Pub Date : 2023-07-01DOI: 10.1097/OP9.0000000000000047
Aeshah A AlAzmi, S. Abdullah, Khalid Abdullah, Stendel Ruediger
Abstract Introduction: At present, there is no supporting evidence-based therapy of proven efficacy to treat posterior fossa syndrome (PFS) after surgical resection of posterior fossa tumors in children where only 22% of patients may experience a full recovery. However, zolpidem, a nonbenzodiazepine hypnotics drug, seems to be a possible treatment option for PFS symptoms. Methods and Materials: This was a retrospective chart review for all children with brain tumors younger than 15 years diagnosed with confirmed PFS after surgical resection at King Abdulaziz Medical City, Jeddah, and received zolpidem to alleviate the PFS symptoms between May 2016 and April 2019. Results: A total of 6 pediatric patients who experienced PFS symptoms (median of 4 days, range 1–7 days) were included. The most commonly observed symptoms were irritability, hypotonia, swallowing deficit, unsteady walking, and delayed speech. To alleviate the PFS symptoms, zolpidem was commenced 2–5 days postoperatively. The median duration of use was 13.5 days. During the hospital course, recovery of speech was observed after 2 weeks in most patients (50%) while 83.3% of patients recovered their normal speech in 4 months although not fully ambulated. No discontinuation of zolpidem use was reported because of adverse events. Conclusion: Most of our children (83.3%) who experienced PFS postresection responded to zolpidem trials which may represent a promising research field.
摘要:目前，尚无证据支持的、被证实有效的治疗儿童后颅窝肿瘤切除术后后颅窝综合征(PFS)的循证疗法，其中只有22%的患者可以完全康复。然而，唑吡坦，一种非苯二氮卓类催眠药物，似乎是PFS症状的可能治疗选择。方法和材料:本研究回顾性回顾了2016年5月至2019年4月期间在吉达国王阿卜杜勒阿齐兹医疗城(King Abdulaziz Medical City)手术切除后确诊为PFS的所有15岁以下脑肿瘤儿童，并接受唑吡坦治疗以缓解PFS症状。结果:共纳入6例出现PFS症状的儿童患者(中位数为4天，范围为1-7天)。最常见的症状是易怒、张力减退、吞咽困难、行走不稳和语言迟缓。为缓解PFS症状，术后2-5天开始使用唑吡坦。中位用药时间为13.5天。在住院期间，大多数患者(50%)在2周后语言恢复，而83.3%的患者在4个月内恢复正常语言，尽管不能完全行走。没有因不良事件而停止使用唑吡坦的报告。结论:绝大多数(83.3%)术后出现PFS的患儿对唑吡坦试验有反应，这可能是一个有前景的研究领域。
{"title":"The outcome of using zolpidem for treatment of postoperative posterior fossa syndrome in children with brain tumor","authors":"Aeshah A AlAzmi, S. Abdullah, Khalid Abdullah, Stendel Ruediger","doi":"10.1097/OP9.0000000000000047","DOIUrl":"https://doi.org/10.1097/OP9.0000000000000047","url":null,"abstract":"Abstract Introduction: At present, there is no supporting evidence-based therapy of proven efficacy to treat posterior fossa syndrome (PFS) after surgical resection of posterior fossa tumors in children where only 22% of patients may experience a full recovery. However, zolpidem, a nonbenzodiazepine hypnotics drug, seems to be a possible treatment option for PFS symptoms. Methods and Materials: This was a retrospective chart review for all children with brain tumors younger than 15 years diagnosed with confirmed PFS after surgical resection at King Abdulaziz Medical City, Jeddah, and received zolpidem to alleviate the PFS symptoms between May 2016 and April 2019. Results: A total of 6 pediatric patients who experienced PFS symptoms (median of 4 days, range 1–7 days) were included. The most commonly observed symptoms were irritability, hypotonia, swallowing deficit, unsteady walking, and delayed speech. To alleviate the PFS symptoms, zolpidem was commenced 2–5 days postoperatively. The median duration of use was 13.5 days. During the hospital course, recovery of speech was observed after 2 weeks in most patients (50%) while 83.3% of patients recovered their normal speech in 4 months although not fully ambulated. No discontinuation of zolpidem use was reported because of adverse events. Conclusion: Most of our children (83.3%) who experienced PFS postresection responded to zolpidem trials which may represent a promising research field.","PeriodicalId":210051,"journal":{"name":"The European Journal of Oncology Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124146788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/OP9.0000000000000046
Violaine Lepage, Julian Gratiaux, Brahim Azzouz, F. Slimano, C. Jouannaud, D. Parent
