BACKGROUND. Among the many diverse Asian ethnic groups living in the US, Cambodian immigrants comprise a small fraction (1.8%) of the total Asian population. Because of their small numbers, Cambodian vital statistics are often combined into Southeast Asian (SA) cancer data consisting of Vietnamese, Thais, Laotians, and Hmong. METHODS. The 2000 Census counts were used for 2 Cambodian populations, Cambodians alone and Cambodians alone and in combination with any other racial/ethnic group for California and for Seattle (Puget Sound area), Washington. Then the cancer incidence rates were calculated using cancer cases from the California and Puget Sound cancer registries between 1998–2002. The 1998–2002 annual age‐adjusted incidence rates, upper bound rates (based on the Cambodian alone population), lower bound rates (based on the Cambodians alone or in combination population) are reported and compared with the rates in the non‐Hispanic White (NHW) population in these regions. RESULTS. The top 5 cancers in Cambodian males are lung and bronchus, liver, prostate, colorectal, and stomach cancers. The sites where the rates are higher in male Cambodians than NHW males are (in ascending rank) nasopharynx, liver, stomach, myeloma, and lung and bronchus. The top 5 cancers for female Cambodians are breast, lung, colon and rectum, cervix, and thyroid. The sites where female rates are greater than NHW female rates are (in ascending rank) nasopharynx, liver, stomach, cervix uteri, oral cavity, and thyroid. CONCLUSIONS. The challenges to address the health issues of Cambodians are complicated by historical events that caused their emigration to the US. Many of the immigrants are survivors of the holocaust in Cambodia. Health programs for Cambodians must deal with the consequences of these issues as well as cultural issues of language and religion in helping Cambodians to reduce their cancer disparities. Cancer 2007. © 2007 American Cancer Society.
Key Points Question Has inclusion of people living with HIV in anti–programmed death 1 and anti–programmed death ligand 1 (anti–PD1/PDL1) immunotherapy trials changed during ongoing Cancer Therapy Evaluation Program advocacy efforts by the National Cancer Institute? Findings In this quality improvement analysis of 87 anti–PD1/PDL1 trials approved by the Cancer Therapy Evaluation Program from January 2014 to May 2019, the proportion of studies including people living with HIV increased from 16% of letters of intent to 70% of approved protocols. Inclusion of people living with HIV on submitted letters of intent increased over time. Meaning This study’s findings suggest that the increasing inclusion rates of people living with HIV in anti–PD1/PDL1 clinical trials are encouraging and that advocacy for these and other underrepresented populations should continue.
Templates of patient brochures and drug-specific brochures on the safe handling of chemotherapy in the home can be created using a collaborative, multi-institutional approach.
In Sub-Saharan Africa, the cancer burden is predicted to increase by > 85% by 2030, the largest increase worldwide. This region has a large HIV-positive population. Drug-drug interactions (DDIs) from concomitant use of multiple drugs increase the risk of drug toxicities, sub-optimal therapy, and drug resistance. With the increase in polypharmacy, involving antiretroviral (ARV), and anticancer drugs, there is a greater need for an appreciation of clinically relevant DDIs. Anticancer and ARV drugs studied in this review were from The World Health Organization's Model List of Essential Medicines 2017. We reviewed; drug package inserts, www.drugbank.ca and www.UpToDate.com, to evaluate pharmacokinetic interactions with cytochrome P450 (CYP450) and ABCB1. The DDIs between drugs were assessed using the University Of Liverpool, UK HIV Drug Interactions Checker, and the LexiComp Drug Interaction tool of www.UpToDate.com. About 70% of ARVs studied interact with CYP450, all involve CYP3A4, and 55% interact with ABCB1. About 65% of anticancer drugs interact with CYP450, 44% of which do so through CYP3A4. About 75% of anticancer drugs interact with ARV drugs, with nine absolute contraindications to concomitant therapy. There exist a substantial number of DDIs between ARV and anticancer drugs, primarily mediated through CYP450 enzymes. Dolutegravir based regimens offer the safest DDI profilefor concurrent use with anticancer drugs. However, there are substantial gaps in our knowledge, and this study serves to highlight the need for additional research to better define these interactions and their effect on drug exposure, as attention to these DDIs is a relatively simple intervention that could lead to optimizing disease treatment.
The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column focuses on the commercially available and investigational agents used to treat malignant diseases and reviews issues related to the preparation, dispensing, and administration of cancer chemotherapy.
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