5180 Background: Pegilated liposomal doxorubicin (PLD) is considered a less toxic drugs as compar... more 5180 Background: Pegilated liposomal doxorubicin (PLD) is considered a less toxic drugs as compared to conventional doxorubicin. The drug has the following indications: AIDS related Kaposi sarcoma, pretreated ovarian carcinoma and breast cancer patients (pts) at risk of cardiotoxicity. Methods: We have reviewed all the cases treated with PLD in our Institute in the last 3 years, out of clinical studies, in order to define the results and toxicity of these very expensive drug in daily clinical practice. Results: From Jan 2001 to Dec 2003 we have treated 108 pts with the following characteristics: 103 women and 5 men, median age 63 yr (range 38–82), 51 ovarian, 37 breast, 5 sarcoma, 4 endometrial, 4 NHL, 3 Kaposi, 2 biliary tract, 1 thyroid and 1 mesothelioma. With regard to ovarian cancer series, 36 pts have been treated with PLD as single agent, 11 in combination with oxaliplatin, 3 with paraplatin and 1 with gemcitabine, respectively. Responses were observed in 7 pts (3 CR + 4 PR) out of 51 pts (14%) and...
Central Venous Catheters (CVC) and ports are essential devices to the medical care of cancer pati... more Central Venous Catheters (CVC) and ports are essential devices to the medical care of cancer patients. Every year about one million CVCs are inserted in cancer patients. The field of oncohematology is making a great contribution to the development of new models of catheters and to the use of innovative materials. New therapeutic protocols, based on continuous administration and higher doses of anticancer drugs with relative phlebitis problems, have raised the issue of long CVC in situ permanence. Different complications are related to the intravascular catheters such as those associated with insertion (pneumothorax, damages to arteries and nerves), or with the duration of catheterization (thrombosis and infections). Furthermore, Catheter-Related Bloodstream Infections (CRBSI), in particular, cause significant mortality and excessive hospital costs. The aim of this prospective study was to analyze the costs related to the use of polyurethane (PU) CVC. 44 patients with a non tunneled double lumen PU CVC in place were followed for 6 months, and for each patient, time of permanence, possible antibiotic prophylaxis, blood parameters, adverse events and medical treatments were monitored. Our results suggest that physicians should pay greater attention to the correlation between new medical devices and the real benefit for the patient, and economic consequences.
Background. Immune checkpoint inhibitors (ICIs) have recently represented a breakthrough in uroth... more Background. Immune checkpoint inhibitors (ICIs) have recently represented a breakthrough in urothelial carcinoma (UC). Proton pump inhibitors (PPIs) are routinely used for extended time periods in UC patients, with these agents having potentially and frequently undervalued effects on ICIs efficacy. Methods. We performed a meta-analysis aimed at investigating the impact of concomitant PPI administration on progression-free survival (PFS) and overall survival (OS) among patients receiving immunotherapy for metastatic UC. Results. Two studies encompassing a total of 1015 patients were included. The pooled Hazard Ratios (HRs) for OS and PFS were 1.55 (95% CI, 1.31–1.84) and 1.43 (95% CI, 1.23–1.66), respectively, suggesting that the administration of PPIs was negatively associated with PFS and with OS in UC patients treated with ICIs. Conclusions. The current meta-analysis represents the first study to provide a systematic evaluation of the impact of concomitant PPI use in UC patients t...
Peripheral neurologic complications are frequent adverse events during oncologic treatments and o... more Peripheral neurologic complications are frequent adverse events during oncologic treatments and often lead to dose reduction, administration delays with time elongation of the therapeutic plan and, not least, worsening of patients’ quality of life. Experience skills are required to recognize symptoms and clinical evidences and the collaboration between different health professionals, in particular oncologists and hospital pharmacists, grants a correct management of this undesirable occurrence. Some classes of drugs (platinates, vinca alkaloids, taxanes) typically develop this kind of side effect, but the genesis of chemotherapy-induced peripheral neuropathy is not linked to a single mechanism. This paper aims from one side at summarizing and explaining all the scattering mechanisms of chemotherapy-induced peripheral neuropathy through a detailed literature revision, on the other side at finding new approaches to possible treatments, in order to facilitate the collaboration between o...
