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Damodar G, Smitha T, Gopinath S, Vijayakumar S, Rao Y. An evaluation of hepatotoxicity in breast cancer patients receiving injection Doxorubicin. Ann Med Health Sci Res 2014; 4:74-9. [PMID: 24669335 PMCID: PMC3952301 DOI: 10.4103/2141-9248.126619] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Hepatic dysfunction in the cancer unit has a significant impact on patient outcomes. The therapeutic application of anthracycline antibiotics are limited by side-effects mainly myelosuppression, chronic cardiotoxicity, and hepatotoxicity. AIM To assess the risk of Hepatotoxicity in breast cancer patients receiving Inj. Doxorubicin. SUBJECTS AND METHODS The investigation was a prospective study that was conducted in cancer patients receiving Inj. Doxorubicin doses of 50 mg/m(2), and 75 mg/m(2) at a South Indian tertiary care hospital. Sample collection was carried out from pre-chemotherapy to 4(th) cycle. Serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), direct bilirubin and total bilirubin were assessed to determine hepatotoxicity. Data were analyzed using unpaired t-test, Pearson correlation using Graph-Pad Prism version 5.00 for Windows, Graph-Pad Software, San Diego, California, USA, www.graphpad.com. RESULTS Breast cancer patients comprised 37% (49/132) of the total female cancer patient population, of which 46 patients with a mean age of 46.6 (13.4) years were included and 30.4% (14/46) patients were developed hepatotoxicity. The mean standard deviation of SGOT, SGPT, direct bilirubin, total bilirubin in the pre-chemotherapy cycle to fourth chemotherapy cycle were found to be 21.97 (5.798) U/L and 181.3 (103.6) U/L, 23.17 (6.237) U/L and 147.6 (90.9) U/L, 0.1351 (0.1186) mg/dL and 0.5445 (0.4587) mg/dL, 0.3094 (1.346) mg/dL and 2.7163 (1.898) mg/dL simultaneously where P < 0.05 which were statistically significant. CONCLUSION There exist a strong correlation between the use of Inj. Doxorubicin and risk for developing hepatotoxicity. The health-care professionals dealing with breast cancer patients need to have awareness for hepatotoxicity with the use of Inj. Doxorubicin therapy.
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Affiliation(s)
- G Damodar
- Department of Pharmacy Practice, Vaagdevi College of Pharmacy, Kakatiya University, Warangal, Andhra Pradesh, India
| | - T Smitha
- Department of Pharmacy Practice, Vaagdevi College of Pharmacy, Kakatiya University, Warangal, Andhra Pradesh, India
| | - S Gopinath
- Department of Pharmacy Practice, Vaagdevi College of Pharmacy, Kakatiya University, Warangal, Andhra Pradesh, India
| | - S Vijayakumar
- Department of Pharmacy Practice, Vaagdevi College of Pharmacy, Kakatiya University, Warangal, Andhra Pradesh, India
| | - Ya Rao
- Department of Oncology, Kakatiya Medical College, MGM Hospital, Warangal, Andhra Pradesh, India
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Rutledge MR, Waddell JA, Solimando DA. Carboplatin (renally dosed) and Etoposide regimen for small-cell lung cancer. Hosp Pharm 2014. [PMID: 24421475 DOI: 10.1310/hpj4804-274.test] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc, 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast.net; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net.
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Affiliation(s)
- Matthew R Rutledge
- Mr. Rutledge is Chief, Hematology-Oncology Pharmacy Service, Department of Pharmacy, Madigan Army Medical Center, Tacoma, Washington. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the US Department of the Army or the Department of Defense
| | - J Aubrey Waddell
- Mr. Rutledge is Chief, Hematology-Oncology Pharmacy Service, Department of Pharmacy, Madigan Army Medical Center, Tacoma, Washington. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the US Department of the Army or the Department of Defense
| | - Dominic A Solimando
- Mr. Rutledge is Chief, Hematology-Oncology Pharmacy Service, Department of Pharmacy, Madigan Army Medical Center, Tacoma, Washington. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the US Department of the Army or the Department of Defense
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103
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Yang J, Solimando DA, Waddell JA. Docetaxel and Cisplatin regimen for non-small-cell lung cancer. Hosp Pharm 2014; 48:550-7. [PMID: 24421519 DOI: 10.1310/hpj4807-550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr., President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@aol.com; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net.
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Affiliation(s)
- Jessie Yang
- Ms. Yang is a Doctor of Pharmacy candidate at the University of New England College of Pharmacy, Portland, Maine
| | - Dominic A Solimando
- Ms. Yang is a Doctor of Pharmacy candidate at the University of New England College of Pharmacy, Portland, Maine
| | - J Aubrey Waddell
- Ms. Yang is a Doctor of Pharmacy candidate at the University of New England College of Pharmacy, Portland, Maine
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104
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Porter CE, Waddell JA, Solimando DA. nab-Paclitaxel Plus Gemcitabine Regimen for Pancreatic Cancer. Hosp Pharm 2014; 49:18-22. [PMID: 24421558 DOI: 10.1310/hpj4901-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc, 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast.net; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net.
