Because their services are based decisively on the collection, analysis and exchange of clinical information or knowledge, within and across organizational boundaries, knowledge management has exceptional application and importance to health care organizations. This article proposes a conceptual framework for a knowledge management system, which is expected to support both hospitals and the oncology network in Brazil. Under this holistic single-case study, triangulation of multiple sources of data collection was used by means of archival records, documents and participant observation, as two of the authors were serving as INCA staff members, thus gaining access to the event and its documentation and being able to perceive reality from an insider point of view. The benefits derived from the present status of the ongoing implementation, so far, are: (i) speediness of cancer diagnosis and enhanced quality of both diagnosis and data used in epidemiological studies; (ii) reduction in treatment costs; (iii) relief of INCA'S labor shortage; (iii) improved management performance; (iv) better use of installed capacity; (v) easiness of massive (explicit) knowledge transference among the members of the network; and (vi) increase in organizational capacity of knowledge retention (institutionalization of procedures).

There is increasing recognition of the potential to use mobile health (mHealth) technologies such as smartphone apps to support clinical care. Mobile apps are progressively being implemented to manage chronic diseases like cancer to improve patient care. The app deployed at the Brazilian National Cancer Institute enables patients to access the appointments/exam booking, medication prescription, and cancer-prevent educational resources, improving self-management, autonomy, and cancer treatment outcomes in resource-limited environments. Despite acknowledging the importance of mHealth, research is still scarce regarding patients’ views on using these innovations in cancer care management.

A indústria farmacêutica configura-se como um oligopólio, com produtos diferenciados em segmentos de classes terapêuticas específicas. As grandes farmacêuticas globais concentram seus esforços de pesquisa e de comercialização nas doenças degenerativas, que trazem maior retorno financeiro. No Brasil, destaca-se a presença de um conjunto de laboratórios públicos, os quais compõem a Rede Brasileira de Produção Pública de Medicamentos (RBPPM), voltados para as necessidades do Sistema Único de Saúde (SUS), em grande parte negligenciadas pelas Big Pharmas. O objetivo deste estudo é investigar o uso pelos laboratórios farmacêuticos oficiais brasileiros das contribuições derivadas das tecnologias da informação e comunicação (TIC), no sentido da integração da cadeia de suprimentos da RBPPM. Em sua primeira fase, a pesquisa de campo foi realizada por meio de uma abordagem quantitativa em todos os laboratórios oficiais afiliados à Associação de Laboratórios Farmacêuticos Oficiais Brasileiros (Alfob). Essa análise permitiu levantar questões que foram aprofundadas por meio da abordagem qualitativa em três laboratórios selecionados da fase anterior. As evidências coletadas permitem concluir que os objetivos descritos na criação da RBPPM, cujo alcance poderia ser facilitado pela adoção dos atributos da GCS pela rede capitaneada pelo Ministério da Saúde, ainda são inci-

This narrative review describes implementation, current status and perspectives of a pharmacogenomic (PGx) program at the Brazilian National Cancer Institute (INCA), targeting the cancer chemotherapeutic drugs – fluoropyrimidines, irinotecan and thiopurines. This initiative, designed as a research project, was supported by a grant from the Brazilian Ministry of Health. A dedicated task force developed standard operational procedures from recruitment of patients to creating PGx reports with dosing recommendations, which were successfully applied to test 100 gastrointestinal cancer INCA outpatients and 162 acute lymphoblastic leukemia pediatric patients from INCA and seven other hospitals. The program has been subsequently expanded to include gastrointestinal cancer patients from three additional cancer treatment centers. We anticipate implementation of routine pre-emptive PGx testing at INCA but acknowledge challenges associated with this transition, such as continuous financing support, availability of trained personnel, adoption of the PGx-informed prescription by the clinical staff and, ultimately, evidence of cost–effectiveness.