Abstract Introduction: Pertuzumab is a humanized monoclonal antibody used in the treatment of human epidermal growth factor receptor 2–positive early breast cancer. Its use can lead to a type-I hypersensitivity, which can be the result of an IgE-related reaction. This case describes a successful desensitization to pertuzumab in a patient diagnosed with a breast cancer. Method: A patient without a personal history of hypersensitivity and diagnosed with a human epidermal growth factor receptor 2–positive breast cancer was started on chemotherapy with association of trastuzumab, pertuzumab, and paclitaxel. While receiving the fourth cycle of pertuzumab, the patient developed a grade 2 hypersensitivity reaction resolved by the intravenous injection of dexchlorpheniramine and methylprednisolone. A premedication protocol has been setting up with a short desensitization protocol. Results: No adverse event occurred during the desensitization, which permits to continue pertuzumab at normal dose with a low occurrence of adverse events (spontaneous and favorable resolution). On analyzing the suspected adverse drug reaction, the event scored 10 and can found to be considered definite using the Naranjo Adverse Drug Reaction Probability Scale. This successful protocol of desensitization has helped to inhibit a hypersensitivity reaction. The monitoring showed the well-tolerance of the patient. Conclusion: This desensitization avoided a too early changing line treatment, which could have been deleterious. Very few cases of pertuzumab hypersensitivity occurred in France, and none benefited from a desensitization. This case illustrated the fact that rapid drug desensitization is possible, important and a simple opportunity to pursuit effective treatments.
{"title":"Successful desensitization of a patient with hypersensitivity to pertuzumab: a case report","authors":"Violaine Lepage, Julian Gratiaux, Brahim Azzouz, F. Slimano, C. Jouannaud, D. Parent","doi":"10.1097/OP9.0000000000000046","DOIUrl":"https://doi.org/10.1097/OP9.0000000000000046","url":null,"abstract":"Abstract Introduction: Pertuzumab is a humanized monoclonal antibody used in the treatment of human epidermal growth factor receptor 2–positive early breast cancer. Its use can lead to a type-I hypersensitivity, which can be the result of an IgE-related reaction. This case describes a successful desensitization to pertuzumab in a patient diagnosed with a breast cancer. Method: A patient without a personal history of hypersensitivity and diagnosed with a human epidermal growth factor receptor 2–positive breast cancer was started on chemotherapy with association of trastuzumab, pertuzumab, and paclitaxel. While receiving the fourth cycle of pertuzumab, the patient developed a grade 2 hypersensitivity reaction resolved by the intravenous injection of dexchlorpheniramine and methylprednisolone. A premedication protocol has been setting up with a short desensitization protocol. Results: No adverse event occurred during the desensitization, which permits to continue pertuzumab at normal dose with a low occurrence of adverse events (spontaneous and favorable resolution). On analyzing the suspected adverse drug reaction, the event scored 10 and can found to be considered definite using the Naranjo Adverse Drug Reaction Probability Scale. This successful protocol of desensitization has helped to inhibit a hypersensitivity reaction. The monitoring showed the well-tolerance of the patient. Conclusion: This desensitization avoided a too early changing line treatment, which could have been deleterious. Very few cases of pertuzumab hypersensitivity occurred in France, and none benefited from a desensitization. This case illustrated the fact that rapid drug desensitization is possible, important and a simple opportunity to pursuit effective treatments.","PeriodicalId":210051,"journal":{"name":"The European Journal of Oncology Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127996597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/OP9.0000000000000048
E. Korczowska, M. Crul, A. Wolc, K. Meier
Supplemental Digital Content is Available in the Text. Abstract Background: A fundamental requirement to ensure the safety of health care workers is to reduce environmental contamination with cytotoxic medicines. Objectives: The primary objective of this collaborative project between the European Society of Oncology Pharmacy (ESOP) and the European Society for Medical Oncology (ESMO) was to evaluate cytotoxic medicine contamination on surfaces in European hospital wards. The secondary objectives were (a) to detect possible internal bodily exposure in staff members and (b) to evaluate the impact of teaching safe handling practices. Materials and methods: Surface contamination in the chemotherapy administration areas was measured in 28 hospitals from 16 European countries before (part I) and after (part II) staff training through a standardized tutorial. Contamination