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Affiliation(s)
- Courtney E Porter
- Dr. Porter is a pharmacy practice (PGY1) resident at Blount Memorial Hospital, Maryville, Tennessee
| | - J Aubrey Waddell
- Dr. Porter is a pharmacy practice (PGY1) resident at Blount Memorial Hospital, Maryville, Tennessee
| | - Dominic A Solimando
- Dr. Porter is a pharmacy practice (PGY1) resident at Blount Memorial Hospital, Maryville, Tennessee
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105
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Sonbol MB, Rana V, Kenderian SS, Finnes H, Witzig TE. Therapeutic options for patients with lymphoma and liver dysfunction or failure during mechlorethamine shortage. Leuk Lymphoma 2013; 55:1815-21. [DOI: 10.3109/10428194.2013.828349] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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106
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Rosen GP, Nguyen HT, Shaibi GQ. Metabolic syndrome in pediatric cancer survivors: a mechanistic review. Pediatr Blood Cancer 2013; 60:1922-8. [PMID: 23913590 DOI: 10.1002/pbc.24703] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 07/02/2013] [Indexed: 12/18/2022]
Abstract
Pediatric cancer survivors have increased risk of obesity, hypertension, dyslipidemia, and type 2 diabetes, leading to premature cardiovascular disease (CVD). Multiple tissues that are involved in glucose homeostasis and lipid metabolism are adversely affected by chemotherapy. This review highlights the relevant tissue and molecular end-organ effects of therapy exposures and synthesizes the current understanding of the mechanisms underlying CVD risk in this vulnerable population. The review also approaches the topic from a developmental perspective, with the goal of providing a translational approach to identifying the antecedents of overt CVD among survivors of pediatric cancer.
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Affiliation(s)
- Galit P Rosen
- Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, Arizona; Department of Child Health, UA College of Medicine-Phoenix, Phoenix, Arizona
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107
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Chen AS, Solimando DA, Waddell JA. Gefitinib, Fluorouracil, Oxaliplatin, and Leucovorin (IFOX) Regimen for Colorectal Cancer. Hosp Pharm 2013; 48:905-11. [DOI: 10.1310/hpj4811-905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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108
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Abstract
Patients presenting in an immunocompromised state merit special consideration when being evaluated for fitness to undergo surgery. A variety of immunodeficient conditions and their respective therapies, including human immunodeficiency virus, cancer, and transplantation, exert numerous systemic effects that may lead to multiorgan dysfunction. Understanding the potential impact of these disease manifestations, and their proper evaluation, is essential in achieving optimal perioperative outcomes for these patients.
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Affiliation(s)
- Michael J Hannaman
- Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, B6/319 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-3272, USA.
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109
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Sahai SK. Perioperative assessment of the cancer patient. Best Pract Res Clin Anaesthesiol 2013; 27:465-80. [PMID: 24267552 DOI: 10.1016/j.bpa.2013.10.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 10/01/2013] [Accepted: 10/02/2013] [Indexed: 11/26/2022]
Abstract
The perioperative evaluation of patients with cancer differs from that of other patients in that the former may have received prior chemotherapy or radiation therapy. These cancer treatments have a wide range of side effects and complications that may affect patients' perioperative risks. The perioperative specialist who evaluates the cancer patient prior to surgery must be familiar with the effects of these treatments and their consequences for the major organ systems. The perioperative specialist must also be familiar with the natural history of cancer and have a basic understanding of how cancer affects the body. In this article, we review the perioperative concerns that are specific to the patient with cancer.
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Affiliation(s)
- Sunil Kumar Sahai
- The Internal Medicine Perioperative Assessment Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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110
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White BN, Waddell JA, Solimando DA. Mitomycin and Fluorouracil With Concurrent Radiation (FUMIR) Regimen for Anal Cancer. Hosp Pharm 2013; 48:464-9. [PMID: 24421505 PMCID: PMC3839500 DOI: 10.1310/hpj4806-464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2023]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc, 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@aol.com; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net.
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Affiliation(s)
- Brittany N White
- Dr. White is a pharmacy practice (PGY1) resident at Blount Memorial Hospital, Maryville, Tennesse
| | - J Aubrey Waddell
- Dr. White is a pharmacy practice (PGY1) resident at Blount Memorial Hospital, Maryville, Tennesse
| | - Dominic A Solimando
- Dr. White is a pharmacy practice (PGY1) resident at Blount Memorial Hospital, Maryville, Tennesse
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111
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Rutledge MR, Waddell JA, Solimando DA. Carboplatin (renally dosed) and Etoposide regimen for small-cell lung cancer. Hosp Pharm 2013; 48:274-9. [PMID: 24421475 PMCID: PMC3839449 DOI: 10.1310/hpj4804-274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc, 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast.net; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net.
