Journal of Oncology Pharmacy Practice最新文献

{"title":"Long term and simulated in-use stabilities of irinotecan chemotherapy polyolefin infusion bags in dose banding conditions.","authors":"Claire Andre, Lydie Lethier, Yves Claude Guillaume","doi":"10.1177/10781552251338763","DOIUrl":"https://doi.org/10.1177/10781552251338763","url":null,"abstract":"<p><p>PurposeThe dose-banding of irinotecan provides the opportunity to anticipate the preparation of this anticancer drug on condition of carrying out stability studies. The aim of this study was to develop and validate a HPLC method for measuring the concentration of irinotecan and to evaluate its long-term stability at standardized rounded doses in polyolefin (POF) infusion bags at 4°C and protected from daylight. Microbiological and Physical stability tests were periodically performed including visual inspection, turbidity, lightness and chromaticity measurements. In addition, in a simulated in-use study, irinotecan quantification was also performed on the solution emitted from the POF infusion bags on a short period (24 h), at room temperature (25°C) and in daylight.MethodsThe HPLC with photodiode array (PDA) detector method was developed and validated (linearity, precision, accuracy, limits of detection and quantification, robustness and degradation test). Diluted irinotecan infusion solutions were aseptically prepared by further dilution of irinotecan stock solution with 0.9% sodium chloride in POF bags at banded doses 200 mg, 300 mg and 370 mg, the three most frequently produced doses in the pharmacy department. The POF bags were stored under refrigeration (4°C) in the dark (long term stability conditions) or at room temperature (25°C) in daylight for a short period 24 h (simulated in-use conditions). Microbiological tests were carried out and the physical and chemical stabilities were evaluated respectively through visual inspection, turbidity, lightness, chromaticity measurements and through chromatographic assays, pH and osmolality monitoring.ResultsThe long - term stability of irinotecan at selected standardized rounded doses (200 mg-300 mg-370 mg) in NaCl 0.9% polyolefin bags was confirmed for at least 84 days at 4 °C and in the dark. Microbiological tests performed on the samples were negative. As well, during the simulated in-use study, no signs of chemical instability were observed.ConclusionsA simple, accurate and stability-indicating HPLC method was developed to determine irinotecan concentrations in dose-banding conditions. As well, this present work including HPLC peak width, lightness and chromaticity measurements of a cytotoxic drug during the time of storage may be a guidance in stability studies. This study supports a centralized production of irinotecan in accordance with the studied conditions.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251338763"},"PeriodicalIF":1.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related adverse effects of Tamoxifen in female breast cancer patients: Insights from the FDA's adverse event reporting system.","authors":"Yuting Chen, Weitao Lu, Li Xin, Xu Tang, Jing Wang, Huancun Feng","doi":"10.1177/10781552251338040","DOIUrl":"https://doi.org/10.1177/10781552251338040","url":null,"abstract":"<p><p>BackgroundTamoxifen is an effective treatment for hormone receptor-positive breast cancer (BC). Despite its effectiveness, there have been many reports of adverse reaction. <b>However, the relationship between Tamoxifen-related adverse events (ADEs) and patient age remains unclear</b>.AimTo enhance clinical medication guidance and drug safety by identifying age-specific ADEs associated with Tamoxifen therapy in female breast cancer patients, thereby offering a more robust foundation for evidence-based clinical practice.MethodsADEs reports of Tamoxifen from the FAERS database were extracted from the first quarter of 2004 to the second quarter of 2023. Reporting odds ratio (ROR) data analysis strategy was used for mining signal strength that represents age differences in ADEs related to Tamoxifen.ResultsThe number of <b>efficient ADE signals associated with Tamoxifen</b> for female BC included in the analysis was 338 in premenopausal women, 847 in perimenopause and 1525 in postmenopause respectively. Our study showed age differences in three age groups of ADEs with Tamoxifen in female BC. <b>Perimenopausal and postmenopausal women receiving tamoxifen therapy demonstrated a significantly higher incidence of adverse drug reactions, particularly involving the gastrointestinal tract, renal/urinary systems, hematologic/lymphatic systems, endocrine functions, and immune responses</b>. It was particularly concerned that ADEs associated with ear and labyrinth disorders had only been reported in perimenopause.ConclusionAge differences was detected in ADE signals related to Tamoxifen. There were significant differences in Tamoxifen related ADEs of premenopausal, perimenopausal and postmenopausal women with BC in different systems. To ensure the safety of medicines, we should be aware of the age-related differences in ADEs and take appropriate preventive measures to reduce incidence of serious ADEs.