Journal of Oncology Pharmacy Practice
Laura A Randolph, Cheri K Walker, Ann T Nguyen, Subi R Zachariah
OBJECTIVE: To provide a foundation to justify the presence of a full-time clinical pharmacist in the ambulatory cancer center in addition to an existing centralized pharmacist through cost avoidance calculation and patient and staff satisfaction surveys. METHODS: The prospective, pilot study took place in an ambulatory cancer center over four weeks in 2014. Cost avoidance values were assigned to interventions performed by a pharmacy resident, who was present in the ambulatory cancer center during clinic hours, along with a centralized oncology pharmacist routinely working with the cancer center...
September 27, 2016: Journal of Oncology Pharmacy Practice
Michael Leung, Kaitlin Highsmith, Amber Rexwinkle
Myelofibrosis is a BCR-ABL-negative myeloproliferative neoplasm characterized by abnormal hematopoiesis. Alterations to the Janus kinase-signal transducer and activator of transcription pathway result in dysregulation of gene transcription and cell proliferation. Patients with symptomatic myelofibrosis present with a variety of signs and symptoms including, but not limited to myelosuppression, marked splenomegaly, abdominal discomfort, fatigue, and blood transfusion-dependence. Traditional myelosuppressive therapies including hydroxyurea, azacitidine, and cladribine aim to reduce constitutional symptoms and control the burden of disease...
September 26, 2016: Journal of Oncology Pharmacy Practice
González G Jonathan, Alonso Á Beatriz, Gloria Julia Nazco C, Batista L Norberto, Gutiérrez N Fernando
INTRODUCTION: The use of trastuzumab with a fluoropyrimidine and platinum compound is currently the standard first-line treatment of patients with metastatic HER2-positive gastric cancer, but it appears that serum levels of trastuzumab determine the clinical effectiveness of this treatment, affecting progression-free survival and overall survival. CASE REPORT: We report the case of a patient with metastatic HER2-positivegastric cancer, receiving XELOX (fluoropyrimidine and oxaliplatin) plus trastuzumab at standard doses, who presented sub-therapeutic serum levels during the first two treatment cycles and rapid disease progression (progression-free survival = 5...
September 23, 2016: Journal of Oncology Pharmacy Practice
Lindsay A Edmondson, Leticia V Smith, Alka Mallik
The programmed-death-1 inhibitors selectively block programmed-death-1 interaction with its receptor, which restores active T-cell response directed at tumor cells, inducing an anti-tumor effect. This nonspecific activation of the immune system can also lead to a wide spectrum of side effects. Nivolumab has been used effectively to prolong survival in patients with metastatic melanoma and is recommended as a category 1 agent for systemic therapy in metastatic or unresectable melanoma per the National Comprehensive Cancer Network guidelines...
September 8, 2016: Journal of Oncology Pharmacy Practice
Mildred Vicente, Mohammad Al Nahedh, Sandeep Parsad, Randall W Knoebel, Jennifer Pisano, Natasha N Pettit
OBJECTIVES: Febrile neutropenia management guidelines recommend the use of vancomycin as part of an empiric antimicrobial regimen when specific criteria are met. Often, vancomycin use among patients with febrile neutropenia is not indicated and may be over utilized for this indication. We sought to evaluate the impact of implementing a febrile neutropenia clinical pathway on empiric vancomycin use for febrile neutropenia and to identify predictors of vancomycin use when not indicated...
September 8, 2016: Journal of Oncology Pharmacy Practice
Sana Qureshi, Ryan B Elliott, Jon D Herrington
Bevacizumab is an important component in the treatment of metastatic colorectal cancer when used with 5-fluorouracil, leucovorin and oxaliplatin or irinotecan. As a molecular target agent, it is considered to be less toxic than traditional chemotherapy; however, bevacizumab has been shown to cause serious, life-threatening adverse effects. The following report describes a case of bevacizumab-associated pulmonary embolism with simultaneous gastrointestinal perforation in a patient with stage IV adenocarcinoma of the descending colon...
September 7, 2016: Journal of Oncology Pharmacy Practice
Belal Firwana, Rahul Ravilla, Mihir Raval, Laura Hutchins, Fade Mahmoud
Immunotherapy with checkpoint inhibitors has revolutionized the management of metastatic melanoma. These checkpoints, namely the cytotoxic T lymphocyte antigen 4 and the programmed T cell death 1 receptor, possess an inhibitory effect on the T cell function. Pharmacologic inhibition of cytotoxic T lymphocyte antigen 4 with ipilimumab and programmed T cell death 1 with either pembrolizumab or nivolumab has resulted in long-term sustained responses among patients with metastatic melanoma. The adverse events of these medications are predominantly immune related...
