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Larisch C, Markowiak T, Ried M, Nowak D, Hofmann HS, Rakete S. The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy. Cancers (Basel) 2023; 15:4872. [PMID: 37835566 PMCID: PMC10571901 DOI: 10.3390/cancers15194872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
Hyperthermic intrathoracic chemotherapy (HITOC) is an additional intraoperative treatment option within the multimodality therapy of pleural malignancies. A chemotherapy perfusion with high-dose cisplatin is performed over a period of 60 min after surgical cytoreduction to improve local tumour control through the eradication of residual tumour cells. Although HITOC is increasingly used, there is only little scientific evidence about the necessary safety measures after HITOC. Therefore, the objective of this study was an analysis of cisplatin excretion via various body fluids after HITOC, with the aim of providing recommendations on occupational health and safety. Five patients undergoing HITOC were included. Before and after the HITOC, as well as during the following days, serum, urine, and bronchial secretion, as well as pleural effusion, were sampled. The platinum levels in the samples were measured using ICP-MS (inductively coupled plasma-mass spectrometry). Immediately after the HITOC, the mean levels of cisplatin increased dramatically in the serum (from 0.79 to 1349 µg/L), urine (from 3.48 to 10,528 µg/g creatinine), and bronchial secretion (from 0.11 to 156 µg/L). Thereafter, the cisplatin levels dropped to 133 µg/L in the serum and 994 µg/g creatinine in the urine within nine days after the HITOC. The AUC ratio shows 59% of the cisplatin being excreted via the urine after 48 h. The sampling of pleural effusion started 24 h after the HITOC, and the cisplatin levels decreased from 618 to 93 µg/L within nine days. Although the cisplatin levels in the body fluids of HITOC patients are much lower compared to patients receiving intravenous chemotherapy, a significant amount of cisplatin is excreted via these body fluids. Consequently, safety precautions must be implemented in the post-HITOC care of patients to avoid occupational exposure to cisplatin.
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Affiliation(s)
- Christopher Larisch
- Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Till Markowiak
- Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Michael Ried
- Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80539 Munich, Germany
- Comprehensive Pneumology Center Munich, German Center for Lung Research, 81377 Munich, Germany
| | - Hans-Stefan Hofmann
- Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
- Department of Thoracic Surgery, Hospital Barmherzige Brueder, 93047 Regensburg, Germany
| | - Stefan Rakete
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80539 Munich, Germany
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Delafoy C, Benoist H, Patin A, Vasseur M, Guillouet S, Eveno C, Guilloit JM, Odou P, Simon N, Saint-Lorant G. Knowledge and practices about safe handling regarding the risk of exposure to antineoplastic drugs for caregivers in compounding units and in operating rooms performing HIPEC/PIPAC. J Oncol Pharm Pract 2023; 29:1628-1636. [PMID: 36514878 DOI: 10.1177/10781552221144303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Ever since the late 1970s, occupational exposure associated with the handling of antineoplastic drugs (ADs) in the healthcare environment has been highlighted and demonstrated. Contamination was detected in both operating rooms (OR) and compounding units (CU), where healthcare workers handle and are exposed to ADs in different ways. In the OR, the risk of exposure is higher and the staff receives less training in handling ADs than in the CU. This study aimed to assess and compare knowledge and practices about the safe handling of ADs by caregivers working in these two locations, namely the CU and OR. METHODS Two questionnaires (one each for the OR and CU) were created by two investigator pharmacists and were completed during a personal interview of 20 min. The questions were related to the following topics: training, knowledge about occupational exposure and questions related to protective practices. A scoring system was implemented to assess the knowledge and practices of each participant. RESULTS In total, 38 caregivers working in the OR and 39 in the CU were included in our study. Significantly more CU staff had specific initial training (p < 0.001) and ongoing training (p < 0.001) in handling ADs. Concerning the knowledge score, OR caregivers had a significantly lower median score for contamination routes (p < 0.001), contamination surfaces (p < 0.001), existing procedures (p < 0.001) and total knowledge (p < 0.001) than CU caregivers. Concerning protective handling practices of ADs, the two locations had nonsignificantly different median scores (p = 0.892). CONCLUSION This study suggests that there is still room for improvement in terms of knowledge and protection practices when handling ADs. An appropriate and tailored training program should be developed and provided to all caregivers who handle or come in contact with ADs.Clinical trial registrationStudy CONTACT, ref. 19-504.
