{"title":"Subcutaneous nivolumab: Advancing operational efficiency and patient-centred care in the NHS.","authors":"Joanne Parkes","doi":"10.1177/10781552251346908","DOIUrl":"https://doi.org/10.1177/10781552251346908","url":null,"abstract":"","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251346908"},"PeriodicalIF":1.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199422","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}
Katie Konieczny, William Eighmy, Emily Rux, Katelyn Yamartino, Terri Parker
{"title":"The utility of intravenous immunoglobulin infection prophylaxis in patients on anti-CD38 therapies.","authors":"Katie Konieczny, William Eighmy, Emily Rux, Katelyn Yamartino, Terri Parker","doi":"10.1177/10781552251347240","DOIUrl":"10.1177/10781552251347240","url":null,"abstract":"<p><p>BackgroundAnti-CD38 directed therapies have emerged as targeted treatments for multiple myeloma (MM) and light chain (AL) amyloidosis. Intravenous immunoglobulin (IVIG) supplementation has been shown to reduce the risk of bacterial infections by 39% in patients with MM receiving anti-CD38 therapies, with a 72% reduction in grade 3-4 infections. However, there is currently no universal guidance on the optimal population in whom to initiate IVIG prophylaxis to prevent these infectious complications.MethodsThis study was a retrospective, single-centered chart review of eligible patients treated at Yale New Haven Health System (YNHHS) from 2016-2022. Eligible patients included adults with MM or AL amyloidosis treated with an anti-CD38 based regimen. The primary outcome was to compare the rate of pneumonia in patients who have received IVIG as compared to patients who have not. The secondary outcome was to identify the immunoglobulin G (IgG) level associated with an increased risk of pneumonia.ResultsRates of pneumonia were found to be higher within the population receiving IVIG as compared to those not receiving IVIG (29.55% vs. 15.41%, p = 0.05). There were no significant differences in the subgroup analyses including line of therapy, anti-CD38 agent, diagnosis, and IgG disease involvement. There was also no significant correlation demonstrated between baseline IgG level and the occurrence of pneumonia (β1 -0.0001, p = 0.37).ConclusionsIVIG supplementation in patients receiving anti-CD38 directed therapy did not significantly reduce the incidence of pneumonia. Given the lack of benefit with IVIG supplementation, careful consideration must be given prior to administration to limit unnecessary utilization.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251347240"},"PeriodicalIF":1.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199423","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":"Case report: Drug-induced vitiligo during treatment with BRAF/MEK inhibitors in a patient with metastatic conjunctival melanoma.","authors":"Seray Saray, Pelin Hızlı","doi":"10.1177/10781552231189819","DOIUrl":"10.1177/10781552231189819","url":null,"abstract":"<p><p>IntroductionAutoimmune side effects can be detected during the use of BRAF/MEK inhibitor. Although its frequency, mechanism and importance are not known exactly, there are cases reported in the literature.Case ReportWe report a case of drug-induced vitiligo in a patient with metastatic conjunctival malignant melanoma who was treated with BRAF/MEK inhibition therapy.Management and OutcomeIn the case, vitiligo was controlled with topical treatments. Follow-up process of the patient has been continuing with no progression on month 12 of the current treatment.DiscussionAlthough ICI-related autoimmune side effects and vitiligo have been described more frequently, vitiligo may also occur secondary to BRAK/MEK inhibition. This case also points out that cutaneous toxicity is manageable with no delay in treatment thanks to collaboration of dermatologists and oncologists.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"670-673"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9885633","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}
Derek Tai, Daniel Park, Priscilla Soria, Pranati Shah, Kendall Wick, So Young Son, Won Jin Jeon, Kum-Ja Lee, Mojtaba Akhtari
{"title":"Hepatic sinusoidal congestion associated with inotuzumab therapy in patients with B-cell acute lymphoblastic leukemia, a proposal for a new clinical entity: Calicheamicin syndrome.","authors":"Derek Tai, Daniel Park, Priscilla Soria, Pranati Shah, Kendall Wick, So Young Son, Won Jin Jeon, Kum-Ja Lee, Mojtaba Akhtari","doi":"10.1177/10781552251332278","DOIUrl":"10.1177/10781552251332278","url":null,"abstract":"<p><p>Inotuzumab (InO) is an anti-CD22 immunoconjugate for patients with relapsed or refractory CD22 positive B-cell acute lymphoblastic leukemia (B-ALL). Liver toxicity is a recognized side effect of InO, including sinusoidal obstruction syndrome (SOS), but is not fully understood. This study describes a new aspect of InO-induced hepatotoxicity by outlining six patients