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251338040"},"PeriodicalIF":1.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved oral anticancer medication (OAM) adherence/toxicity assessment documentation: A quality improvement initiative.","authors":"Lisa M Holle, Andrea Moran, Margaret Savage, Grace Morrison, Michael K Keng","doi":"10.1177/10781552251340308","DOIUrl":"https://doi.org/10.1177/10781552251340308","url":null,"abstract":"&lt;p&gt;&lt;p&gt;IntroductionAdherence and toxicity symptoms ideally are monitored within 7-14 days after initiating oral anticancer medication (OAM). After implementing a formal OAM program at our institution, we found our adherence and toxicity monitoring was suboptimal and sought to improve our processes to reduce patient risk, using a formal quality improvement methodology.Patient and methodsAdult patients with a solid tumor or hematologic malignancy newly prescribed on OAM were included. We manually collected data from the EMR at baseline and monthly during Plan-Do-Study-Act (PDSA) cycles. An interprofessional, multidisciplinary team was formed and developed a workflow process map for a newly prescribed OAM. Nine key process measure tasks necessary to accurately document OAM adherence/toxicity following OAM initiation were identified. The outcome measure was percentage of these 9 key tasks. Balance measures (unintended consequences as result of process changes) included OAM related provider and emergency department (ED) visits, hospitalizations and telephone messages. Descriptive statistics were used. We used a statistical process control chart method to examine our outcome measure and two-sample (assuming equal variance) two-tailed t-test (alpha, 0.05) to compare process, outcome and baseline measures.ResultsAt baseline, our outcome measure (percentage of 9 key process tasks completed) was 50%; individual process outcomes ranged from 4.2% to 95.8%. PDSA#1 included staff education about appropriate documentation of patient OAM education. Following this intervention, the outcome measure was 53% (process measures ranged 10-100%). PDSA#2 included nursing workflow retraining, which further improved outcome measure to 55% (process measures 11.5-100%) and balance measures. PDSA#3 included a more standardized process, training for new employees and OAM start date patient education sheet. The outcome measure significantly improved from 50% at baseline to 67% (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). All process measures (the 9 key tasks) improved from baseline, with the most significant occurring with 1) informed consent signed (58.3% to 100%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001); 2) patient education completed/documented (25% to 42.9%; &lt;i&gt;p&lt;/i&gt; &lt; 0.004); 3) OAM start date documentation (33.3% to 75%; &lt;i&gt;p&lt;/i&gt; &lt; 0.002); and 4) OAM adherence/toxicity assessment appointment scheduled (4.2 to 21.4%; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Balance measures improved compared with baseline, with number of phone messages significantly reduced (41.7% vs 33%; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Sustainability of these improvements was shown up to 6 months following the last intervention.ConclusionThis quality improvement initiative improved the percentage of toxicity/adherence documentation tasks necessary to ensure appropriate OAM adherence/toxicity monitoring was completed by day 10 of cycle 1 following a newly prescribed OAM. This also resulted in fewer OAM-related telephone messages, which not only decreases provider time but signifies fewer","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251340308"},"PeriodicalIF":1.