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Affiliation(s)
- Matthew R Rutledge
- Mr. Rutledge is Chief, Hematology-Oncology Pharmacy Service, Department of Pharmacy, Madigan Army Medical Center, Tacoma, Washington. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the US Department of the Army or the Department of Defense
| | - J Aubrey Waddell
- Mr. Rutledge is Chief, Hematology-Oncology Pharmacy Service, Department of Pharmacy, Madigan Army Medical Center, Tacoma, Washington. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the US Department of the Army or the Department of Defense
| | - Dominic A Solimando
- Mr. Rutledge is Chief, Hematology-Oncology Pharmacy Service, Department of Pharmacy, Madigan Army Medical Center, Tacoma, Washington. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the US Department of the Army or the Department of Defense
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112
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Landier W, Armenian SH, Lee J, Thomas O, Wong FL, Francisco L, Herrera C, Kasper C, Wilson KD, Zomorodi M, Bhatia S. Yield of screening for long-term complications using the children's oncology group long-term follow-up guidelines. J Clin Oncol 2012; 30:4401-8. [PMID: 23091100 PMCID: PMC3515770 DOI: 10.1200/jco.2012.43.4951] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 08/22/2012] [Indexed: 01/10/2023] Open
Abstract
PURPOSE The Children's Oncology Group Long-Term Follow-Up (COG-LTFU) Guidelines use consensus-based recommendations for exposure-driven, risk-based screening for early detection of long-term complications in childhood cancer survivors. However, the yield from these recommendations is not known. METHODS Survivors underwent COG-LTFU Guideline-directed screening. Yield was classified as negligible/negative (< 1%), intermediate (≥ 1% to < 10%), or high (≥ 10%). For long-term complications with high yield, logistic regression was used to identify subgroups more likely to screen positive. RESULTS Over the course of 1,188 clinic visits, 370 childhood cancer survivors (53% male; 47% Hispanic; 69% leukemia/lymphoma survivors; median age at diagnosis, 11.1 years [range, 0.3 to 21.9 years]; time from diagnosis, 10.5 years [range, 5 to 55.8 years]) underwent 4,992 screening tests. High-yield tests included thyroid function (hypothyroidism, 10.1%), audiometry (hearing loss, 22.6%), dual-energy x-ray absorptiometry scans (low bone mineral density [BMD], 23.2%), serum ferritin (iron overload, 24.0%), and pulmonary function testing/chest x-ray (pulmonary dysfunction, 84.1%). Regression analysis failed to identify subgroups more likely to result in high screening yield, with the exception of low BMD (2.5-fold increased risk for males [P = .04]; 3.3-fold increased risk for nonobese survivors [P = .01]). Screening tests with negligible/negative (< 1%) yield included complete blood counts (therapy-related leukemia), dipstick urinalysis for proteinuria and serum blood urea nitrogen/creatinine (glomerular defects), microscopic urinalysis for hematuria (hemorrhagic cystitis, bladder cancer), ECG (anthracycline-related conduction disorder), and hepatitis B and HIV serology. CONCLUSION Screening tests with a high yield are appropriate for risk groups targeted for screening by the COG-LTFU Guidelines. Elimination of screening tests with negligible/negative yield should be given consideration.
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Affiliation(s)
| | | | - Jin Lee
- All authors: City of Hope, Duarte, CA
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113
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Sen'kova AV, Mironova NL, Patutina OA, Ageeva TA, Zenkova MA. The Toxic Effects of Polychemotherapy onto the Liver Are Accelerated by the Upregulated MDR of Lymphosarcoma. ISRN ONCOLOGY 2012; 2012:721612. [PMID: 23251817 PMCID: PMC3517856 DOI: 10.5402/2012/721612] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 10/15/2012] [Indexed: 11/23/2022]
Abstract
Antitumor therapy of hematological malignancies is impeded due to the high toxicity of polychemotherapy toward liver and increasing multiple drug resistance (MDR) of tumor cells under the pressure of polychemotherapy. These two problems can augment each other and significantly reduce the efficiency of antineoplastic therapy. We studied the combined effect of polychemotherapy and upregulated MDR of lymphosarcoma RLS(40) onto the liver of experimental mice using two treatment schemes. Scheme 1 is artificial: the tumor was subjected to four courses of polychemotherapy while the liver of the tumor-bearing mice was exposed to only one. This was achieved by threefold tumor retransplantation taken from animals subjected to chemotherapy into intact animals. Scheme 2 displays "real-life" status of patients with MDR malignancies: both the tumor and the liver of tumor-bearing mice were subjected to three sequential courses of polychemotherapy. Our data show that the strengthening of MDR phenotype of RLS(40) under polychemotherapy and toxic pressure of polychemotherapy itself has a synergistic damaging effect on the liver that is expressed in the accumulation of destructive changes in the liver tissue, the reduction of the regeneration capacity of the liver, and increasing of Pgp expression on the surface of hepatocytes.
