Prevention of vasculitis and vascular pain by side route administration of vinorelbine: A case report.

A 49-year-old female with non-small-cell lung cancer was placed on adjuvant chemotherapy with vinorelbine (25 mg/m2: Day 1.8) and cisplatin (80 mg/m2: Day 1). The simultaneous intravenous infusion of vinorelbine from the side route and 500 mL of saline from the main route successfully prevented vasculitis and vascular pain.

Thyroid dysfunction with atezolizumab plus bevacizumab after lenvatinib in hepatocellular carcinoma: A case series.

Atezolizumab plus bevacizumab is the recommended first-line treatment for unresectable hepatocellular carcinoma, based on guidelines from the Barcelona Clinic Liver Cancer prognosis and treatment strategy. However, atezolizumab plus bevacizumab may be used after administration of lenvatinib. Here, we present four patients who developed thyroid dysfunction after second-line treatment with atezolizumab plus bevacizumab, but not after lenvatinib alone. The patients were treated with lenvatinib and/or atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma at Showa University Northern Yokohama Hospital. Of patients treated with only lenvatinib or atezolizumab plus bevacizumab, 2/18 (11%) and 4/15 (27%) developed thyroid dysfunction, respectively. All four patients treated with atezolizumab plus bevacizumab after lenvatinib developed hypothyroidism after 2-14 doses of atezolizumab plus bevacizumab. Three patients developed Grade 2 symptoms and were treated with levothyroxine sodium. In patients with hepatocellular carcinoma, the incidence of thyroid dysfunction may be higher among patients treated with atezolizumab plus bevacizumab after lenvatinib than those treated with lenvatinib or atezolizumab plus bevacizumab alone.

Community pharmacists' measurement of health-related quality of life for breast cancer with positive hormone receptors: A prospective observational study.

Objectives: Many patients with hormone-receptor positive breast cancer undergo prolonged treatment. However, the long-term patient quality of life assessment has not been examined. Using community pharmacists' assistance is one method for assessing long-term quality of life. Thus, this study aimed to understand the ongoing health-related quality of life and quality-adjusted life year among breast cancer patients so that community pharmacists may contribute to their pharmacotherapy. Methods: We conducted a prospective observational study with 22 breast cancer patients who had health-related quality of life at the initial measurement and 6 months later. Results: Regarding the health-related quality of life, quality-adjusted life year concerning all patients was 0.890 (95% confidence interval: 0.846-0.935). Quality-adjusted life year concerning those younger than 65 years was 0.907 (95% confidence interval: 0.841-0.973), and that for individuals older than 65 years was 0.874 (95% confidence interval: 0.804-0.943). The adjuvant chemotherapy group had a lower health-related quality of life at the initial measurement (0.887; 95% confidence interval: 0.833-0.941) but showed a higher quality of life 6 months later (0.951; 95% confidence interval: 0894-1.010). Quality-adjusted life year for individuals regarding adjuvant chemotherapy was 0.919 (95% confidence interval: 0.874-0.964). In contrast, the life-prolonged group had a higher health-related quality of life at the initial measurement, which was lower 6 months later. Conclusions: As a result of measuring quality of life using the EuroQol 5-dimensions-5-levels, this study revealed a decline in health-related quality of life in patients undergoing hormonal therapy for breast cancer. The study is expected to assist community pharmacists in managing outpatients.

Safety of immune checkpoint inhibitors in non-small-cell lung cancer patients with idiopathic interstitial pneumonia: a matched case-control study.

PURPOSE: The immune checkpoint inhibitor nivolumab is commonly used for non-small-cell lung cancer treatment. Immune checkpoint inhibitors cause immune-related adverse events, including interstitial pneumonia. However, there are no studies on the risk factors for interstitial pneumonia exacerbation after immune checkpoint inhibitor administration in patients with a history of different types of interstitial pneumonia. Therefore, we aimed to investigate the risk factors for interstitial pneumonia exacerbation in patients with non-small-cell lung cancer and a history of interstitial pneumonia. We also aimed to explore differences in the risk of interstitial pneumonia exacerbation due to various types of interstitial pneumonia-idiopathic interstitial pneumonia, immune-related pneumonitis, and radiation pneumonitis. METHODS: Eleven patients with a history of interstitial pneumonia exacerbation following the administration of immune checkpoint inhibitor were included in the study. We performed 1:2 matching based on age and sex. Twenty-two patients whose interstitial pneumonia did not worsen after immune checkpoint inhibitor administration belonged to the control group. We calculated odds ratios for each factor in the patients and control subjects. RESULTS: The odds ratio of idiopathic interstitial pneumonia in the case group was 0.15 (95% confidence interval: 0.03-0.89) (p = 0.03). There were no significant differences in other factors, such as smoking history, pulmonary emphysema, and chronic obstructive pulmonary disease. CONCLUSION: The administration of immune checkpoint inhibitors in non-small-cell lung cancer patients with a history of idiopathic interstitial pneumonia might be a viable treatment option and have clinical benefits.

Effectiveness of corticosteroids on immune checkpoint inhibitor-induced interstitial pneumonia among patients with a history of interstitial pneumonia: A case series.

There are few reports on the effectiveness of corticosteroids for immune checkpoint inhibitor-induced interstitial pneumonia in patients with a history of interstitial pneumonia. We report on 10 non-small cell lung cancer patients with a history of interstitial pneumonia who experienced immune checkpoint inhibitor-induced interstitial pneumonia. The immune checkpoint inhibitor-induced interstitial pneumonia lasted for a median duration of 41.5 days (range = 22-127 days). Eight of the ten patients responded to corticosteroid monotherapy; one patient responded to corticosteroids and the immunosuppressant, tacrolimus; and one patient did not improve after corticosteroid treatment. In non-small cell lung cancer patients with a history of interstitial pneumonia, immune checkpoint inhibitor-induced interstitial pneumonia was generally responds to corticosteroids.

[Evaluation of the Tolerability of Gemcitabine and Cisplatin Combination Chemotherapy with a Small Quantity of Replacement Fluid for Biliary Tract Cancer].

Cisplatin therapy induces kidney injury as a side effect. Thus, replacement fluid must be administered to prevent kidney injury. In our hospital, we use a Gemcitabine and Cisplatin combination chemotherapy (GC) at a total volume of approximately 500 mL for biliary tract cancer. We investigated the safety of GC with a small amount of replacement fluid. As a result, no serious adverse events and renal injury occurred that required discontinuation of treatment. The median overall survival time was 260 d (95% confidence interval, 154-367 d). This study suggests that GC with a small amount of replacement fluid could be performed tolerability. But we need to be careful about choosing patients such as patients who can drink 1 L orally and patients who can be treated as outpatients.