Taking into consideration the progress in cancer treatment, an increase in the number of adult survivors of childhood cancer is expected. These survivors will have received treatment that predisposes them to late morbidity and increased risk of early mortality. The aim of this single-center retrospective cohort study was to describe the frequency and identify risk factors associated with late adverse events related to cancer treatment in survivors of childhood and adolescent cancer. Patients were recruited from 2010 to 2014. All possible late adverse effects identified, were classified according to CTCAE grading system version 4.0. The variables were characterized and stratified according to the presence or not of late effects. Odds ratio was used as a measure of association in bivariate analysis to identify characteristics associated with the late effects of treatment. Among 111 potentially eligible participants, 62 survivors met the inclusion criteria; 17 (27.4%) had abnormal test results observed in the systems: 8 (47%) in the endocrine and metabolic, 7 (41.2%) in the cardiovascular, 5 (29.4%) in the musculoskeletal, and 1 (5.9%) in auditory and renal systems. Frequency and severity of late adverse events were not affected by treatments employed; except for radiotherapy which was associated with a higher risk of late adverse effect occurrences.
With the development of innovative cancer treatments over recent decades, the cost of cancer care has risen exponentially, limiting patient access to patented originator biotherapeutics in many countries. The introduction of biosimilars to the market has created new opportunities as well the need for changes in practice within healthcare institutions. A ‘biosimilar’ is a biotherapeutic product which is highly similar in terms of quality, safety and efficacy to an already licensed originator product. Although biosimilars lack clinically meaningful differences in therapeutic activity as compared to the originator product, these complex biological molecules are not considered identical chemical copies, unlike generics, and minor differences in molecular structure and inactive compounds may exist. A thorough understanding of these differences and their clinical implications is necessary for optimising medicines-use practices involving biosimilars. This position statement, developed by the International Society of Oncology Pharmacy Practitioners Biosimilars Taskforce, aims to provide the global oncology pharmacy community with guidance to support decisions around biosimilar use. The 11 statements cover the regulation and evaluation of biosimilars, practical issues around local implementation, the education of healthcare staff and patients, and the requirement for ongoing pharmacovigilance and outcome monitoring.
Introdução: O paciente idoso com câncer possui risco potencial de polimedicação pelo aumento de comorbidade e complexidade do tratamento do câncer que, muitas vezes, inclui múltiplos antineoplásicos e medicamentos de suporte. Objetivo: Identificar a frequência de polimedicação, o uso de medicamentos potencialmente inapropriados e a interação medicamentosa em pacientes idosos com câncer. Método: Coletaram-se informações sociodemográficas, farmacológicas e clinicas de 20 pacientes idosos (≥65 anos) com câncer, polimedicados (≥cinco medicamentos), de julho a agosto de 2016, em um ambulatório em São Luís – MA, por meio de prontuário eletrônico e questionários aplicados em entrevistas. Para analise dos dados, utilizaram-se as ferramentas: Classificação Anatômica Terapêutica Química, Micromedex®, Drugs®, Lexicomp® e o Manual de fitoterápicos da Anfarmag. O Beers Criteria 2015 foi utilizado para identificação dos medicamentos potencialmente inapropriados para idosos. Resultados: Entre os pacientes, 70% eram do sexo masculino, com idade media de 73 anos (DP=7,9). Os tipos de câncer mais prevalentes foram os de próstata e mama. Quanto às comorbidades, as cardiovasculares e as endócrinas foram as mais relatadas. Foram identificados 134 medicamentos prescritos e de automedicação, dos quais, 41 eram antineoplásicos. Oitenta por cento dos pacientes estavam expostos a risco potencial de interação medicamentosa, totalizando 90 (63,2% de gravidade moderada, 21,2% importante e 8,8% menor). Detectaram-se quatro interações envolvendo plantas medicinais e sete medicamentos inapropriados para idosos em 20% e 65% dos pacientes, respectivamente. Conclusão: Entre os pacientes incluídos neste estudo, verificou-se a ocorrência de polimedicação, de interações medicamentosas potenciais e do uso de medicamentos potencialmente inapropriados para idosos.
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