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Affiliation(s)
- Alexandra V Sen'kova
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of Russian Academy of Science, Lavrentiev Avenue 8, Novosibirsk 630090, Russia ; Novosibirsk State Medical University, Krasnyi Prospect 52, Novosibirsk 630091, Russia
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114
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Solimando DA, Waddell JA. Cisplatin, Epirubicin, Levoleucovorin (or Leucovorin), and Fluorouracil (PELF) Regimen for Gastric Cancer. Hosp Pharm 2012. [DOI: 10.1310/hpj4711-834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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115
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Moller AG, Solimando DA, Waddell JA. Cyclophosphamide, Epirubicin, and Fluorouracil (CEF) Regimen for Breast Cancer. Hosp Pharm 2012. [DOI: 10.1310/hpj4709-683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Alexandra G. Moller
- oncology pharmacist at Fort Belvoir Community Hospital, Ft. Belvoir, Virginia
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116
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Sun J, Solimando DA, Waddell JA. Cisplatin, Vinblastine, and Dacarbazine (CVD) Regimen for Melanoma. Hosp Pharm 2012. [DOI: 10.1310/hpj4707-518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Jeanne Sun
- U.S. Pharmacopeia, Rockville, Maryland. University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Dominic A. Solimando
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
| | - J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
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117
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Chaparro AB, Solimando DA, Waddell JA. Gemcitabine, Docetaxel, and Capecitabine (GTX) Regimen for Metastatic Pancreatic Cancer. Hosp Pharm 2012. [DOI: 10.1310/hpj4706-432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Ana B. Chaparro
- Department of Pharmacy, William Beaumont Army Medical Center, El Paso, Texas
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118
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Abstract
Cirrhosis and chronic liver disease are common illnesses that cause high mortality and require treatment. Medication use in these patients may be challenging because of idiosyncratic or dose-dependent drug toxicity. Therefore, drug choice and drug dose adaptations play an important role. The objective of this clinical review is to discuss the literature about and challenges in drug use in patients with chronic liver disease. To make good decisions regarding drug choice and dose adjustments in these patients, well-defined clinical information about diagnoses and laboratory results (creatinine, international normalized ratio, bilirubin, and serologies) as well as in some instances, pathological findings like liver biopsies are needed. In a second step, these data should be organized in electronically supported clinical decision systems, which can then assist providers in making choices about medication selection and dosage. In summary, although substantial research has been done in the field of drug use in patients with liver dysfunction, a great deal also remains to be learned. Although many of these patients can now be identified, it is still very difficult to assess their individual level of hepatic function. The degree of risk associated with drug use and how best to use medications in these patients represents an important area for further study. In the future, pharmacogenomics and electronic linking of clinical data may well prove helpful for making decisions about optimal drug choices in this complex group of patients.
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119
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Yates DM, Waddell JA, Solimando DA. Docetaxel, Carboplatin, and Trastuzumab (TCH) for HER2-Positive Breast Cancer. Hosp Pharm 2012. [DOI: 10.1310/hpj4703-187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Danielle M. Yates
- PGY-1 Pharmacy Practice Resident at Blount Memorial Hospital, Maryville, Tennessee
| | - J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
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120
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Rutledge MR, Solimando DA, Waddell JA. Caplri (XelIri) Regimen for Advanced and Metastatic Colorectal or Esophogastric Cancer. Hosp Pharm 2012. [DOI: 10.1310/hpj4702-98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- M. R. Rutledge
- Hematology-Oncology Pharmacy Service, Department of Pharmacy, Madigan Army Medical Center, Tacoma, Washington
| | | | - J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
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121
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Lee JN, Waddell JA, Dominic AS. Gemcitabine and Erlotinib (GE) Regimen for Pancreatic Cancer. Hosp Pharm 2012. [DOI: 10.1310/hpj4701-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Jessica N. Lee
- Dr. Lee is a PGY1 pharmacy practice resident at Blount Memorial Hospital, Maryville, Tennessee
| | - J. Aubrey Waddell
- Dr. Lee is a PGY1 pharmacy practice resident at Blount Memorial Hospital, Maryville, Tennessee
| | - A. Solimando Dominic
- Dr. Lee is a PGY1 pharmacy practice resident at Blount Memorial Hospital, Maryville, Tennessee
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122
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Erin KM, Waddell JA, Dominic AS. Cyclophosphamide, Bortezomib and Dexamethasone (CyBorD) Regimen for Multiple Myeloma. Hosp Pharm 2011. [DOI: 10.1310/hpj4611-839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
| | - J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
| | - A. Solimando Dominic
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
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123
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Massoud RV, Solimando DA, Waddell JA. Leucovorin, Fluorouracil, and Irinotecan (FOLFIRI) plus Bevacizumab for Metastatic Colorectal Cancer. Hosp Pharm 2011. [DOI: 10.1310/hpj4610-748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- R. Vivian Massoud
- Washington Hospital Center, Washington, DC. University School of Pharmacy, Richmond, Virginia
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124
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Aparo S, Goel S. Evolvement of the treatment paradigm for metastatic colon cancer. From chemotherapy to targeted therapy. Crit Rev Oncol Hematol 2011; 83:47-58. [PMID: 21944740 DOI: 10.1016/j.critrevonc.2011.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 08/11/2011] [Accepted: 08/17/2011] [Indexed: 01/27/2023] Open
Abstract
Colorectal Cancer is the second most common cancer in incidence and mortality in the United States. In spite of current screening strategies 1 out of 5 patients still presents with metastatic disease. During the last 10-15 years there has been significant increase in the availability of chemotherapy options for this disease. The recent introduction of molecular markers to the treatment algorithm allows oncologists to tailor treatments for each particular patient. In the following article we give an overview of the landmark publications that led to our current standards and we give our view on particular situations in which the available evidence is not so helpful in making therapeutic decisions.