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete color vision loss in a patient with metastatic melanoma of the skin treated with nivolumab-relatlimab.","authors":"Ruba Alchaikh Hassan, Anderson Vu, Henry Tsai, Constantin A Dasanu","doi":"10.1177/10781552251340014","DOIUrl":"https://doi.org/10.1177/10781552251340014","url":null,"abstract":"<p><p>IntroductionThe combination nivolumab-relatlimab has demonstrated therapeutic benefits for patients with metastatic melanoma. However, its adverse effects can affect various organs, including the eye.Case reportWe present the case of an 80-year-old man who developed complete color blindness after the 2^nd dose of nivolumab-relatlimab for advanced cutaneous melanoma. He also had significant blurry vision. Fundoscopy identified bilateral serous macular detachment. Ocular coherence tomography confirmed serous infiltration within the macula. After a thorough investigation, causality assessment linked this retinal effect to nivolumab-relatlimab (probable relationship via Naranjo criteria).Management and outcomeThe patient was treated with corticosteroids, intravenous immunoglobulin (IVIG), rituximab, and plasmapheresis, with improvement in blurry vision. However, he continued to experience persistent absence of color perception (\"black and white vision\") at a follow-up visit six months later.Discussion/conclusionFurther studies are necessary to understand the exact pathophysiology of this process. We hypothesize that it involves direct toxicity to the photoreceptors or retinal ganglion cells, leading to irreversible color vision loss. Effective strategies for preventing this significant, life-changing toxic effect of nivolumab-relatlimab should be sought.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251340014"},"PeriodicalIF":1.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical safety of a 1-h infusion of cisplatin approach in a broad cancer population.","authors":"Esther L Albuquerque, Justin G Horowitz, Grace C Lee","doi":"10.1177/10781552251340630","DOIUrl":"https://doi.org/10.1177/10781552251340630","url":null,"abstract":"<p><p>IntroductionCisplatin has ubiquitous use throughout many cancer types and is incorporated in various regimens. Nephrotoxicity is a well-known side effect of cisplatin, occurring in up to one third of patients. Early clinical data showed elevated peak concentrations are correlated with increased incidence of nephrotoxicity, suggesting prolonging infusion duration may abate this known toxicity. A recent study showed there was no difference in rates of acute kidney injury (AKI) between rapid (1-h) and standard (3-h) infusions of cisplatin, however, cisplatin was administered inpatient with prolonged and aggressive hydration methods. Therefore, we aimed to compare outcomes in patients who received rapid-infusion vs. standard-infusion cisplatin in the outpatient setting at our institution.MethodsThis single center, pre-post intervention study evaluated outpatient visits between January 2022 and March 2024. Cisplatin was administered over 3-h at Mays Cancer Center, UT Health San Antonio, prior to an institutional practice change to 1-h (rapid infusion) that took place February 2023. The co-primary outcomes were the maximum decrease in eGFR from baseline and the incidence of stage 1 or higher AKI. Secondary outcomes included rates of treatment modification and rates of healthcare resource utilization.ResultsA total of 53 patients with a chemotherapy regimen containing cisplatin met study criteria. Baseline characteristics were similar for the standard (n = 28) and rapid infusion (n = 25) groups. The maximum decrease in eGFR in the standard infusion vs. rapid infusion group did not differ (15.2 vs 18.0 mL/min/1.73 m², respectively; <i>p</i> = 0.89). The incidence of stage 1 or higher AKI was not significantly different between the standard and rapid infusion cohorts (<i>p</i> = 0.13). No differences were identified for the secondary outcomes including rates of regimen modifications or hospitalizations due to AKI or time to AKI in 120 days after the first cisplatin dose.ConclusionIn this pre-post intervention analysis neither occurrence nor severity of nephrotoxicity appeared to be affected by the infusion rate of cisplatin in the outpatient setting. Rapid infusion of cisplatin over 1-h appears to be a feasible option without increased safety risk for patients.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251340630"},"PeriodicalIF":1.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using bispecific antibodies in a patient with peritoneal dialysis for relapsed multiple myeloma.","authors":"Heng Jiang, Yagya Ahlawat, Amir Steinberg","doi":"10.1177/10781552251341235","DOIUrl":"https://doi.org/10.1177/10781552251341235","url":null,"abstract":"<p><p>IntroductionBispecific antibodies (BsAbs) are a promising therapy for relapsed/refractory multiple myeloma (RRMM), but their efficacy in patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) remains unclear. Given the prevalence of renal impairment in MM, understanding BsAbs' use in this population is critical.Case ReportWe present a 72-year-old woman with ESRD on PD diagnosed with RRMM after developing a pathologic humeral fracture. Bone marrow biopsy confirmed lambda light chain multiple myeloma with extensive skeletal involvement.Management & OutcomeThe patient was treated with upfront radiation, and then received daratumumab, cyclophosphamide, bortezomib, and dexamethasone (Dara-CyBorD), followed by carfilzomib, lenalidomide, and dexamethasone (KRd) upon progression. Due to limited response, teclistamab was initiated, achieving a significant but transient response, prompting a switch to talquetamab. Following relapse, she was transitioned to elotuzumab, pomalidomide, and dexamethasone, then selinexor as a bridge to chimeric antigen receptor T-cell (CAR-T) therapy.DiscussionThis case demonstrates that BsAbs may be effective in RRMM patients on PD, though responses were transient. Further research is needed to explore BsAbs' pharmacokinetics, optimal dosing, and long-term outcomes in dialysis-dependent MM patients.