5180 Background: Pegilated liposomal doxorubicin (PLD) is considered a less toxic drugs as compar... more 5180 Background: Pegilated liposomal doxorubicin (PLD) is considered a less toxic drugs as compared to conventional doxorubicin. The drug has the following indications: AIDS related Kaposi sarcoma, pretreated ovarian carcinoma and breast cancer patients (pts) at risk of cardiotoxicity. Methods: We have reviewed all the cases treated with PLD in our Institute in the last 3 years, out of clinical studies, in order to define the results and toxicity of these very expensive drug in daily clinical practice. Results: From Jan 2001 to Dec 2003 we have treated 108 pts with the following characteristics: 103 women and 5 men, median age 63 yr (range 38–82), 51 ovarian, 37 breast, 5 sarcoma, 4 endometrial, 4 NHL, 3 Kaposi, 2 biliary tract, 1 thyroid and 1 mesothelioma. With regard to ovarian cancer series, 36 pts have been treated with PLD as single agent, 11 in combination with oxaliplatin, 3 with paraplatin and 1 with gemcitabine, respectively. Responses were observed in 7 pts (3 CR + 4 PR) out of 51 pts (14%) and...
Central Venous Catheters (CVC) and ports are essential devices to the medical care of cancer pati... more Central Venous Catheters (CVC) and ports are essential devices to the medical care of cancer patients. Every year about one million CVCs are inserted in cancer patients. The field of oncohematology is making a great contribution to the development of new models of catheters and to the use of innovative materials. New therapeutic protocols, based on continuous administration and higher doses of anticancer drugs with relative phlebitis problems, have raised the issue of long CVC in situ permanence. Different complications are related to the intravascular catheters such as those associated with insertion (pneumothorax, damages to arteries and nerves), or with the duration of catheterization (thrombosis and infections). Furthermore, Catheter-Related Bloodstream Infections (CRBSI), in particular, cause significant mortality and excessive hospital costs. The aim of this prospective study was to analyze the costs related to the use of polyurethane (PU) CVC. 44 patients with a non tunneled double lumen PU CVC in place were followed for 6 months, and for each patient, time of permanence, possible antibiotic prophylaxis, blood parameters, adverse events and medical treatments were monitored. Our results suggest that physicians should pay greater attention to the correlation between new medical devices and the real benefit for the patient, and economic consequences.
Background. Immune checkpoint inhibitors (ICIs) have recently represented a breakthrough in uroth... more Background. Immune checkpoint inhibitors (ICIs) have recently represented a breakthrough in urothelial carcinoma (UC). Proton pump inhibitors (PPIs) are routinely used for extended time periods in UC patients, with these agents having potentially and frequently undervalued effects on ICIs efficacy. Methods. We performed a meta-analysis aimed at investigating the impact of concomitant PPI administration on progression-free survival (PFS) and overall survival (OS) among patients receiving immunotherapy for metastatic UC. Results. Two studies encompassing a total of 1015 patients were included. The pooled Hazard Ratios (HRs) for OS and PFS were 1.55 (95% CI, 1.31–1.84) and 1.43 (95% CI, 1.23–1.66), respectively, suggesting that the administration of PPIs was negatively associated with PFS and with OS in UC patients treated with ICIs. Conclusions. The current meta-analysis represents the first study to provide a systematic evaluation of the impact of concomitant PPI use in UC patients t...
Peripheral neurologic complications are frequent adverse events during oncologic treatments and o... more Peripheral neurologic complications are frequent adverse events during oncologic treatments and often lead to dose reduction, administration delays with time elongation of the therapeutic plan and, not least, worsening of patients’ quality of life. Experience skills are required to recognize symptoms and clinical evidences and the collaboration between different health professionals, in particular oncologists and hospital pharmacists, grants a correct management of this undesirable occurrence. Some classes of drugs (platinates, vinca alkaloids, taxanes) typically develop this kind of side effect, but the genesis of chemotherapy-induced peripheral neuropathy is not linked to a single mechanism. This paper aims from one side at summarizing and explaining all the scattering mechanisms of chemotherapy-induced peripheral neuropathy through a detailed literature revision, on the other side at finding new approaches to possible treatments, in order to facilitate the collaboration between o...
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