RESUMO
Recently, novel therapeutic regimens, such as FOLFIRINOX, have been demonstrated to show promising anti-cancer activity and to be superior to single-agent gemcitabine for unresectable pancreatic cancer patients with good performance status. In this study, we report 2 cases of pancreatic cancer treated with FOLFIRINOX and G-CSF prophylaxis at the standard therapeutic dose, after treatment with gemcitabine and S-1 chemotherapy failed. It has been reported that grade 3-4 neutropenia frequently occurs in patients treated with the FOLFIRINOX regimen. Furthermore, granulocyte colony-stimulating factor(G-CSF) has not been recommended for helping with neutropenia in pancreatic cancer patients treated with FOLFIRINOX: however, prophylactic use of G-CSF is recommended for cancer patients who are at high risk of neutropenic events. On the other hand, modified FOLFIRINOX(no bolus 5-FU)has demonstrated an improved safety profile with maintained efficacy, and further randomized studies to compare the overall survivals of the modified FOLFIRINOX versus FOLFIRINOX regimen and G-CSF prophylaxis are hence needed in the future.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Neutropenia/prevenção & controle , Neoplasias Pancreáticas/tratamento farmacológico , Idoso , Evolução Fatal , Feminino , Humanos , Masculino , Neutropenia/induzido quimicamenteRESUMO
Here, we report about a 60-year-old woman with metastatic breast cancer who was successfully treated for paclitaxelinduced peripheral neuropathy with duloxetine. She was administered trastuzumab plus paclitaxel(PTX)combination therapy that was ultimately discontinued because of grade 3 peripheral neuropathy detected on day 15, according to the CTCAE (v4.0). She was administered duloxetine on day 90 after the end of the previous therapy because of the peripheral neuropathy. Thereafter, the peripheral neuropathy decreased to grade 1, which enabled PTX administration on her request. Further trials are required to confirm the efficacy of duloxetine.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Paclitaxel/efeitos adversos , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , Tiofenos/uso terapêutico , Anticorpos Monoclonais Humanizados/administração & dosagem , Neoplasias da Mama/patologia , Cloridrato de Duloxetina , Feminino , Humanos , Pessoa de Meia-Idade , Paclitaxel/administração & dosagem , Doenças do Sistema Nervoso Periférico/induzido quimicamente , TrastuzumabRESUMO
Gefitinib anderlotinib, which are epidermal growth factor receptor(EGFR)tyrosine kinase inhibitors(TKIs), have been usedfor the treatment of inoperable andrecurrent non-small cell lung cancer(NSCLC)patients. These drugs are known to cause a skin rash, one of the major side effects, at a high frequency. Biotin is a water-soluble vitamin, andit belongs to the vitamin B family. It is well known that biotin deficiency increases the risk of skin dermatitis. We administered biotin to four patients with skin rash, all of whom were treatedwith either gefitinib or erlotinib andwere unable to be treatedby a steroid ointment alone. In all patients, administration of biotin reduced the skin rash. Surprisingly, in 2 patients in whom EGFR-TKI therapy was discontinued because of the skin rash, the administration of biotin allowed for long-term gefitinib or erlotinib treatment. Biotin may be considereduseful for the treatment of skin rash causedby EGFR-TKIs. Further trials may be needed to confirm the value of biotin in this setting.
Assuntos
Antineoplásicos/efeitos adversos , Biotina/uso terapêutico , Eritema/tratamento farmacológico , Inibidores de Proteínas Quinases/efeitos adversos , Quinazolinas/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Cloridrato de Erlotinib , Eritema/induzido quimicamente , Feminino , Gefitinibe , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Estudos Prospectivos , Inibidores de Proteínas Quinases/uso terapêutico , Quinazolinas/uso terapêuticoRESUMO
Epirubicin hydrochloride injection is indicated as a therapy for patients with primary breast cancer. This drug has been reclassified as a drug with high emetic potential according to the American Society of Clinical Oncology Guidelines for Antiemetics in Oncology. Therefore, patients who receive this agent should also receive fosaprepitant dimeglumine, an anti-emetic agent. However, it has been reported that fosaprepitant induces vascular pain when used in anthracycline-based regimens administered via the peripheral veins. In order to relieve the fosaprepitant and epirubicin-induced vascular pain associated with vasculitis, dexamethasone was administered at the onset of vascular pain. There is a possibility that the fosaprepitant and epirubicin-induced pain may improve owing to the administration of dexamethasone; however, further trials are required to confirm the effect of this method.
Assuntos
Antieméticos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Dexametasona/uso terapêutico , Dor/prevenção & controle , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Epirubicina/administração & dosagem , Epirubicina/efeitos adversos , Humanos , Pessoa de Meia-Idade , Morfolinas/administração & dosagem , Morfolinas/efeitos adversos , Dor/induzido quimicamente , Vômito/induzido quimicamente , Vômito/prevenção & controle , Adulto JovemRESUMO
Agents used in cancer treatment can cause many side effects in patients. Oxaliplatin is a platinum-based cytotoxic agent that is used in the treatment of colorectal cancers, and one of its potential side effects is vascular pain. The current article will discuss the coadministration of dexamethasone and its potential effect on oxaliplatin-related vascular pain.