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251341235"},"PeriodicalIF":1.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist-led interventions associated with symptoms identified by electronic patient-reported outcome battery: A descriptive study.","authors":"Sara Sarpas, Ding Quan Ng, Daniela Arcos, Alexandre Chan","doi":"10.1177/10781552251340922","DOIUrl":"https://doi.org/10.1177/10781552251340922","url":null,"abstract":"<p><p>IntroductionAt the University of California Irvine (UCI) in Orange County California, we published an implementation study to evaluate the use of an electronic patient-reported outcome (ePRO) tool to guide pharmacist-led chemotherapy education in newly diagnosed cancer patients. The goal of this secondary analysis was to describe the types of pharmacist-led interventions performed in the implementation study.MethodsUsing a pre-configured ePRO battery, patients' symptoms were assessed in seven domains (cognitive impairment, physical impairment, pain, depression, anxiety, fatigue, nausea/vomiting) at each infusion visit. Other symptoms that were brought up during the visit were also documented. Based on symptom scores calculated in real-time, pharmacists implemented personalized patient care strategies and documented them in the clinical notes. Descriptive statistics were employed to evaluate the type of interventions employed for each symptom domain.ResultsAmong 250 patients enrolled, the average age of participants was 60 years old (SD = 14.6), with 129 (52%) being female, and 134 (54%) of participants identified as white. The preconfigured ePRO battery identified clinically important symptoms at 47.3% of the visits, and other clinically important symptoms were identified at 23.4% of the visits. Pharmacist education was performed for 311 (55%) of 564 visits examined throughout the study. The highest proportions of pharmacological interventions were performed to manage nausea/vomiting (51 visits), followed by gastrointestinal symptoms (21 visits), and pain (16 visits). Additional provider communication was performed for managing nausea/vomiting (14 visits), pain (9 visits), and neurological symptoms (9 visits).ConclusionWe observed a high rate of pharmacist-led education after the institution of ePRO to evaluate symptoms in patients undergoing anticancer treatment. Future studies should consider incorporating additional ePRO domains to include a wide range of patient-reported symptoms tailored to each type of anticancer treatment.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251340922"},"PeriodicalIF":1.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rechallenge of an alternative CDK 4/6 inhibitor after hepatotoxicity in the treatment of hormone-positive metastatic breast cancer.","authors":"Kasey Jackson, Kiera Roubal, Christopher Rangel, Frank Brescia","doi":"10.1177/10781552251340613","DOIUrl":"https://doi.org/10.1177/10781552251340613","url":null,"abstract":"<p><p>IntroductionCyclin Dependent Kinase (CDK) 4/6 inhibitors are changing the landscape of breast cancer treatment. These medications are generally well-tolerated, but incidences of hepatotoxicity have been reported in the literature.Case ReportIn this case, we present a 36-year-old Caucasian female who was diagnosed with hormone-receptor (HR) positive, human epidermal growth factor receptor 2 (HER2) negative metastatic breast cancer who initiated first line treatment with an aromatase inhibitor and a cyclin-dependent kinase (CDK) 4/6 inhibitor, ribociclib. Following treatment initiation, she experienced grade 4 hepatoxicity.Management and OutcomeRibociclib was discontinued due to probable cause of hepatotoxicity based on a Naranjo score of 7. Once her liver enzymes resolved to grade 1 toxicity, she was transitioned to another CDK 4/6 inhibitor, palbociclib. The patient has remained on palbociclib for 1 year of treatment with normalization of her liver function enzymes and stable disease.DiscussionThis case presents a successful rechallenge of an alternative CDK 4/6 inhibitor after grade 4 ribociclib-induced hepatotoxicity and reviews similar cases of ribociclib-induced hepatoxicity and management strategies.