{"title":"Facts and figures of the compassionate use of onco-hematological drugs from 2016 to 2021: Results from the multicentric observational study Compass-O.","authors":"Annamaria Mascolo, Irene Dell'Anno, Leonardo Dondi, Cristina Scavone, Annalisa Capuano, Marialuisa Giordano, Adriano Cristinziano, Domenico Tarantino, Marcello Pani, Carla Masini, Caterina Donati, Elisabetta Rossin, Graziella Lagana, Alice Ballerio, Gabriele Bagaglini, Gabriella Bonanni, Alberto Vergati, Arturo Cavaliere, Rosanna Celenza, Alessandro D'Arpino, Nello Martini, Carlo Piccinni","doi":"10.1177/10781552251327117","DOIUrl":"https://doi.org/10.1177/10781552251327117","url":null,"abstract":"<p><p>BackgroundCompassionate drug use (CDU) is a topic of debate in the scientific community characterized by a lack of information, especially in the onco-hematology area.AimThe Compass-O study aimed to provide updated data on CDU of onco-hematological drugs for the period 2016-2021.MethodCompass-O is a retrospective observational study with data obtained from 7 Italian Units for cytotoxic drug preparations (<i>Unità Farmaci Antiblastici, UFA</i>). Drugs and Therapeutic Indications (TI) were described separately and as drug-TI combinations, providing the mean Patients Per Year (mPPY) and the Years of Use (YoU).ResultsA total of 783 requests of CDU were retrieved, referring to 156.3 mPPY (max: 272 in 2021; min: 84 in 2018). The 52.2% of subjects was female, and the 63.2% aged >60 years. A total of 709 (90.5%) CDUs referred to solid tumors and 74 (9.5%) to liquid tumors. CDU referred to 93 drug-TI combinations. The most recurrent drug-TIs were nivolumab-lung carcinoma (mPPY: 36.5; YoU: 2) for solid tumors, and azacytidine-acute myeloid leukemia (6.0; 1) for liquid tumors. The most frequent TIs were lung carcinoma (45.7; 6) and breast cancer (37.0; 4) for solid tumors, and chronic lymphocytic leukemia (5.0; 2) and multiple myeloma (4.7; 6) for liquid tumors.ConclusionCompass-O provided an updated framework of the CDU in onco-hematology, showing its large-scale phenomenon and the relevance of UFA as a data source, underlining the need for a national observatory to monitor CDU.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251327117"},"PeriodicalIF":1.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625174","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}
Yejin Seo, Karen Suchanek Hudmon, Kellie Jones Weddle, Yuehwern Yih, Kathy D Miller, Ephrem Abebe
{"title":"Mapping the patient journey: Understanding oral anticancer medication use among patients diagnosed with breast cancer.","authors":"Yejin Seo, Karen Suchanek Hudmon, Kellie Jones Weddle, Yuehwern Yih, Kathy D Miller, Ephrem Abebe","doi":"10.1177/10781552251323205","DOIUrl":"https://doi.org/10.1177/10781552251323205","url":null,"abstract":"<p><p>IntroductionA growing number of patients with breast cancer use oral anticancer medications (OAMs) but may face barriers in managing their therapy at home, potentially impacting their treatment outcomes. Understanding these barriers is essential to designing effective interventions. This study aimed to identify unmet medication management needs of patients with breast cancer receiving OAMs.MethodsQualitative semi-structured interviews were conducted to create patient-specific journey maps describing OAM use. Participants were recruited from a federally qualified health center's breast cancer clinic in central Indiana. Eligible patients were 18 years of age or older, diagnosed with breast cancer, and currently receiving OAMs. Participants completed a sociodemographic survey, and researchers and participants collaborated to create visual storyboards of medication use experiences, highlighting timelines, key markers, and barriers. Journey maps were consolidated, and personas were created to represent patients with similar characteristics. Participants were categorized by medication type: specialty (requiring specialty pharmacies) or traditional (available at community pharmacies).ResultsTwelve participants (11 females, 1 male; median age 65.5 years, range 37-75) were interviewed. Four were receiving specialty medications (palbociclib, ribociclib), and eight were receiving traditional medications (tamoxifen, anastrozole, exemestane). Two personas were created. The specialty medication group reported difficulties navigating the insurance system, whereas the traditional group did not. All participants experienced side effects, and sub-optimal adherence (n = 2) was reported only in the traditional group.ConclusionThis study provides insights into the patient experience with OAMs. Personas and journey maps can guide the development of tailored interventions to improve treatment outcomes.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251323205"},"PeriodicalIF":1.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625180","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}
