[Verification of reduction in preparation time and cost of cyclophosphamide when using the closed-system drug transfer device].

The closed-system transfer device (CSTD), which is used to prevent the exposure of medical staff to anticancer drugs, has been reported to allow safe preparation and administration of these drugs to patients. At many medical institutions, however, the use of such devices is limited to select anticancer drugs. This could be attributable to the longer preparation time compared to the conventional injection technique with a syringe and needle, as well as the fact that the anticancer drugs are too expensive to be covered by the remuneration available for medical services. Against this background, we measured the time required to prepare cyclophosphamide(CPA)and estimated the cost incurred. Our results indicated that the preparation time for either a single dose of 100 mg CPA or a combination of 100 mg CPA and 500 mg of another drug(100mg+500 mg group)was significantly longer than that for 500 mg of a single drug. On the other hand, use of a CSTD reduced the total cost (drug cost+CSTD cost)on switching to a single dose of 500 mg, resulting in a 5-year savings as follows: 3,755,217 yen for ChemoCLAVE®, 6,302,622 yen for PhaSeal®, and 2,698,451 yen for Chemosafe®. These findings suggest that the appropriate selection of drugs, including a large standard dose of CPA, allows shortened preparation time and reduced total drug cost as well as CSTD cost.

[Comparative examination of preparation time in docetaxel hydrate formulation].

Docetaxel hydrate(DTX), a taxane anticancer drug, is known to be effective against a wide range of cancers, including breast cancer and non-small cell lung cancer. The DTX preparation Taxotere(2-vial DTX)has conventionally required dissolution in the attached solvent, while Onetaxotere(1-vial DTX), a newer product, is provided as a solution. This allows reduction of preparation time, so that improvement in operational efficiency can be expected. In this study, we measured the actual preparation time for 2-vial DTX and 1-vial DTX to compare their usefulness. The median preparation time for 2-vial DTX(n=84)and 1-vial DTX(n=84)was significantly different, with the respective values being 6. 52 minutes and 2. 67 minutes(p<0. 01). By switching to 1-vial DTXfrom 2-vial DTX, which requires preparation of a premix solution with the attached solvent, the preparation procedure in daily practice becomes more convenient. This is because of a shorter preparation time as well as a lower risk of contamination, suggesting the usefulness of 1-vial DTX.

[Expression of allergic reactions to oxaliplatin].

Oxaliplatin (L-OHP), a platinum-containing antineoplastic agent, is a key drug for the treatment of colorectal cancer. However, it is often difficult to continue with its treatment because of the expression of allergic reactions. This study was an investigation of the expression of allergic reactions resulting from administration of L-OHP. A retrospective analysis was performed on patients undergoing therapeutic regimens including L-OHP, from April 2009 to November 2010 in Juntendo University Urayasu Hospital. The results showed that allergic reactions were expressed in 15 out of 81 patients (18. 5%). A high correlation was found between the time from administration until expression of the allergic reaction, and the number of treatment courses (r=-0. 521, p=0. 047). When patient characteristics were compared between the allergic reaction group and the no-reaction group, it was suggested that differences due to the regimen or the presence or absence of liver metastasis, which is considered to be related to drug metabolism, had no effect. Items showing significant differences were sexual difference(p=0. 022)and the effect of changes depending on the dose form of L-OHP(p=0. 003). It was possible to continue treatment with L-OHP in six patients even after expression of allergic reactions. Anti-allergy measures such as additional administration of steroids or antihistamines were suggested to be useful for continuing treatment.