with four antineoplastic medicines and total platinum was assessed using wipe samples taken from four comparable surfaces in each part of the project. In addition, hospitals that showed a high level of surface contamination, collected 24-hour urine of five staff members (part III). The samples were analyzed by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) and inductively coupled plasma-mass spectrometry (ICP-MS). Results: In total, 112 and 104 wipe samples (part I and part II) and 32 urine samples (part III) were collected. Surface contamination occurred in all participating hospitals. The most contaminated spot was the floor in the nurses' station. The most frequently found compound was platinum, and the medicine that showed the highest amount of contamination was cyclophosphamide (8.18 ng/cm2 in part I and 0.53 ng/cm2 in part II). Urine samples were positive for gemcitabine and cyclophosphamide in 1 and 2 nurses, respectively. The intervention by tutorial lowered the levels of contamination, both in number (from 48% to 41%) and in amount of contamination. Conclusion: The MASHA-2 study shows that contamination of surfaces with cytotoxic medicines in European hospitals is a widespread phenomenon. Bodily exposure of nurses was clearly detected. Surface contamination decreased after training on safe handling practices. Nevertheless, further optimization of occupational safety is warranted.
{"title":"Protecting the health care workforce from cytotoxic drugs contamination in the hospital wards: the results of the pan-European MASHA-2 project","authors":"E. Korczowska, M. Crul, A. Wolc, K. Meier","doi":"10.1097/OP9.0000000000000048","DOIUrl":"https://doi.org/10.1097/OP9.0000000000000048","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Abstract Background: A fundamental requirement to ensure the safety of health care workers is to reduce environmental contamination with cytotoxic medicines. Objectives: The primary objective of this collaborative project between the European Society of Oncology Pharmacy (ESOP) and the European Society for Medical Oncology (ESMO) was to evaluate cytotoxic medicine contamination on surfaces in European hospital wards. The secondary objectives were (a) to detect possible internal bodily exposure in staff members and (b) to evaluate the impact of teaching safe handling practices. Materials and methods: Surface contamination in the chemotherapy administration areas was measured in 28 hospitals from 16 European countries before (part I) and after (part II) staff training through a standardized tutorial. Contamination with four antineoplastic medicines and total platinum was assessed using wipe samples taken from four comparable surfaces in each part of the project. In addition, hospitals that showed a high level of surface contamination, collected 24-hour urine of five staff members (part III). The samples were analyzed by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) and inductively coupled plasma-mass spectrometry (ICP-MS). Results: In total, 112 and 104 wipe samples (part I and part II) and 32 urine samples (part III) were collected. Surface contamination occurred in all participating hospitals. The most contaminated spot was the floor in the nurses' station. The most frequently found compound was platinum, and the medicine that showed the highest amount of contamination was cyclophosphamide (8.18 ng/cm2 in part I and 0.53 ng/cm2 in part II). Urine samples were positive for gemcitabine and cyclophosphamide in 1 and 2 nurses, respectively. The intervention by tutorial lowered the levels of contamination, both in number (from 48% to 41%) and in amount of contamination. Conclusion: The MASHA-2 study shows that contamination of surfaces with cytotoxic medicines in European hospitals is a widespread phenomenon. Bodily exposure of nurses was clearly detected. Surface contamination decreased after training on safe handling practices. Nevertheless, further optimization of occupational safety is warranted.","PeriodicalId":210051,"journal":{"name":"The European Journal of Oncology Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121879798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1097/OP9.0000000000000045
Leanda Grobler, A. Orchard, S. D. Moodley, Ion Pypers, Razeeya Khan
