[Factors Associated with the Continuation of Anamorelin in Patients with Cancer-associated Cachexia: A Single-center Retrospective Study].

Cancer-associated cachexia, a multifactorial syndrome involving loss of muscle mass and anorexia, affects the survival of cancer patients. Anamorelin was the first drug approved in Japan for the treatment of cachexia. However, cases in which anamorelin is discontinued within 3 weeks are often observed in clinical practice. This study aimed to explore the factors associated with continued anamorelin dosing. We retrospectively reviewed records of patients with lung, gastric, pancreatic, and colorectal cancer who started anamorelin at Fukuoka University Hospital from April 2021 to November 2022. Patients were divided into two groups based on the duration of anamorelin administration: 15 patients were classified into the <3 weeks group and 22 were classified into the ≥3 weeks group. The primary objective was to explore the potential factors associated with the continuation of anamorelin, and the secondary objectives were to compare survival and nutritional indices. In the univariate analysis, there were significant differences between the two groups in terms of cancer type (p=0.007) and serum albumin level (p=0.026). In the multivariate analysis, gastric cancer and albumin 2.7 g/dL or less were associated with the continuation of anamorelin. Survival was significantly shorter in the <3 weeks group (p=0.019). This study suggests that the continuation of anamorelin may be influenced by specific tumor types and serum albumin levels. Furthermore, the duration of anamorelin administration may affect patient survival.

[The Department of Pharmacy at Fukuoka University Hospital's Role in Preventing Hepatitis B Virus Reactivation in Patients Taking Oral Anticancer Drugs].

At the Department of Pharmacy of Fukuoka University Hospital, hepatitis B virus(HBV)screening tests, and HBV-DNA quantitative monitoring, are conducted before starting chemotherapy with injectable anticancer drugs. If certain tests have not been performed, the pharmacists order them as part of the protocol based pharmacotherapy management(PBPM)system. However, the status of HBV-related testing among patients taking oral anticancer drugs is unclear. Therefore, we surveyed the status of HBV-related testing in patients, who were prescribed oral anticancer drugs with a label warning regarding HBV reactivation, at our hospital between August 1 and September 30, 2021. We examined the effect of pharmacist support for HBV reactivation measures based on the PBPM. During the study, 247 patients were prescribed oral anticancer drugs, and 36% did not undergo HBV screening or HBV-DNA quantitative monitoring. Screening or monitoring was performed in most cases after they were ordered by the pharmacists or after informing the physicians. These results suggest that HBV-related testing in patients taking oral anticancer drugs is inadequate, and pharmacist support based on the PBPM may help prevent the development of hepatitis and facilitate the continuation of anticancer drug treatment for underlying diseases.

[A Case of Rheumatoid Arthritis Caused by Pembrolizumab Treatment for Non-Small Cell Lung Cancer].

A man in his 40s underwent a transbronchial lung biopsy and received a diagnosis of adenocarcinoma of the right upper lobe of the lung(cT4N0M0, Stage Ⅲ)with no EGFR gene mutation, no ALK fusion gene, no ROS1 fusion gene, and a tumor proportion score(TPS)of 50-74%. During the postoperative follow-up period, enlarged right supraclavicular lymph nodes and right upper and lower paratracheal lymph nodes were detected, diagnosed as recurrence by positron emission tomography-computed tomography. Although a positive rheumatoid factor test, as the patient had no symptoms of rheumatoid arthritis(RA), treatment with pembrolizumab was initiated. Before the second treatment course, a pharmacist conversing with the patient observed that the patient was experiencing pain in his fingers. After discussing the possibility of treatment continuation and test items with the attending physician, the patient underwent tests and received a diagnosis of RA.