Taylor Gabbard, Bernard L Marini, Kamran M Mirza, Lydia Benitez, Martina Fraga, Kristen M Pettit, Dale L Bixby, Patrick W Burke, Anthony J Perissinotti
{"title":"Therapeutic outcomes of patients with acute erythroid leukemia treated with hypomethylating agents.","authors":"Taylor Gabbard, Bernard L Marini, Kamran M Mirza, Lydia Benitez, Martina Fraga, Kristen M Pettit, Dale L Bixby, Patrick W Burke, Anthony J Perissinotti","doi":"10.1177/10781552251323578","DOIUrl":"https://doi.org/10.1177/10781552251323578","url":null,"abstract":"<p><p>Acute erythroid leukemia treatment is associated with poor survival. The most common treatments are intensive chemotherapy regimens and hypomethylating agents. Choice of preferred therapy is complex, and data are conflicting on the optimal regimen. The definition of AEL has also shifted with time but the impacts of these changes on survival reporting are largely unknown.We designed a single-center, retrospective review of patients meeting the 2001 World Health Organization definition of acute erythroid leukemia. Patients were treated with an intensive chemotherapy or a hypomethylating agent regimen. The primary outcome was overall survival.Most patients were older with complex karyotypes. Median overall survival did not differ between treatment groups. When survival was stratified by WHO 2022 diagnosis, patients meeting MDS criteria had notably increased survival outcomes while patients still meeting the definition of AEL did poorly regardless of induction regimen.Treatment of acute erythroid leukemia remains complex with poor survival outcomes.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251323578"},"PeriodicalIF":1.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537319","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}
Rand Al-Hadaddin, Nour Mustafa, Ahmad Alyamani, Nour Faqeer
{"title":"Qualitative analysis of clinical pharmacy interventions in an inpatient leukemia service.","authors":"Rand Al-Hadaddin, Nour Mustafa, Ahmad Alyamani, Nour Faqeer","doi":"10.1177/10781552241296407","DOIUrl":"10.1177/10781552241296407","url":null,"abstract":"<p><p>IntroductionLeukemia, a complex hematological malignancy, requires a multidisciplinary treatment approach, with clinical pharmacists playing a crucial role. However, their involvement in clinical practice is not well-documented in the literature. This study aimed to examine the characteristics of clinical pharmacy interventions (CPIs) reported by clinical pharmacists.MethodThis retrospective study involved extraction of CPIs entered into a pharmacy documentation database \"Quantifi<sup>®</sup>\" between January 2019 and June 2023. These CPIs included direct clinical pharmacist interventions (DCPIs), detected medication errors (MEs) and adverse drug reactions (ADRs).ResultsA total of 6286 CPIs were extracted, of which DCPIs, MEs and ADRs accounted for 5701 (90.7%), 357 (5.7%) and 228 (3.6%) reports, respectively. The most prevalent DCPIs were drug therapy discontinuation (n = 1080, 18.9%). Antimicrobials were the most common medications associated with DCPIs (n = 1991, 34.9%). Physicians accepted 99.4% of DCPIs and 64.1% (n = 3656) of direct interventions were considered significant. Among detected MEs, antimicrobials were the most reported medications (n = 158, 44.3%), with pharmacy internal errors being the most prevalent cause of the events (n = 172, 48.2%). Among the reported ADRs, hematological reactions were the most common (n = 81, 35.5%), and antineoplastic agents were the most frequently associated medications with ADRs (n = 164, 71.9%).ConclusionThis study highlights the crucial role of clinical pharmacists in managing leukemia patients, emphasizing their key interventions and ability to identify MEs and ADRs. Further research is needed to explore the clinical outcomes and financial impact of their involvement.