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Affiliation(s)
- Santiago Aparo
- Albert Einstein College of Medicine, Department of Medical Oncology, Montefiore Medical Center, Bronx, NY 10467, USA.
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125
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An evaluation of hepatotoxicity and nephrotoxicity of liposomal amphotericin B (L-AMB). J Med Toxicol 2011; 7:12-5. [PMID: 21057910 DOI: 10.1007/s13181-010-0120-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Hepatic and renal functions are important considerations when selecting antifungal therapy. This investigation of liposomal amphotericin B (L-AMB) was conducted to determine the incidence and factors associated with the development of hepatotoxicity and nephrotoxicity. A retrospective chart review was conducted of 100 consecutive patients receiving L-AMB at doses of 1, 3, and 5 mg/kg. Hepatotoxicity was defined as an increase of bilirubin greater than 1.5 mg/dl or AST and ALT greater than three times the normal range. Nephrotoxicity was defined as an increase in serum creatinine of 0.5 mg/dl or an increase of 50% from baseline. Patients were included if they were 18 years of age or older. Patients were excluded if they had developed hepatic or renal dysfunction prior to L-AMB administration. Seventy-five patients were included based upon the predefined inclusion/exclusion criteria. Twenty-one percent (16/75) developed hepatotoxicity based upon the predefined criteria. There were no additive correlates for this adverse effect. Overall, 56% (42/75) of patients developed nephrotoxicity. Seventy-four percent (31/42) were exposed to IV contrast, and 90% (38/42) were receiving nephrotoxins concurrently. Age, cumulative dose, concomitant nephrotoxins, and IV contrast exposure were associated with increased nephrotoxicity (p<0.001). The development of hepatotoxicity was observed; however, no correlates (age, dose escalation, or cumulative dose) were significantly associated with its occurrence. Overall nephrotoxicity with L-AMB was common and often multifactorial. Lipid amphotericin B products are associated with lower rates of nephrotoxicity than conventional amphotericin; however, in this analysis, L-AMB was associated with a high incidence of nephrotoxicity.
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126
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Waddell JA, Solimando DA. Leucovorin, Fluorouracil, Irinotecan, and Oxaliplatin (FOLFIRINOX) Regimen. Hosp Pharm 2011. [DOI: 10.1310/hpj4607-482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
| | - Dominic A. Solimando
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
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127
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Liu ML, Chien LY, Tai CJ, Lin KC, Tai CJ. Effectiveness of Traditional Chinese Medicine for Liver Protection and Chemotherapy Completion among Cancer Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:291843. [PMID: 19920087 PMCID: PMC3142889 DOI: 10.1093/ecam/nep185] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Accepted: 10/15/2009] [Indexed: 12/26/2022]
Abstract
While traditional Chinese medicine (TCM) is widely used among Chinese patients with cancer, studies evaluating the effectiveness of TCM using objective indicators are rare. We examined the effectiveness of TCM for liver protection and completion of chemotherapy among patients with cancer receiving chemotherapy. We used a case-control design to examine the medical records of patients with cancer who received chemotherapy in a teaching hospital in Taipei in 2004. A total of 184 courses of chemotherapy among 89 patients were studied. Of the 184 courses, 42 used TCM jointly with chemotherapy served as cases, while the remaining 142 courses served as controls. Outcome variables included counts of cancelled or delayed chemotherapies and liver function (aspartate aminotransferase, AST and alanine aminotransferase, ALT) 1 week before, during and 2 weeks after chemotherapy. Generalized estimating equations were used to analyze the data. Patients who had concomitant TCM with chemotherapy had lower serum ALT and AST during chemotherapy than the controls given that the age, sex, cancer stage, radiotherapy sites, cancer diagnosis and potential hepatotoxicity of the chemotherapeutic drugs were controlled for in the model [β = −3.48, 95% confidence interval (CI) −10.08 to 3.11 for AST; β = −5.95, 95% CI: −11.47 to −0.44 for ALT]. There was no significant difference between the case and control groups for odds of completing one course of chemotherapy. Use of TCM with chemotherapy resulted in protection of the liver during chemotherapy, as manifested by lower serum AST and ALT levels.
