Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 6 de 6
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Bull Cancer ; 110(12): 1343-1351, 2023 Dec.
Artigo em Francês | MEDLINE | ID: mdl-37827964

RESUMO

Antibody Drug Conjugates (ADC) and bispecific antibodies are booming and were the subject of the scientific event proposed by the French Society of Oncological Pharmacy, October 13, 2022. An ADC is composed of the antibody targeting a receptor expressed on the tumor cell, the spacer making it possible to attach the cytotoxic to the antibody and to control its distribution in the body, and the cytotoxic. Therapeutic antibodies, monoclonal and conjugated, have particular pharmacokinetics. Unlike monoclonal antibodies for which the standard dose is most often fixed, this is expressed in mg/m2 (or mg/kg) and capped at 2m2 (or 100kg) for conjugates. The linked cytotoxics are powerful cytotoxics: mitotic spindle poisons (emtansine, monomethyl auristatin E or vedotin), topoisomerase I inhibitors (deruxtecan, SN 38) or antibiotics (ozogamicin). In senology, trastuzumab deruxtecan (anti-HER2) and sacituzumab govitecan (anti-Trop 2) are now modifying treatment standards for patients with metastatic breast cancer, respectively HER2 3X or HER2 low and triple negative. In metastatic bladder cancer, enfortumab vedotin (anti-nectin 4) is positioned as the 2nd line of treatment. Bispecific antibodies, on the other hand, are able to target two epitopes, an antigen specific to a tumor cell and one to an immune cell, allowing a bridge between the killer immune cells and the tumor cells. For lymphoma proliferation, many bispecific antibodies are in development. The most advanced are glofitamab, epcoritamab and mosunetuzumab, which target the CD20 of B lymphocytes and the CD3 of T lymphocytes. Bispecific antibodies are also emerging in the treatment of myeloma with teclistamab and elranatamab (anti-CD3 and anti-BCMA) or talquetamab (anti-GPRC5D and anti-CD3). Conjugated antibodies, and more recently bispecific antibodies, are potential game changers in cancer treatment and researchs are needed to improve their efficacy and safety.


Assuntos
Anticorpos Biespecíficos , Antineoplásicos , Neoplasias da Mama , Imunoconjugados , Humanos , Feminino , Anticorpos Biespecíficos/uso terapêutico , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Imunoconjugados/uso terapêutico
2.
Cancer Treat Rev ; 88: 102063, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32623296

RESUMO

The Coronavirus disease (COVID-19) pandemic is disrupting our health environment. As expected, studies highlighted the great susceptibility of cancer patients to COVID-19 and more severe complications, leading oncologists to deeply rethink patient cancer care. This review is dedicated to the optimization of care pathways and therapeutics in cancer patients during the pandemic and aims to discuss successive issues. First we focused on the international guidelines proposing adjustments and alternative options to cancer care in order to limit hospital admission and cytopenic treatment in cancer patients, most of whom are immunocompromised. In addition cancer patients are prone to polypharmacy, enhancing the risk of drug-related problems as adverse events and drug-drug interactions. Due to increased risk in case of COVID-19, we reported a comprehensive review of all the drug-related problems between COVID-19 and antineoplastics. Moreover, in the absence of approved drug against COVID-19, infected patients may be included in clinical trials evaluating new drugs with a lack of knowledge, particularly in cancer patients. Focusing on the several experimental drugs currently being evaluated, we set up an original data board helping oncologists and pharmacists to identify promptly drug-related problems between antineoplastics and experimental drugs. Finally additional and concrete recommendations are provided, supporting oncologists and pharmacists in their efforts to manage cancer patients and to optimize their treatments in this new era related to COVID-19.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/imunologia , Oncologia/normas , Neoplasias/tratamento farmacológico , Neoplasias/imunologia , Farmácia/normas , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/imunologia , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Betacoronavirus/isolamento & purificação , COVID-19 , Ensaios Clínicos como Assunto/métodos , Ensaios Clínicos como Assunto/normas , Infecções por Coronavirus/virologia , Humanos , Oncologia/métodos , Neoplasias/virologia , Pandemias , Farmácia/métodos , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto , SARS-CoV-2
3.
Anticancer Drugs ; 24(10): 1093-7, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23962903

RESUMO

There is currently a paucity of data on salvage intracerebrospinal fluid (intra-CSF) chemotherapy in leptomeningeal metastases (LM). This report is a single-institution experience with salvage treatment in patients with breast cancer (BC) and LM. This retrospective cohort describes 24 consecutive patients with BC selected for a second-line of treatment for LM. The first line of LM treatment consisted of intra-CSF liposomal cytarabine in all patients combined with systemic therapy in 18 cases and radiotherapy in four cases. Second-line (salvage) treatment utilized intra-CSF thiotepa in all and systemic chemotherapy in nine patients. No patient received CNS-directed radiotherapy. The median Eastern Cooperative Oncology Group performance status at initiation of intra-CSF thiotepa treatment was 3 (range 1-4). The median progression-free survival and median survival following intra-CSF thiotepa was 3.1 months (range 3 days-2 years) and 4.0 months (range 6 days-2.5 years), respectively. The median overall survival from LM diagnosis was 9.5 months (range 1.3 months-2.7 years). No grade 3 or higher toxicity was observed. Recognizing the limits of a retrospective study, intra-CSF thiotepa has an acceptable toxicity profile and appears to be a reasonable option for selected BC patients.