who developed abnormal liver function tests (LFTs) and thrombocytopenia, with liver biopsies showing sinusoidal congestion without evidence of SOS. Liver biopsies were obtained from all six patients and LFTs were monitored before initiating InO treatment, during treatment, and after discontinuing treatment. All six patients experienced abnormal LFTs at a median of 15 days after the last dose of InO and improvement in LFTs at a median of 17 days after discontinuing InO. Initial baseline AST, ALT, ALP, and total bilirubin values prior to InO therapy ranged from 10-45 U/L, 10-45 U/L, 60-207 U/L, and 0.2-0.9 mg/dL respectively and increased up to 2 to 4 times the upper limit of normal after completing varying cycles of InO with hepatotoxicity grades ranging from 1-2. LFTs returned to 1 to 1.5 times the upper limit of normal after discontinuing InO. The patients' liver biopsies all demonstrated different levels of hepatic sinusoidal congestion (HSC) without evidence of SOS. This study provides new evidence describing HSC, where we hypothesize that InO induced hepatotoxicity are due to calicheamicin. We propose a new clinical entity called \"calicheamicin syndrome\" with its quadriad components: History of using InO or GO, elevated LFTs, thrombocytopenia, and abnormal liver imaging.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"656-669"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970617","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":"Targeted therapy in TNBC: Exploring the role of antibody-drug conjugates with a focus on sacituzumab govitecan.","authors":"Nahida Siddiqui, Moduru Tejo Arun, Kummari Aparna, Madishetti Abhishek Murthy, Tadikonda Rama Rao","doi":"10.1177/10781552251316433","DOIUrl":"10.1177/10781552251316433","url":null,"abstract":"<p><p>ObjectivesTo underscore the prevalence and mortality of breast cancer and review advancements in metastatic TNBC management, with a particularly focus on the role of antibody-drug conjugates (ADCs), emphasizing the safety and therapeutic potential of Sacituzumab govitecan (SG) as a groundbreaking ADC.Data SourcesThis review gathers scientific data from the past decade, sourced from PUBMED, ClinicalTrials.gov, and Google Scholar to retrieve relevant studies focused on SG in metastatic TNBC treatment.Data SummaryBreast cancer is the most common cancer in women, with TNBC being particularly aggressive and difficult to treat. Recent advancements, such as ADCs, have enhanced treatment options. The third-generation Trop-2-targeting ADC, SG, shows promise for metastatic TNBC. This review summarizes available scientific data on SG's safety, efficacy, and future potential. It also discusses ongoing clinical trials evaluating SG in various combinations, offering hope for improved therapeutic strategies in this high-risk group.ConclusionsADCs hold great promise for transforming anti-tumor therapies over the next decade and SG has demonstrated substantial efficacy and a manageable safety profile in treating metastatic TNBC. Ongoing trials show that combining SG with immunotherapies enhances its potential, offering hope for better outcomes in patients with limited options. These findings highlight the need for further research to fully define SG's role in optimizing treatment strategies.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"649-655"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052896","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}
Anisa Kamel, Melissa Sanders, Hannah Dyk, Tatum Hamilton
{"title":"A retrospective review of rasburicase utilization in pediatric and adult patients across a large health system.","authors":"Anisa Kamel, Melissa Sanders, Hannah Dyk, Tatum Hamilton","doi":"10.1177/10781552241253214","DOIUrl":"10.1177/10781552241253214","url":null,"abstract":"<p><p>PurposeThis study aimed to characterize rasburicase dosing and duration. Secondary objectives included characterizing the indication of rasburicase and identifying the utilization of prophylactic therapy for tumor lysis syndrome (TLS).MethodsThis retrospective review included patients 0 to 89 years old admitted between 1 January 2021 and 31 December 2021, and received at least one dose of rasburicase. Patients were excluded if they were >89 years old, pregnant, lactating, or received rasburicase outpatient.ResultsA total of 192 patients, 176 adults and 16 pediatric patients were included in the retrospective review. Of the total population, 184 received a fixed dose of rasburicase and 8 patients received a weight-based dose (0.15 mg/kg/dose) of rasburicase. The average dose administered was 3.4 mg for fixed and 2.99 mg for weight-based dosing. Nearly half (49.5%) the patients received rasburicase for an elevated uric acid but did not meet Cairo-Bishop criteria for TLS. Only 42.2% received at least one dose of allopurinol within 5 days prior to rasburicase and 18.8% received aggressive hydration within 72 h prior to rasburicase.ConclusionThe majority of rasburicase administered was ordered as fixed dose for a uric acid level ≥7.5 mg/dL. Most patients did not meet criteria for laboratory or clinical TLS and less than half the patients received prophylactic allopurinol and/or aggressive hydration. These study results are supported by recent literature for fixed dose rasburicase as a safe and economical dosing strategy compared to weight-based dosing.