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251340613"},"PeriodicalIF":1.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for delayed high-dose methotrexate elimination: A practical issue for diffuse large B-cell lymphoma patients.","authors":"Margot Vattaire-Hervé, Antoine Le Bozec, Justine Clarenne, Guillaume Cohet, Violaine Lepage, Chloé Gossery, Elise Michelet-Huot, Anne Quinquenel, Isabelle Madelaine, Eric Durot, Florian Slimano","doi":"10.1177/10781552251340000","DOIUrl":"https://doi.org/10.1177/10781552251340000","url":null,"abstract":"<p><p>PurposeThe high-dose methotrexate (HD-MTX) regimen (>1 g/m²) is the standard of care for preventing and managing central nervous system (CNS) invasion in diffuse large B-cell lymphoma (DLBCL). Delayed elimination of HD-MTX can lead to severe toxicity. Albumin is a suggested biological marker to predict delayed elimination. This study aims to evaluate whether serum albumin can be used as a predictive factor.MethodsThis retrospective bicentric study includes DLBCL patients, receiving HD-MTX from 06.30.2016 to 12.31.2023 using CHIMI0v5.9. Data collected included demographic, biological, clinical and therapeutic. Eligible patients were over 18 years, with DLBCL diagnosis, available serum albumin before HD-MTX, with therapeutic drug monitoring of plasma methotrexate available. Univariate and multivariate analysis compared patients with and without delayed elimination.ResultsA total of 68 patients were included, with 15 suffering delayed elimination. Univariate analysis showed that male and Body Surface Area ≥ 2 m² (BSA) patients were more likely to have delayed clearance (respectively p = 0.01; p = 0.05). The association with male sex was confirmed in multivariate analysis (p = 0.01). Most cases of hypoalbuminemia were classified as grade 1 or 2. Patients with hypoalbuminemia received lower doses of MTX. Serum albumin level was not significantly associated with delayed elimination (p = 0.8).ConclusionsOverall, mainly biometric factors are associated with delayed elimination, highlighting the problem of prescribing habits based on body surface area. Albuminemia's role remains debated, and this study does not provide a conclusion, as patients with hypoalbuminemia received lower HD-MTX doses. Studies should account factors related to inflammation, nutrition and specific biomarkers (prealbumin).</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251340000"},"PeriodicalIF":1.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-based muscle analysis risk assessment of treatment-related toxicity in metastatic colorectal cancer.","authors":"Matthew Lei, Ryan D Nipp, Erica Tavares, Uvette Lou, Erica Grasso, Stephanie Mui, J Peter Marquardt, Till D Best, Emily E Van Seventer, Anurag Saraf, Ismail Tahir, Nora K Horick, Florian J Fintelmann, Eric J Roeland","doi":"10.1177/10781552251338048","DOIUrl":"https://doi.org/10.1177/10781552251338048","url":null,"abstract":"<p><p>IntroductionUp to 60% of adults with metastatic colorectal cancer (mCRC) receiving combination cytotoxic chemotherapy may experience loss of skeletal muscle mass and function. This study explores associations of artificial intelligence (AI)-based skeletal muscle assessment with hematologic toxicity and chemotherapy relative dose intensity (RDI) in adults with mCRC receiving standard combination chemotherapy.MethodsWe conducted a retrospective analysis of adults with mCRC receiving first-line FOLFOX or FOLFIRI over 6 months (≤12 cycles) from 1/2011 to 11/2018. We used a validated AI-based skeletal muscle assessment on baseline (prior to starting chemotherapy) computed tomography scans to determine skeletal muscle index (SMI, cm²/m²), categorizing low SMI using independent sex-specific cut-off values. We sought to evaluate the association between low SMI and the incidence of grade ≥3 (G ≥ 3) cytopenia over 6 months. Secondary endpoints included time to G ≥ 3 cytopenia and RDI.ResultsOverall, 126 adults met inclusion (median age = 61 years [range, 29-85]; 56 [44%] female) with a median BMI of 26.6 kg/m² (IQR, 24.1-30.5 kg/m²), including 59 (47%) with a low SMI. G ≥ 3 neutropenia incidence was higher in adults with low SMI (31% vs. 15%, p = 0.036). There was no difference for other G ≥ 3 cytopenias (39% vs 24%, p = 0.067) or median time to G ≥ 3 neutropenia (p = 0.053). Patients with a low SMI had a lower 5FU-bolus RDI (p = 0.045).ConclusionAdults with mCRC receiving first-line chemotherapy with low SMI experienced more G ≥ 3 neutropenia and decreased 5-FU bolus RDI.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251338048"},"PeriodicalIF":1.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}