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Affiliation(s)
- Mei-Ling Liu
- Department of Nursing, Taipei Veterans General Hospital, Taiwan
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128
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Furst JM, Solimando DA, Waddell JA. Paclitaxel, Carboplatin, and Bevacizumab. Hosp Pharm 2011. [DOI: 10.1310/hpj4606-406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
| | - Dominic A. Solimando
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
| | - J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
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129
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Cheung MC, Jones RL, Judson I. Acute liver toxicity with ifosfamide in the treatment of sarcoma: a case report. J Med Case Rep 2011; 5:180. [PMID: 21569511 PMCID: PMC3117822 DOI: 10.1186/1752-1947-5-180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 05/13/2011] [Indexed: 11/20/2022] Open
Abstract
Introduction Ifosfamide is a chemotherapy agent infrequently associated with liver toxicity. To the best of our knowledge, this report is the first to describe serious liver toxicity associated with ifosfamide used in combination with doxorubicin that caused acute but fully reversible liver failure and encephalopathy. This report reviews the possible mechanisms by which ifosfamide causes this adverse effect. Case report A 61-year-old Caucasian woman who presented with an inoperable right neck mass due to synovial sarcoma was treated with standard-dose ifosfamide and doxorubicin. Within 24 hours of completing the first cycle of chemotherapy, she developed significant derangements in liver function, with a 250-fold increase in transaminase and associated synthetic function impairment and encephalopathy. No other causes of liver failure were identified. Both biochemical tests and encephalopathy were reversed after supportive management and treatment with N-acetylcysteine. No liver toxicity was observed with subsequent cycles of chemotherapy with doxorubicin alone. Conclusion This case highlights the possibility that chemotherapy agents can cause rare and idiosyncratic toxicities, so physicians must be vigilant for drug reactions, especially when patients do not respond to usual treatment.
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130
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King CL, Waddell JA, Solimando DA. Gemcitabine and Carboplatin (GC) Regimen for Advanced Non-Small-Cell Lung Cancer. Hosp Pharm 2011. [DOI: 10.1310/hpj4605-322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Crystal L. King
- PGY-1 Pharmacy Practice Resident at Blount Memorial Hospital, Maryville, Tennessee
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131
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Grimes SS, Waddell JA, Solimando DA. Weekly Paclitaxel and Carboplatin for Non-Small-Cell Lung Cancer. Hosp Pharm 2011. [DOI: 10.1310/hpj4603-166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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132
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Zomp A, Solimando DA, Waddell JA. CODOX-M/IVAC for non-Hodgkin Lymphomas. Hosp Pharm 2011. [DOI: 10.1310/hpj4602-91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Amanda Zomp
- Campbell University College of Pharmacy and Health Sciences, Buies Creek, North Carolina, when this publication was written. She is currently a pharmacy practice resident at Palmetto Health Richland in Columbia, South Carolina
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133
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Torrisi JM, Schwartz LH, Gollub MJ, Ginsberg MS, Bosl GJ, Hricak H. CT Findings of Chemotherapy-induced Toxicity: What Radiologists Need to Know about the Clinical and Radiologic Manifestations of Chemotherapy Toxicity. Radiology 2011; 258:41-56. [DOI: 10.1148/radiol.10092129] [Citation(s) in RCA: 153] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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134
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Yarbro LM, Solimando DA, Waddell JA. Stanford V Regimen for Hodgkin Lymphoma. Hosp Pharm 2010. [DOI: 10.1310/hpj4512-906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Laura M. Yarbro
- Oncology Pharmacy Resident (PGY2) at the Southern Arizona Veterans Affairs Healthcare System, Tucson, Arizona
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135
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Rubbia-Brandt L. [Hepatic lesions induced by systemic chemotherapy for digestive cancer]. Ann Pathol 2010; 30:421-5. [PMID: 21167427 DOI: 10.1016/j.annpat.2010.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 09/27/2010] [Indexed: 01/30/2023]
Abstract
The anticancerous chemotherapies are often responsible for toxic injury of the nontumoral liver. Two types of histological lesions were recently reported during the treatment of digestive cancers: the sinusoidal obstruction syndrome (SOS); or veno-occlusive disease associated with the use of oxaliplatine, and steatohepatitis associated with the use of irinotecan. The SOS is a cause of increased postoperative morbidity, particularly during major hepatectomy or when more than six cycles of chemotherapy are administered. Steatohepatitis increases the postoperative morbidity and mortality. The new targeted molecules do not seem to modify the postoperative course. Hepatic injury and postoperative complications associated with chemotherapies used in the treatment of digestive cancers are summarized in this review.
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Abstract
Sinusoidal obstruction syndrome (SOS), formerly named venoocclusive disease, is a well-known complication of hematopoietic stem cell transplantation and ingestion of food or drinks contaminated by pyrrolizidine alkaloids. Many other drugs and toxins have been associated with SOS, including several chemotherapeutic agents and immunosuppressors. SOS contributes to significant morbidity and mortality in all these settings. This review describes the histologic lesions of SOS, details its pathogenesis as it is understood today, specifies the recent data on its causes and how it may influence clinical management of colorectal liver metastases, and discusses the current knowledge on diagnosis and preventive options.