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"276-281"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622358","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":"The effect of Bevacizumab treatment on the incidence of hypertension in patients with ovarian cancer: a systematic review and meta-analysis.","authors":"Xiaoyan Zhang, Jumei Hu, Xijing Fan, Qiaoqiao Chen, Danjun Zheng, Minjuan Huang, Yuanqing Xu","doi":"10.1177/10781552241307868","DOIUrl":"10.1177/10781552241307868","url":null,"abstract":"<p><p>IntroductionThis study aims to evaluate the effect of bevacizumab treatment on the incidence of hypertension in patients with ovarian cancer.MethodsA comprehensive search of PubMed, Scopus, Embase, Cochrane, Web of Science, and Google Scholar databases was conducted until August 2024. We included only randomized clinical trials that compared ovarian cancer patients treated with Bevacizumab to those treated with other therapies. The primary outcome was the relative risk (RR) of developing hypertension, stratified by grade. Statistical analyses were performed using a random-effects model to account for heterogeneity between studies. Subgroup analyses were conducted based on hypertension severity (grade ≥2 and grade ≥3) and disease stage. Sensitivity analyses and publication bias assessments were also performed.ResultsA total of 11 randomized trials were included, comprising 5212 patients. The meta-analysis revealed that patients receiving Bevacizumab had a significantly higher risk of hypertension compared to controls (RR = 2.91, 95% CI: 1.65-5.16, P = 0.0002). Subgroup analysis showed that the risk of grade ≥2 hypertension was 1.68 times higher (95% CI: 0.92-3.07), and grade ≥3 hypertension was 5.10 times higher (95% CI: 2.46-10.55) in the Bevacizumab group. Sensitivity analysis confirmed the robustness of these findings, and no significant publication bias was detected.ConclusionBevacizumab treatment in ovarian cancer significantly increases the risk of hypertension, particularly severe hypertension (grade ≥3). These findings underscore the need for vigilant blood pressure monitoring and management in patients receiving Bevacizumab to mitigate cardiovascular complications and optimize treatment outcomes.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"294-304"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390363","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}
Nora Alkhudair, Jude Howaidi, Mohammed Alnuhait, Majed Alshamrani, Mansour Khan, Atika Alharbi, Fouad Alnajjar, Eshtyag Bajnaid, Hajer Almodaheem, Mansour Alhowimel, Ali Alzahrani, Amr Khardaly, Mohammed Alnahedh, Hamdi Elsoudi, Hana Alabdulkareem, Ahmed Alrashidan, Musa Alzahrani, Abdullah Alrajhi
{"title":"Revitalizing oncology medications access in Saudi Arabia: Current challenges and recommendations by the Saudi Oncology Pharmacy Assembly.","authors":"Nora Alkhudair, Jude Howaidi, Mohammed Alnuhait, Majed Alshamrani, Mansour Khan, Atika Alharbi, Fouad Alnajjar, Eshtyag Bajnaid, Hajer Almodaheem, Mansour Alhowimel, Ali Alzahrani, Amr Khardaly, Mohammed Alnahedh, Hamdi Elsoudi, Hana Alabdulkareem, Ahmed Alrashidan, Musa Alzahrani, Abdullah Alrajhi","doi":"10.1177/10781552241232697","DOIUrl":"10.1177/10781552241232697","url":null,"abstract":"<p><p>BackgroundCancer care is posing immense challenges to healthcare systems globally. Advances in screening, monitoring, and treating cancer improved patient outcomes and survival rates yet amplified the disease burden. Multiple barriers might impede early access to innovative therapies. We thoroughly examined the current challenges in oncology medication access in Saudi Arabia and provided consensus recommendations to revitalize the process.MethodsA focus group discussion was conducted. Expert healthcare providers (pharmacists and physicians) were invited to participate based on prespecified criteria. The research team conducted a qualitative analysis of the discussion to identify themes and formulate recommendations.ResultsFourteen experts were equally distributed into two groups, limiting the number in each group to 7. Pharmacists were 12 (∼86%), and physicians were 2 (∼14%). Ten were practicing in governmental hospitals, four representing different sectors; regulatory bodies, including Ministry of Health, National Unified Procurement Company, and Saudi Food and Drug Authority. Five themes were identified: national cancer burden, local data availability, pharmacoeconomic evaluation, patients reported outcomes, administration, and procurement. Consensus recommendations were formulated to optimize the formulary management process, enabling informed decision-making and facilitating early medication access for cancer patients.ConclusionsThe formulary management process can be enhanced by addressing the national cancer burden, promoting local data availability, conducting pharmacoeconomic evaluations, focusing on patient outcomes, and improving administration and procurement procedures. Implementing these recommendations can improve access to oncology medications and improve patient care outcomes in Saudi Arabia.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"245-250"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Pérez-Codesido, V Azzi Virgini, S Fertani, P Jandus