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"634-640"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092335","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":"Cytomegalovirus viremia and hepatitis B reactivation in patient with RET fusion-positive non-small cell lung cancer treated with pralsetinib.","authors":"Alanna Lehman, Anthony Perissinotti, Sam Aitken","doi":"10.1177/10781552241304000","DOIUrl":"10.1177/10781552241304000","url":null,"abstract":"<p><p>IntroductionMutated rearranged during transfection (RET) kinase is found in approximately 1-2% non-small-cell lung cancer (NSCLC) patients. These patients are typically younger, non-smokers, and have non-squamous histology. Pralsetinib is a novel RET inhibitor that showed promising efficacy and tolerability in the ARROW trial. Due to the small percentage of patients that have RET mutated NSCLC, real world data on safety is still needed.Case reportThis case report outlines a patient who was initiated on pralsetinib for RET mutated NSCLC and subsequently developed reactivation of cytomegalovirus (CMV) viremia and hepatitis B.Management and outcomeThe patient was initiated on valganciclovir and entecavir with subsequent improvement in viral loads. They were able to reinitiate pralsetinib at a lower dose following improvement of CMV and hepatitis B viral load with continuation of entecavir.DiscussionRET is responsible for activation of several signaling paths including PI3K/AKT and JAK/STAT. Those pathways are involved in the immune system. When reviewing current JAK inhibitors and PI3K inhibitors on the market, there is mixed data on HBV reactivation and CMV viremia, though theoretically possible. Therefore, this should be evaluated and addressed in further studies. The educational value of this case could provide valuable insights for baseline monitoring and management for similarly effected patients.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"674-678"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846806","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}
Michael Williams, Zartash Gul, Justin Graff, Brittany Mejaki, Sherjeel Sana, Stephen Medlin
{"title":"Comparison of intermittent intravenous tacrolimus to continuous tacrolimus in adult allogeneic stem cell transplant recipients.","authors":"Michael Williams, Zartash Gul, Justin Graff, Brittany Mejaki, Sherjeel Sana, Stephen Medlin","doi":"10.1177/10781552241252606","DOIUrl":"10.1177/10781552241252606","url":null,"abstract":"<p><p><b>Introduction:</b> Initial continuous intravenous (CIV) tacrolimus (0.03 mg/kg/day based on ideal body weight [IBW]) has been favored for graft versus host disease (GVHD) prevention in allogeneic stem cell transplant patients due to the consistent, steady-state degree of immunosuppression; however, this method poses many logistical challenges. We implemented intermittent (IIV) tacrolimus at a starting dose of 0.015 mg/kg IBW twice daily over 4 h. To our knowledge this is the first retrospective comparison of CIV to IIV tacrolimus. <b>Objectives:</b> The primary objective was to evaluate the safety of IIV tacrolimus in comparison to CIV with respect to nephrotoxicity and neurotoxicity. The secondary objectives were to compare the incidence of grade II-IV acute GVHD (aGVHD) and chronic GVHD (cGVHD) at day +180, outcomes including relapse and overall survival, cell engraftment, and reactivation of cytomegalovirus and Epstein-Barr virus. <b>Methods:</b> This retrospective, single-center review evaluated adults who received an allogeneic stem cell transplant patients between January 1, 2020, and December 31, 2022. <b>Results:</b> Fifty-one unique patients were eligible for evaluation - 28 in the IIV cohort and 23 in the CIV group. The number of patients who developed nephrotoxicity and neurotoxicity were comparable between groups with no significant differences noted. No severe neurotoxicity was identified in either population. Secondary objectives revealed no significant difference in GVHD incidence or survival outcomes. <b>Conclusion:</b> IIV tacrolimus is comparable to CIV in terms of safety while also maintaining similar outcomes at day +180. IIV is a safe and feasible alternative to CIV in adult allogeneic stem cell transplant recipients.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"627-633"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856499","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}
Maíra Araújo Henriques, Frank do Carmo Guedes Júnior, Lílian Minako Karube, Rosângela Santos de Abreu, José Pereira de Moura Neto, Igor Rafael Dos Santos Magalhães