September 2, 2016: Journal of Oncology Pharmacy Practice
Anastasia Finn, Carolyn Bondarenka, Kathy Edwards, Rebekah Hartwell, Cathy Letton, Andy Perez
BACKGROUND: With the ever growing arsenal of oral chemotherapy agents now available, cancer treatment is being increasingly managed in the outpatient setting. However, oral chemotherapy use is often associated with several potential obstacles and complications. In order to provide optimal patient safety and oral chemotherapy monitoring, our institution implemented an oral chemotherapy program managed by clinical pharmacists electronically through Epic Beacon. OBJECTIVE: To describe implementation of a novel pharmacist-managed oral chemotherapy program and evaluate pharmacist interventions before and after implementation of an oral chemotherapy program...
August 29, 2016: Journal of Oncology Pharmacy Practice
Ricardo S Kuchenbecker, Daniel M Mota
BACKGROUND: Brazil recently approved synthetic phosphoetanolamine, a popularly dubbed 'cancer pill', a substance that has been shown to kill cancer cells in lab animal models but was not yet formally accessed in humans, and thus despite the existence of any evidence of its efficacy and safety. METHODS: The authors describe the recent decision of Brazil to aprove phosphoetanolamine in the context of growing 'judicialization' to promote access to medicines and thus reinforcing a growing sense of legal uncertainty...
August 26, 2016: Journal of Oncology Pharmacy Practice
Varinder Kaur, Arjun Swami, Atrash Shebli, Sara Shalin, Muthu Veeraputhiran, Peter Emanuel, Yogesh Jethava
Blastic plasmacytoid dendritic cell neoplasm is rare myeloid malignancy clinically characterized by non-pruritic, violaceous and papulo-nodular skin lesions, together with bone marrow and lymph node involvement. Histologically, there is infiltration of dermis by neoplastic mono-nuclear CD4, CD56, CD123 co-expressing cells with epidermal sparing. Most commonly blastic plasmacytoid dendritic cell neoplasm presents as a de-novo condition, and treatment-related blastic plasmacytoid dendritic cell neoplasm is a rare phenomenon...
August 24, 2016: Journal of Oncology Pharmacy Practice
Jennifer S Steward, Heather M Bullard, Timothy J O'Rourke, Alan D Campbell, Brett T Brinker, Kathleen J Yost, Amy C Vanderwoude, William L Scott, Polly E Kintzel
PURPOSE: Grade ≥3 adverse effects prolong hospitalization and reduce chemotherapy dose intensity. The purpose of this study was to evaluate the rate and severity of high-dose methotrexate-related acute kidney injury and analyze its effect on hospital length of stay and relative chemotherapy dose intensity. METHODS: This was a retrospective cohort analysis. Patients receiving ≥1 dose of high-dose methotrexate were analyzed for acute kidney injury and length of stay...
August 19, 2016: Journal of Oncology Pharmacy Practice
Saeed K Alzghari, Susan E Seago, Christian T Cable, Jon D Herrington
High-dose cytarabine is recommended for re-induction chemotherapy in patients less than 60 years of age with acute myelogenous leukemia. This case describes a patient receiving high-dose cytarabine for re-induction and subsequently developed tingling and numbness in her hands and feet followed by severe pain, swelling, and erythema consistent with a diagnosis of palmar-plantar erythrodysesthesia. Furthermore, the patient's hemoglobin, platelets, and neutrophils did not recover after over 30 days post high-dose cytarabine...
August 16, 2016: Journal of Oncology Pharmacy Practice
Florentine Mv Rompelman, Adrianus Aj Smit, Eric Jf Franssen, Mirjam Crul
BACKGROUND: Lung cancer patients have a high risk for drug-drug interactions, as they use numerous types of concomitant medicines including antineoplastic agents, cancer treatment co-medication, and medicines aimed at several types of comorbidities. OBJECTIVE: The primary objective of this study is to determine the incidence and the clinical relevance of the drug-drug interactions between antineoplastic agents and regular medication used by lung cancer patients...
August 16, 2016: Journal of Oncology Pharmacy Practice
Ayberk Yenilmez, Annette P Hood, Lien H Nguyen, Man Y Merl
PURPOSE: To evaluate and compare the rate of hypersensitivity reactions between two low-dose steroid pre-medication regimens for paclitaxel-based treatments. METHODS: This was a single-center, retrospective, descriptive study, comparing the incidence of hypersensitivity reactions in two different dexamethasone pre-medication regimens that took place between July 2013 to December 2014. Patients who were paclitaxel-naïve with a diagnosis of breast or gynecological cancers were included...
August 16, 2016: Journal of Oncology Pharmacy Practice
Ma Ángeles Fernández de Palencia Espinosa, Ma Sacramento Díaz Carrasco, Andrés Sánchez Salinas, Amelia de la Rubia Nieto, Alberto Espuny Miró
BACKGROUND: Frequently, haematological patients undergo highly complex and intensive treatment protocols, so a high risk of drug-drug interactions could be expected. OBJECTIVES: To determine prevalence of clinically relevant drug-drug interactions, to identify the most frequent drug-drug interactions and associated risk factors. METHODS: A prospective, observational and descriptive study was carried out from November 2012 to February 2013...
August 10, 2016: Journal of Oncology Pharmacy Practice
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