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137
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De Freitas EF, Solimando DA, Waddell JA. Lapatinib and Capecitabine. Hosp Pharm 2010. [DOI: 10.1310/hpj4510-762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Erik Frank De Freitas
- Department of Pharmacy, Tripler Military Medical Center, Honolulu, Hawaii. At the time of this writing, Hematology-Oncology Pharmacy Service, Department of Pharmacy, Walter Reed Army Medical Center, Washington, DC
| | - Dominic A. Solimando
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
| | - J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
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138
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Waddell JA, Solimando DA. Leucovorin, Fluorouracil, and Oxaliplatin (FOLFOX) Regimens plus Bevacizumab for Colorectal Cancer. Hosp Pharm 2010. [DOI: 10.1310/hpj4509-685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
| | - Dominic A. Solimando
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
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139
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Wu K, Solimando DA, Waddell JA. Docetaxel and Carboplatin (DC) for Ovarian Cancer. Hosp Pharm 2010. [DOI: 10.1310/hpj4508-607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Kimberly Wu
- University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Dominic A. Solimando
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
| | - J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
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140
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Waddell JA, Solimando DA. Epirubicin, Cisplatin, and Capecitabine (ECX) Regimen. Hosp Pharm 2010. [DOI: 10.1310/hpj4507-527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- J. Aubrey Waddell
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
| | - Dominic A. Solimando
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
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141
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Solimando DA, Moussavian PA, Franklin K, Waddell JA. Docetaxel, Cisplatin, and Fluorouracil (TCF) for Head and Neck Cancers. Hosp Pharm 2010. [DOI: 10.1310/hpj4506-453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Parvaneh A. Moussavian
- Supervisor of the Investigational Drug Section, Department of Pharmacy, Walter Reed Army Medical Center, Washington, DC
| | - Kaitlyn Franklin
- Doctor of Pharmacy student at Lake Erie College of Osteopathic Medicine School of Pharmacy, Erie, Pennsylvania
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142
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Castellino S, Muir A, Shah A, Shope S, McMullen K, Ruble K, Barber A, Davidoff A, Hudson MM. Hepato-biliary late effects in survivors of childhood and adolescent cancer: a report from the Children's Oncology Group. Pediatr Blood Cancer 2010; 54:663-9. [PMID: 19890896 PMCID: PMC2838980 DOI: 10.1002/pbc.22265] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Curative therapy for childhood and adolescent cancer translates to 1 in 640 young adults being a survivor of cancer. Although acute hepato-biliary toxicity occurs commonly during pediatric cancer therapy, the impact of antineoplastic therapy on long-term liver health in childhood/adolescent cancer survivors is unknown. This article reviews the medical literature on late liver dysfunction following treatment for childhood/adolescent cancer. We also outline the Children's Oncology Group (COG) guidelines for screening and follow-up of hepato-biliary sequelae. As the population of survivors grow and age, vigilance for risks to hepatic health needs to continue based on specific exposures during curative cancer therapy.
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Affiliation(s)
- Sharon Castellino
- Department of Pediatrics, Wake Forest University, Winston-Salem, NC27157, USA.
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143
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Halford ZR, Solimando DA, Waddell JA. Docetaxel and Prednisone (DP) for Advanced Prostate Cancer. Hosp Pharm 2010. [DOI: 10.1310/hpj4504-293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Dominic A. Solimando
- Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203
| | - J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804
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144
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Teusink AC, Hall PD. Toxicities of gemcitabine in patients with severe hepatic dysfunction. Ann Pharmacother 2010; 44:750-4. [PMID: 20233917 DOI: 10.1345/aph.1m587] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine the relationship between doses of gemcitabine and absolute neutrophil count and thrombocytopenia in patients with severe hepatic dysfunction (total bilirubin > or =4.5 mg/dL), and the relationship between doses of gemcitabine in patients with severe hepatic dysfunction and nonhematologic toxicity. CASE SUMMARY A retrospective chart review was conducted for patients receiving gemcitabine at the Medical University of South Carolina from October 2006 through October 2008. Seven patients were identified who had an elevated total bilirubin level (> or =4.5 mg/dL) at the time they were receiving gemcitabine. All 7 patients received gemcitabine 1000 mg/m(2) throughout their treatment, regardless of liver function. Six patients did not experience significant hematologic toxicity warranting a dose reduction or a dose being held. One patient developed thrombocytopenia, warranting a dose being held. DISCUSSION Gemcitabine is a chemotherapy agent frequently used for the treatment of pancreatic cancer as well as metastatic breast, lung, and ovarian cancer. To date there is limited information on dosing of gemcitabine in patients with an elevated total bilirubin. A previous study looking at lower grades of liver dysfunction suggested empiric dose reductions be made in these patients because of increased incidence of toxicity. CONCLUSIONS These results indicate the possibility that no initial dose reduction is necessary for patients with liver dysfunction receiving gemcitabine; however, close monitoring of these patients is required.