{"title":"Association between plasma imatinib levels and response to treatment of chronic myeloid leukemia in patients from Manaus, Brazil.","authors":"Maíra Araújo Henriques, Frank do Carmo Guedes Júnior, Lílian Minako Karube, Rosângela Santos de Abreu, José Pereira de Moura Neto, Igor Rafael Dos Santos Magalhães","doi":"10.1177/10781552241252374","DOIUrl":"10.1177/10781552241252374","url":null,"abstract":"<p><p>IntroductionImatinib mesylate (IM) is the drug of choice for the treatment of chronic myeloid leukemia (CML). However, despite most of the results obtained with this therapy being positive, some patients still present a suboptimal therapeutic response or still develop some type of resistance. Therefore, the aim of this study was to evaluate IM plasma levels in CML patients treated at a referral unit in Manaus and correlate them with variables that might interfere with these levels.MethodsData from 52 patients were obtained through a standardized questionnaire containing clinical, sociodemographic, lifestyle, and use of other medication information, as well as an estimate of therapeutic adherence. Additionally, blood collection was performed to measure the plasma concentration of the drug using the HPLC-UV technique. Molecular studies were done to identify the presence of polymorphism in the ABCG2 C421A membrane transporter.ResultsMost patients were male with a mean age of 52 ± 12.3 years (95% CI 49.0-55.9). There was a high variation in drug concentrations in the range from 0 to 4694 ng/mL, with a mean of 1558.59 ± 989.79 ng/mL (95% CI 1283.0-1834.1).ConclusionApproximately two-thirds of patients were classified in the drug-level range considered therapeutic, and there was a correlation between plasma concentration and higher molecular response. Additionally, most individuals had the normal genotype for the ABCG2 C421A polymorphism but further studies should be performed to reveal the role of this variable in the outcome of the disease in this population.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"608-615"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850013","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}
Marisela Tan Banez, Sol Atienza, Allison Butts, Megan Derba, Katie Dicke, Kimberly Haverstick, Bernadette B Heron, Sarah K Cimino, Matthew Shane Loop, Shannon Hough, Julianna A Merten, Donald C Moore, Vishal Shah, Kate D Taucher, Junyu Matt Zhang, Zahra Mahmoudjafari
{"title":"Oncology stewardship practice in the United States: A Hematology/Oncology Pharmacy Association national survey.","authors":"Marisela Tan Banez, Sol Atienza, Allison Butts, Megan Derba, Katie Dicke, Kimberly Haverstick, Bernadette B Heron, Sarah K Cimino, Matthew Shane Loop, Shannon Hough, Julianna A Merten, Donald C Moore, Vishal Shah, Kate D Taucher, Junyu Matt Zhang, Zahra Mahmoudjafari","doi":"10.1177/10781552241265280","DOIUrl":"10.1177/10781552241265280","url":null,"abstract":"<p><p>IntroductionThe treatment of cancer is associated with high risk for toxicity and high cost. Strategies to enhance the value, quality, and safety of cancer care are often managed independently of one another. Oncology stewardship is a potential framework to unify these efforts and enhance outcomes. This landscape survey establishes baseline information on oncology stewardship in the United States.MethodsThe Hematology/Oncology Pharmacy Association (HOPA) distributed a 38-item survey composed of demographic, institutional, clinical decision-making, support staff, metrics, and technology sections to 675 HOPA members between 9 September 2022 and 9 October 2022.ResultsMost organizations (78%) have adopted general pharmacy stewardship practices; however, only 31% reported having established a formalized oncology stewardship team. More than 70% of respondents reported implementation of biosimilars, formulary management, and dose rounding as oncology stewardship initiatives in both inpatient and outpatient settings. Frequently cited barriers to oncology stewardship included lack of clinical pharmacist availability (74%), lack of oncology stewardship training (62%), lack of physician/provider buy-in (32%), and lack of cost-saving metrics (33%). Only 6.6% of survey respondents reported their organization had defined \"value in oncology.\" Lack of a formalized stewardship program was most often cited (77%) as the rationale for not defining value.ConclusionsLess than one-third of respondents have established oncology stewardship programs; however, most are providing oncology stewardship practices. This manuscript serves as a call to action for stakeholders to work together to formalize oncology stewardship programs that optimize value, quality, and safety for patients with cancer.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"517-527"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875145","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}