Assuntos
Antineoplásicos Alquilantes/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias Meníngeas , Terapia de Salvação , Tiotepa/uso terapêutico , Adulto , Antineoplásicos Alquilantes/administração & dosagem , Antineoplásicos Alquilantes/líquido cefalorraquidiano , Neoplasias da Mama/líquido cefalorraquidiano , Neoplasias da Mama/patologia , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Meníngeas/líquido cefalorraquidiano , Neoplasias Meníngeas/tratamento farmacológico , Neoplasias Meníngeas/secundário , Pessoa de Meia-Idade , Estudos Retrospectivos , Punção Espinal , Tiotepa/administração & dosagem , Tiotepa/líquido cefalorraquidiano
4.
Anticancer Res ; 33(5): 2057-63, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23645756

RESUMO

BACKGROUND/AIM: Prolonged overall survival (OS) has been reported for selected patients with leptomeningeal metastases (LM). The management and treatment of such patients is poorly-described. We report our experience on breast cancer (BC)-associated LM and patients with prolonged survival. PATIENTS AND METHODS: Eleven patients with BC and LM had an OS >12 months in which treatment is described. RESULTS: Combined intra-cerebro spinal fluid (CSF) and systemic treatment were administered until disease progression or toxicity in all but two patients. Involved-field radiotherapy was administered to two patients. Median OS in this selected cohort following LM diagnosis, was 21.0 (range=13-33.3) months. CONCLUSION: Prolonged OS but also prolonged responses can be observed in BC with LM. An individualized and multi-disciplinary approach is advised for the management of these patients.


Assuntos
Neoplasias da Mama/mortalidade , Carcinoma Ductal de Mama/mortalidade , Carcinoma Lobular/mortalidade , Neoplasias Meníngeas/mortalidade , Adulto , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/terapia , Carcinoma Lobular/patologia , Carcinoma Lobular/terapia , Terapia Combinada , Feminino , Seguimentos , Humanos , Neoplasias Meníngeas/secundário , Neoplasias Meníngeas/terapia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
5.
JPEN J Parenter Enteral Nutr ; 35(3): 395-401, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21527603

RESUMO

BACKGROUND: Plasticizers such as di(2-ethylhexyl) phthalate (DEHP) are added to polyvinyl chloride (PVC) to confer flexibility. However, DEHP is associated with reproductive disorders in humans. Because of its noncovalent bond to the PVC matrix, this plasticizer tends to leach easily. Infants and children undergoing cyclic, long-term parenteral nutrition (PN) could be particularly at risk of potential toxicity from DEHP due to regular exposure. Malondialdehyde (MDA) is one of the most commonly used markers of free radical activity. The purpose of this study was to investigate how long-term exposure to phthalate affects the plasmatic rate of MDA. METHODS: Studies were performed on 7 randomized infants and children on regular cyclic, long-term PN, and the results were compared with those of 5 nontreated infants. The circulating concentrations of DEHP in children and infants during the PN therapy were measured by high-performance liquid chromatography. The concentrations were assessed before and after the PN session. In the same way, plasma MDA concentrations were measured. RESULTS: The circulating concentrations of DEHP before and after a 10- to 11-hour cyclic PN treatment in 7 infants and children under regular perfusion ranged widely, showing a significant increase after the treatment among all the patients. The same phenomenon observed with the rate of MDA showed that the 2 events are closely dependent. Therefore, long-term exposure to DEHP during cyclic PN raised plasma MDA levels, indicating increased oxidative stress. CONCLUSION: Long-term exposure to DEHP during PN increased free radical activity in vivo.


Assuntos
Dietilexilftalato/efeitos adversos , Exposição Ambiental/efeitos adversos , Malondialdeído/sangue , Estresse Oxidativo , Nutrição Parenteral/efeitos adversos , Plastificantes/efeitos adversos , Adolescente , Biomarcadores , Criança , Pré-Escolar , Cromatografia Líquida de Alta Pressão , Equipamentos e Provisões/efeitos adversos , Feminino , Humanos , Lactente , Masculino , Nutrição Parenteral/métodos
6.
J Oncol Pharm Pract ; 17(3): 252-9, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20525750

RESUMO

The treatment of leptomeningeal metastasis is based on protocols linking systemic chemotherapies and intrathecal injections of antineoplastic agents. Since the late 1960s, cases of accidental intrathecal injections of vinca-alkaloids, which have almost always proved fatal, have been documented. The most concerned countries, supported by the WHO, have published numerous recommendations aimed at reducing this type of risk. The aim of our work was to improve safety procedures for the intrathecal administration of antineoplastic drugs in an oncology hospital: the Centre Oscar Lambret, Lille, France. To this end, we compiled and analyzed a total of eight international recommendations. Our method was to meet the requirements of the AFSSAPS (French agency for the safety of health products), then to adopt recommended procedures in other countries, where appropriate. We considered the whole drugs circuit from prescription to administration. Improvements basically focused on the computerization of prescription, the dilution in mini-bags of vinca-alkaloids, and the additional labeling of intrathecally administered preparations as well as those with some vinca-alkaloids. This multidisciplinary approach to improve our practices complements the precautions taken by healthcare teams.


Assuntos
Antineoplásicos/administração & dosagem , Erros de Medicação/prevenção & controle , Neoplasias Meníngeas/tratamento farmacológico , Serviço de Farmácia Hospitalar/normas , Alcaloides de Vinca/administração & dosagem , Antineoplásicos/efeitos adversos , Lista de Checagem/normas , Composição de Medicamentos/normas , Rotulagem de Medicamentos/normas , Prescrição Eletrônica/normas , França , Fidelidade a Diretrizes , Humanos , Injeções Espinhais , Neoplasias Meníngeas/secundário , Equipe de Assistência ao Paciente/normas , Segurança do Paciente , Guias de Prática Clínica como Assunto , Avaliação de Programas e Projetos de Saúde , Alcaloides de Vinca/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...