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Affiliation(s)
- Ashley Correll Teusink
- Medical University of South Carolina/South Carolina College of Pharmacy, Charleston, USA
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145
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Rubbia-Brandt L, Lauwers GY, Wang H, Majno PE, Tanabe K, Zhu AX, Brezault C, Soubrane O, Abdalla EK, Vauthey JN, Mentha G, Terris B. Sinusoidal obstruction syndrome and nodular regenerative hyperplasia are frequent oxaliplatin-associated liver lesions and partially prevented by bevacizumab in patients with hepatic colorectal metastasis. Histopathology 2010; 56:430-9. [PMID: 20459550 DOI: 10.1111/j.1365-2559.2010.03511.x] [Citation(s) in RCA: 212] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIMS Because of its efficacy, oxaliplatin (OX) is increasingly used as a chemotherapeutic agent in the treatment of colorectal liver metastases (CRLM). Oxaliplatin-associated liver toxicity has been reported and can affect clinical practice, but studies on its prevalence and a full pathological description are lacking. The aims of this study were to fill this gap by providing, from a pathologist's perspective, a detailed assessment of the spectrum of hepatic lesions associated with OX, to suggest a scoring system to quantify them, and to investigate the protective effect of bevacizumab against OX-associated damage. METHODS AND RESULTS The spectrum of oxaliplatin-associated liver lesions was investigated in a multi-institutional series of surgically resected CRLM (n = 385). Among 274 patients treated by OX, 54% had moderate/severe sinusoidal obstruction syndrome (SOS). Peliosis, centrilobular perisinusoidal/venular fibrosis and nodular regenerative hyperplasia (NRH) developed in 10.6%, 47% and 24.5%, respectively. The 111 patients treated by surgery alone had no lesions. Hepatic lesions were less severe in patients treated with OX/bevacizumab (n = 70) compared with the group treated by OX alone (n = 204), with an incidence of moderate/severe SOS (31.4% versus 62.2%), peliosis (4.3% versus 14.6%), NRH (11.4% versus 28.9%, respectively) and centrilobular/venular fibrosis (31.4% versus 52%, respectively) (P < 0.001). CONCLUSIONS Pathologists should be aware of the distinctive lesions associated with OX and of their high prevalence. OX-related lesions are less frequent in patients treated with bevacizumab, suggesting that this drug has a preventive effect. Uniform criteria for diagnosis and grading of OX-associated lesions should help to include histological data in the optimal multidisciplinary management of CRLM.
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146
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Rutledge MR, Waddell JA, Solimando DA. Bortezomib and Dexamethasone (BD) Regimen for Multiple Myeloma. Hosp Pharm 2010. [DOI: 10.1310/hpj4501-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires that pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparing, dispensing, and administering antineoplastic therapy, and to the agents, commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
- Matthew R. Rutledge
- Hematology-Oncology Pharmacy Service, Department of Pharmacy, Madigan Army Medical Center, Tacoma, Washington
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147
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Solimando DA, Waddell JA. Epirubicin, Cisplatin, and Fluorouracil (ECF) Regimen. Hosp Pharm 2009. [DOI: 10.1310/hpj4412-1072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparing, dispensing, and administering antineoplastic therapy and to the agents, commercially available and investigational, used to treat malignant diseases.
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148
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Waddell JA, Solimando DA. Pemetrexed and Carboplatin (PC) Regimen. Hosp Pharm 2009. [DOI: 10.1310/hpj4411-946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparing, dispensing, and administering antineoplastic therapy and to the agents, commercially available and investigational, used to treat malignant diseases.
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149
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Abstract
Chemotherapy is meant to be toxic, but it is particularly aimed at the tumor cells. Collateral damage may occur to normal cells and tissues, especially if they are fairly rapidly regenerating, as is the case for bone marrow cells, intestinal epithelial cells, and liver cells after hepatic injury. The liver has a great capacity to resist injury, overcome it, and to regenerate, even after quite massive injury (resection of 50%-65%, for example). This capacity may make it susceptible to chemotherapeutic toxicity, and a struggle between injury and adaptation, leading to recovery and tolerance or to failure and death. If the chemotherapy is aimed just at delaying progression of the cancer for a few weeks or months, it may not be worth the risk of irreversible liver injury developing in that time. Close clinical observation and sound clinical judgment are required.
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Affiliation(s)
- John R Senior
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD 20993-0002, USA.
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150
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Solimando DA, Waddell JA. BEACOPP (escalated) Regimen for Hodgkin Lymphoma. Hosp Pharm 2009. [DOI: 10.1310/hpj4410-858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparing, dispensing, and administering antineoplastic therapy and to the agents, commercially available and investigational, used to treat malignant diseases.
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Affiliation(s)
| | - J. Aubrey Waddell
- University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E Lamar Alexander Parkway, Maryville, TN 37804
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