{"title":"Successful desensitization to etoposide in a patient after cardiac arrest.","authors":"S Pérez-Codesido, V Azzi Virgini, S Fertani, P Jandus","doi":"10.1177/10781552241280723","DOIUrl":"10.1177/10781552241280723","url":null,"abstract":"<p><p>IntroductionEtoposide phosphate is a chemotherapeutic agent used to treat various malignant neoplasms. Hypersensitivity reactions may occur with its use, and in rare cases, an anaphylactic reaction can manifest. Available options for patients experiencing hypersensitivity reactions include premedication, changing treatment, or undergoing desensitization. Various pediatric desensitization protocols have been described, ranging from six to fifteen steps, while published adult cases are rare.Case ReportWe report the case of a 61-year-old woman with small-cell lung cancer and brain metastases. In November 2019, she underwent the second cycle of cisplatin and etoposide phosphate treatment. While receiving etoposide phosphate, she experienced dyspnea and suffered a cardiorespiratory arrest, leading to cardiopulmonary resuscitation and subsequent admission to the Intensive Care Unit. Her acute tryptase levels were notably elevated at 18 µg/L (compared to a baseline tryptase level of 6,6 µg/L) during the reaction.Case ManagementWe implemented a 16-step desensitization protocol (without premedication) under close monitoring in an intermediate care unit. The protocol was successfully executed over three cycles until tumor progression mandated a modification in systemic treatment.DiscussionTo our knowledge, this is the first documented case of successful desensitization to etoposide phosphate in a patient who experienced cardiac arrest during a hypersensitivity reaction. Although protocols of varying lengths have been published, we emphasize the importance of individualizing each protocol to fit the severity of the reaction and the resources and experience of each unit.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"336-340"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The risk of pocket infection or bloodstream infection following central venous port placement for the patients with Cetuximab therapy.","authors":"Shintaro Sueyoshi, Takeharu Ono, Shun-Ichi Chitose, Mioko Fukahori, Takashi Kurita, Hirohito Umeno","doi":"10.1177/10781552231225933","DOIUrl":"10.1177/10781552231225933","url":null,"abstract":"<p><p>ObjectiveCetuximab is a molecular targeted drug that targets epithelial growth factor receptors. The skin toxicity of cetuximab arising from epithelial growth factor inhibition is well known. Some patients with cetuximab therapy decided to make central venous port during the long-term intravenous treatments. Therefore, the author hypothesized that cetuximab administration might increase the risk of central venous port-related infection due to damage to skin barrier function. The main aim of the present study was to investigate the relationship between cetuximab administration and central venous port-related infection.MethodsA total of 83 patients had a central venous port placed from 2016 through 2021. We analyzed, retrospectively, the relationship between cetuximab therapy and the incidence of central venous port-related infection involving central line-associated bloodstream infection and pocket infection. Additionally, the risk factors of central venous port-related infection were examined in the population undergoing cetuximab therapy.ResultsIn total populations (83 cases), central line-associated bloodstream infection happened in five patients (6%) and pocket infection happened in six patients (7%) after central venous port placement. In the cetuximab therapy group (45 cases), there were four patients with central line-associated bloodstream infection (9%) and six with pocket infection (13%). The pocket infection happened more frequently in the cetuximab group than the other group with significant differences. Additionally, in the cetuximab group, the patients who had an interval of less than seven days between central venous port placement and cetuximab dosing, or central venous port placement preceded by cetuximab dosing had more pocket infection with significant differences.ConclusionSkin complications after the central venous port placement were related to cetuximab administration and the timing of cetuximab therapy.