Abstract Introduction: Metastatic breast cancer (mBC) remains incurable, with a median overall survival (OS) of approximately 3 years and a 5-year survival rate of approximately 25%, irrespective of the economic classification of the country where treatment is received. Cyclin-dependent kinase (CDK) inhibitors increase overall survival in both first and second-line settings in the treatment of hormone receptor–positive, human epidermal growth factor receptor 2–negative mBC. This retrospective cohort study investigated the progression-free survival in women with mBC receiving combination therapy with abemaciclib (CDK4/CDK6 inhibitor) and letrozole or fulvestrant as opposed to abemaciclib only. Methods: The study included all eligible women with stage IV breast cancer treated with abemaciclib at a private oncology facility in Johannesburg over the study period. Data were collected from medical records from April 1, 2019 to March 31, 2021. Analyses were conducted to assess the overall survival rate, progression-free survival probability, and safety of abemaciclib in women with stage IV breast cancer. Results: Thirty-two patients were eligible for inclusion in this study. The progression-free survival probability was 60% after a period of 17 months, irrespective of treatment options. After 17 months, the OS of women on a combination of abemaciclib and letrozole was 80%, on a combination of abemaciclib and fulvestrant was 80%, and on abemaciclib monotherapy was 70%. The most noted adverse effects were diarrhea (92.0%), neutropenia (92.0%), fatigue (48.0%), and hepatotoxicity (16.0%). Discussion: Abemaciclib with endocrine therapy or an aromatase inhibitor provided an improvement in the OS compared with abemaciclib monotherapy. These findings are representative of the use of abemaciclib in a local population and are similar to those of larger studies conducted internationally.
{"title":"Recurrence rate in patients with stage IV breast cancer: a retrospective cohort study","authors":"Leanda Grobler, A. Orchard, S. D. Moodley, Ion Pypers, Razeeya Khan","doi":"10.1097/OP9.0000000000000045","DOIUrl":"https://doi.org/10.1097/OP9.0000000000000045","url":null,"abstract":"Abstract Introduction: Metastatic breast cancer (mBC) remains incurable, with a median overall survival (OS) of approximately 3 years and a 5-year survival rate of approximately 25%, irrespective of the economic classification of the country where treatment is received. Cyclin-dependent kinase (CDK) inhibitors increase overall survival in both first and second-line settings in the treatment of hormone receptor–positive, human epidermal growth factor receptor 2–negative mBC. This retrospective cohort study investigated the progression-free survival in women with mBC receiving combination therapy with abemaciclib (CDK4/CDK6 inhibitor) and letrozole or fulvestrant as opposed to abemaciclib only. Methods: The study included all eligible women with stage IV breast cancer treated with abemaciclib at a private oncology facility in Johannesburg over the study period. Data were collected from medical records from April 1, 2019 to March 31, 2021. Analyses were conducted to assess the overall survival rate, progression-free survival probability, and safety of abemaciclib in women with stage IV breast cancer. Results: Thirty-two patients were eligible for inclusion in this study. The progression-free survival probability was 60% after a period of 17 months, irrespective of treatment options. After 17 months, the OS of women on a combination of abemaciclib and letrozole was 80%, on a combination of abemaciclib and fulvestrant was 80%, and on abemaciclib monotherapy was 70%. The most noted adverse effects were diarrhea (92.0%), neutropenia (92.0%), fatigue (48.0%), and hepatotoxicity (16.0%). Discussion: Abemaciclib with endocrine therapy or an aromatase inhibitor provided an improvement in the OS compared with abemaciclib monotherapy. These findings are representative of the use of abemaciclib in a local population and are similar to those of larger studies conducted internationally.","PeriodicalId":210051,"journal":{"name":"The European Journal of Oncology Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129729157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1097/OP9.0000000000000044
A. Bienert, K. Meier, Antonina S. Kokisheva, Rodrigo A. Gama Brambila, Marianna Veraldi, Nuno Carlos Rosa de Lima Vilaca Marques, Maja Kuzmanović, Dan Paul Andreianu, F. Badibouidi, Romina Morales Vallespin
