がん専門薬剤師による臨床アウトカムの創出

Abstract

The management of effective and safe chemotherapy is an important responsibility of oncology-specialized pharmacists. In this review, we introduce the efforts undertaken for the management of cisplatin-induced nephrotoxicity (CIN) and taxane-associated acute pain syndrome (T-APS) and safer chemotherapy procedures.(1) CIN management We evaluated the nephroprotective effect of magnesium premedication using clinical and fundamental studies, suggesting that magnesium attenuates CIN by regulating the renal transporter expression to reduce the renal platinum accumulation. Additionally, we revealed that non-steroidal anti-in ammatory drugs (NSAIDs) affect CIN.(2) T-APS management We revealed that the situation of pre-administered NSAIDs does not affect T-APS and additional dexamethasone prophylaxis attenuates T-APS severity. Furthermore, we assessed the risk factors for T-APS incidence under dexamethasone premedication, revealing that peg lgrastim co-administration and ages <55 years are independently associated.(3) Safer chemotherapy procedure Chemotherapy regimen management is an important oncological pharmacy practice. We evaluated the availability of the pharmaceutical review and demonstrated its utility, appropriate regimen review coverage, and quality practice sharing between the oncology-specialized and non-specialized pharmacists. Moreover, we developed a management system for safer denosumab administration focusing on hypocalcemia and evaluated its use, suggesting that early intervention prevents severe symptom prevalence. Additionally, we revealed that approximately 70％ of pharmaceutical proposals attenuate the patientʼs painful symptoms in outpatient chemotherapy, suggesting that continuous pharmaceutical care in cancer treatment is necessary. As the evaluation of pharmaceutical care and adverse effects management contributes to advanced cancer care, further assessments are required.