Reporting environmental contamination results to healthcare workers could play a crucial role in decreasing the risk of occupational exposure to antineoplastic drugs

Comparison of Three Chemotherapy Protocols With Electrochemotherapy for the Treatment of Feline Cutaneous Squamous Cell Carcinoma

Electrochemotherapy (ECT) with intravenous (IV) and/or intratumoral (IT) bleomycin has shown considerable efficacy in the treatment of non-resectable feline cutaneous squamous cell carcinoma (cSCC), boasting response rates of up to 95%, but other chemotherapy protocols have not yet been investigated. The objective of this prospective multicentre study was to compare the overall response rate (ORR) and progression-free interval (PFI) between cats with cSCC treated with ECT using IT and IV carboplatin (IV + IT), IV carboplatin (IV) or IV bleomycin (IV). A total of 44 cats with unresectable cSCC across three centres were enrolled and treated with ECT using carboplatin IV + IT (n = 10), carboplatin IV (n = 11) or bleomycin IV (n = 23). Treatment response according to RECIST criteria was recorded at 2 and 4 weeks post-treatment, and patients were followed until disease progression and/or death. All three groups were comparable regarding age, sex, weight, and lesion size. Adverse events were generally mild, localised and similar between groups. ORRs were 90.0% (carboplatin IV + IT), 90.9% (carboplatin IV) and 95.6% (bleomycin IV) and were not significantly different (p = 0.79). Median PFI was not reached for carboplatin IV + IT or carboplatin IV and was 566 days for bleomycin IV, with no significant difference between the three groups (p = 0.81). This study suggests that ECT using IV or IV + IT carboplatin is a reasonable alternative therapeutic option for managing cSCC, and further studies are warranted to compare outcomes between treatment protocols.

Evaluating oxidative stress biomarkers in oncology nurses exposed to antineoplastic drugs: A cross-sectional study

PURPOSE

Antineoplastic drugs (ADs) are widely used in cancer treatment. Nurses in chemotherapy centers are exposed to these drugs during preparation. They can affect healthy cells, leading to teratogenic and mutagenic effects, as well as oxidative stress. This study aimed to evaluate oxidative stress biomarkers in the nurses exposed to these drugs.

METHOD

This study was conducted on 30 nurses exposed to ADs and 30 nurses with no exposure to these drugs as non-exposed group. Oxidative stress biomarkers were measured in the blood serum samples of both groups, including malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), total antioxidant capacity (TAC), and blood thiol groups.

RESULTS

Considering the possibility of confounding effect of nutritional supplement consumption, the effect of this factor was adjusted in the analysis. A significant difference was observed for CAT, SOD, thiol, and TAC biomarkers between two groups (P < 0.05). However, the difference in MDA and GPx biomarkers between two groups was not statistically significant.

CONCLUSIONS

The findings of the present study showed that supplement consumption has a significant effect on the biomarker of total antioxidant capacity. Thus, total antioxidant capacity measurement is advised as the best biomarker for tracking oxidative status in nurses exposed to ADs due to its capacity to measure all antioxidants in the body, except the thiol group, and its lower cost when compared to other biomarkers. Furthermore, it can be claimed that the consumption of nutritional supplements has a greater effect on the non-enzymatic biomarkers of oxidative stress than on enzymatic antioxidant system.

Canadian monitoring program of the surface contamination with 11 antineoplastic drugs in 124 centers

INTRODUCTION

Occupational exposure to antineoplastic drugs can lead to long-term adverse effects on workers' health. A reproducible Canadian surface monitoring program was established in 2010. The objective was to describe contamination with 11 antineoplastic drugs measured on 12 surfaces among hospitals participating in this annual monitoring program.

METHODS

Each hospital sampled six standardized sites in oncology pharmacies and six in outpatient clinics. Ultra-performance liquid chromatography coupled with tandem mass spectrometry was used for cyclophosphamide, docetaxel, doxorubicin, etoposide, 5-fluorouracil, gemcitabine, irinotecan, methotrexate, paclitaxel, and vinorelbine. Platinum-based drugs were analyzed by inductively coupled plasma mass spectrometry; this excludes inorganic platinum from the environment. Hospitals filled out an online questionnaire about their practices; a Kolmogorov-Smirnov test was used for some practices.

RESULTS

One hundred and twenty-four Canadian hospitals participated. Cyclophosphamide (405/1445, 28%), gemcitabine (347/1445, 24%), and platinum (71/756, 9%) were the most frequent. The 90th percentile of surface concentration was 0.01 ng/cm² for cyclophosphamide and 0.003 ng/cm² for gemcitabine. Centers that prepared 5000 or more antineoplastic per year had higher concentrations of cyclophosphamide and gemcitabine on their surfaces (p  =  0.0001). Almost half maintained a hazardous drugs committee (46/119, 39%), but this did not influence the cyclophosphamide contamination (p  =  0.051). Hazardous drugs training was more frequent for oncology pharmacy and nursing staff than for hygiene and sanitation staff.

CONCLUSIONS

This monitoring program allowed centers to benchmark their contamination with pragmatic contamination thresholds derived from the Canadian 90th percentiles. Regular participation and local hazardous drug committee involvement provide an opportunity to review practices, identify risk areas, and refresh training.