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"195-202"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521195","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":"Enteral tube administration of extemporaneously compounded suspensions of venetoclax according to an institutional medication use process.","authors":"Sakib T Haque, Joseph S Bubalo","doi":"10.1177/10781552241299690","DOIUrl":"10.1177/10781552241299690","url":null,"abstract":"<p><p>IntroductionVenetoclax is a potent oral oncology drug (OOD) frequently used to treat hematologic cancers due to its convenience and high efficacy. However, some patients cannot tolerate solid oral formulations, requiring a reformulated version of venetoclax for effective administration. Currently, there is limited information in the literature regarding the extemporaneous compounding of venetoclax.MethodsWe present our institution's medication use process (MUP) for preparing compounded suspensions of venetoclax for patients with dysphagia who cannot tolerate solid oral formulations. This report has two main aims: to review our MUP from design to implementation, illustrated with real patient cases, and to present it as a strategy for administering venetoclax-based therapies to patients with dysphagia or feeding tubes. From February 2020 to January 2024, 17 patients received venetoclax through the standard MUP, with four developing tumor lysis syndrome (TLS). This study describes their clinical courses and evaluates their responses to the compounded suspensions, considering the uncertain effects of venetoclax prepared through this method.ResultsThe four patients received venetoclax suspensions during hospitalization due to swallowing difficulties or nutritional support needs. We prepared extemporaneous venetoclax suspensions to ensure continuous therapy, thus avoiding treatment interruptions. TLS was managed using rasburicase and prophylactic allopurinol.ConclusionsThe clinical outcomes indicate that the current MUP provides a practical approach to administering venetoclax for dysphagic patients. However, additional research is needed to determine if there are pharmacokinetic differences in the bioavailability of venetoclax between oral and enterally delivered formulations. Further studies will help inform best practices for patient care.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"315-320"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668320","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":"Temozolomide overcoming resistance to immune checkpoint inhibitors in relapsed/refractory metastatic melanoma? Insights from a single center series.","authors":"Constantin A Dasanu, Steven C Plaxe","doi":"10.1177/10781552241302421","DOIUrl":"10.1177/10781552241302421","url":null,"abstract":"<p><p>There is a need to develop more effective salvage therapies for patients with relapsed melanoma of the skin. Research has shown that chemotherapy-induced cancer cell death may increase immunogenic antigen exposure, or upregulation of co-inhibitory ligands such as PD-L1, thereby augmenting immune checkpoint inhibitor (ICI) efficacy. In addition, chemotherapy preconditioning may lead to depletion of Tregs, known to suppress immune anti-melanoma responses. As a result, regimens including both chemotherapy and ICI constructs are currently successfully employed in the 1<sup>st</sup> line therapy of many solid tumors. We report a series of three patients with metastatic melanoma, refractory to ICI treatment, who responded to salvage therapy with temozolomide (TMZ) in combination with PD-1 inhibitors, with or without CTLA-4 inhibitors. The responses were durable, each lasting more than 12 months. In two patients, complete responses are ongoing at 13 and 15 months, respectively. Randomized clinical trials with TMZ plus ICIs for patients with relapsed or refractory malignant melanoma seem warranted.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"321-324"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710489","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}