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Affiliation(s)
- Clémence Delafoy
- Department of Pharmacy, CHU Caen, Caen, France
- UNICAEN, UNIROUEN, ABTE, Centre de Lutte Contre le Cancer F. Baclesse, Normandie University, Caen, France
| | - Hubert Benoist
- Department of Pharmacy, CHU Caen, Caen, France
- UNICAEN, UNIROUEN, ABTE, Centre de Lutte Contre le Cancer F. Baclesse, Normandie University, Caen, France
| | - Alex Patin
- Department of Pharmacy, CHU Caen, Caen, France
| | - Michèle Vasseur
- ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, CHU Lille, University of Lille, Lille, France
- Institut of Pharmacy, CHU Lille, Lille, France
| | - Sonia Guillouet
- UNICAEN, CHU de Caen Normandie, Néphrologie, Direction des Soins, Normandie University, Caen, France
| | - Clarisse Eveno
- Department of Digestive Surgery, CHU Lille, Lille, France
| | - Jean-Marc Guilloit
- Department of Surgery, Comprehensive Cancer Center F. Baclesse, Caen, France
| | - Pascal Odou
- ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, CHU Lille, University of Lille, Lille, France
- Institut of Pharmacy, CHU Lille, Lille, France
| | - Nicolas Simon
- ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, CHU Lille, University of Lille, Lille, France
- Institut of Pharmacy, CHU Lille, Lille, France
| | - Guillaume Saint-Lorant
- Department of Pharmacy, CHU Caen, Caen, France
- UNICAEN, UNIROUEN, ABTE, Centre de Lutte Contre le Cancer F. Baclesse, Normandie University, Caen, France
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Mastronardi V, Moglianetti M, Ragusa E, Zunino R, Pompa PP. From a Chemotherapeutic Drug to a High-Performance Nanocatalyst: A Fast Colorimetric Test for Cisplatin Detection at ppb Level. BIOSENSORS 2022; 12:bios12060375. [PMID: 35735523 PMCID: PMC9221495 DOI: 10.3390/bios12060375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 12/12/2022]
Abstract
A rapid point-of-care method for the colorimetric detection of cisplatin was developed, exploiting the efficient conversion of the chemotherapeutic drug into a high-performance nanocatalyst with peroxidase enzyme mimics. This assay provides high specificity and ppb-detection sensitivity with the naked eye or a smartphone-based readout, outperforming many standard laboratory-based techniques. The nanocatalyst-enabled colorimetric assay can be integrated with machine-learning methods, providing accurate quantitative measurements. Such a combined approach opens interesting perspectives for the on-site monitoring of both chemotherapeutic patients to achieve optimal treatments and healthcare workers to prevent their unsafe exposure.
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Affiliation(s)
- Valentina Mastronardi
- Nanobiointeractions & Nanodiagnostics, Istituto Italiano di Tecnologia (IIT), Via Morego, 16163 Genova, Italy; (V.M.); (M.M.)
| | - Mauro Moglianetti
- Nanobiointeractions & Nanodiagnostics, Istituto Italiano di Tecnologia (IIT), Via Morego, 16163 Genova, Italy; (V.M.); (M.M.)
| | - Edoardo Ragusa
- Department of Electrical, Electronic, Telecommunications Engineering and Naval Architecture, University of Genova, Via Opera Pia, 11a, 16145 Genova, Italy; (E.R.); (R.Z.)
| | - Rodolfo Zunino
- Department of Electrical, Electronic, Telecommunications Engineering and Naval Architecture, University of Genova, Via Opera Pia, 11a, 16145 Genova, Italy; (E.R.); (R.Z.)
| | - Pier Paolo Pompa
- Nanobiointeractions & Nanodiagnostics, Istituto Italiano di Tecnologia (IIT), Via Morego, 16163 Genova, Italy; (V.M.); (M.M.)
- Correspondence:
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