Abstract Introduction: The 2019 coronavirus pandemic has caused serious health crises around the world such as psychological reactions of health workers. The way we work (stress, anxiety, and psychological problems) and the activities assigned to pharmacists, such as vaccination, have changed. So, we conducted a survey to investigate their psychophysical well-being and the influence of vaccination on the daily work of pharmacists. Methods: The survey (translated into 9 languages and distributed online) on mental health was sent to all ESOP members in March 2021 and February 2022 and on vaccination in December 2020, March 2021, and February 2022. The data were analyzed using Excel (Microsoft Office 2016, Microsoft, Redmond, WA) and basic descriptive statistics. Results: Over 800 colleagues from different health areas and 62 countries took part in the survey. As a result of poor mental health and increased workload as a consequence of the pandemic, it was observed in 30% (2021) and 15% (2022) of respondents, while increased cooperation among healthcare workers was observed in 65% of responders. In the vaccination survey, less than half of the professionals surveyed were directly involved in the vaccination process, conducted mainly in hospitals at first and then in other centers to increase coverage, such as “Community Pharmacy.” For the first time, there have been reports of pharmacists authorized to administer vaccines in some countries. Conclusions: With the spread of the virus, the increased workload has affected the mental health of health workers. Although a slight improvement from 2022 vs 2021 was observed, there is a need now to work on improving mental health of health care workers, to protect/care about them, and also to ensure that they will not leave the profession to ensure health care for patients with cancer and COVID-19 (and in general to all patients). Vaccination was an opportunity for the pharmacist to play a more active role that reinforces the value of pharmaceutical practice.
{"title":"Impact of COVID-19 on Mental Health of Oncology Health Care Workers and Interdisciplinary Collaboration: Results of Surveys in 2021 and 2022","authors":"A. Bienert, K. Meier, Antonina S. Kokisheva, Rodrigo A. Gama Brambila, Marianna Veraldi, Nuno Carlos Rosa de Lima Vilaca Marques, Maja Kuzmanović, Dan Paul Andreianu, F. Badibouidi, Romina Morales Vallespin","doi":"10.1097/OP9.0000000000000044","DOIUrl":"https://doi.org/10.1097/OP9.0000000000000044","url":null,"abstract":"Abstract Introduction: The 2019 coronavirus pandemic has caused serious health crises around the world such as psychological reactions of health workers. The way we work (stress, anxiety, and psychological problems) and the activities assigned to pharmacists, such as vaccination, have changed. So, we conducted a survey to investigate their psychophysical well-being and the influence of vaccination on the daily work of pharmacists. Methods: The survey (translated into 9 languages and distributed online) on mental health was sent to all ESOP members in March 2021 and February 2022 and on vaccination in December 2020, March 2021, and February 2022. The data were analyzed using Excel (Microsoft Office 2016, Microsoft, Redmond, WA) and basic descriptive statistics. Results: Over 800 colleagues from different health areas and 62 countries took part in the survey. As a result of poor mental health and increased workload as a consequence of the pandemic, it was observed in 30% (2021) and 15% (2022) of respondents, while increased cooperation among healthcare workers was observed in 65% of responders. In the vaccination survey, less than half of the professionals surveyed were directly involved in the vaccination process, conducted mainly in hospitals at first and then in other centers to increase coverage, such as “Community Pharmacy.” For the first time, there have been reports of pharmacists authorized to administer vaccines in some countries. Conclusions: With the spread of the virus, the increased workload has affected the mental health of health workers. Although a slight improvement from 2022 vs 2021 was observed, there is a need now to work on improving mental health of health care workers, to protect/care about them, and also to ensure that they will not leave the profession to ensure health care for patients with cancer and COVID-19 (and in general to all patients). Vaccination was an opportunity for the pharmacist to play a more active role that reinforces the value of pharmaceutical practice.","PeriodicalId":210051,"journal":{"name":"The European Journal of Oncology Pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128717711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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