Development of a rapid risk evaluation tool for herbs/drugs interactions in cancer patients: a multicentric experience in south of France.

Cancer patients use herbs in spite of severe interactions risks with major anticancer drugs. In daily practice, it is very difficult for oncologists to detect and define the risk of a herb-anticancer drug interaction (HDI). In this work, we realised a state of play in one of the most populated region of France by evaluating, through a specific questionnaire, the position of a representative panel of oncologists. About 80% of them thought that herbs interact with anticancer treatments whereas only 15.4% of them actually knew the real HDI. About 89.1% of them thought that a practical detection tool would be relevant and useful for their daily practice. Then, we constructed a tool in order to rapidly evaluate a HDI risk level. Based on experts' reviews and using a criticality matrix, we determined the HDI risk level between 11 herbs and 126 anticancer drugs. Then, we measured satisfactory of oncologists. All of them considered the tool as useful in their daily practice and then used it. This work highlighted that even if HDI has been integrated as a theoretical risk, its practical detection and risk evaluation is difficult to implement for oncologists in their daily practice. Thus, the tool we developed should answer to an unmet medical need.

SFPO and ESOP recommendations for the practical stability of anticancer drugs: an update.

The recommendations for the practical stability of anticancer drugs published in 2010 by the French Society of Hospital Pharmacists (SFPO) and the European Society of Oncology Pharmacists (ESOP) have been updated. Ten new molecules have been included (asparaginase, azacitidine, bevacizumab, clofarabine, eribuline mesylate, folinate sodium, levofolinate calcium, nelarabine, rituximab, temsirolimus).

Seventy-two-hour stability of Taxol in 5% dextrose or 0.9% sodium chloride in Viaflo, Freeflex, Ecoflac and Macoflex N non-PVC bags.

BACKGROUND AND OBJECTIVES: Taxol (paclitaxel), is an antimicrotubule agent widely prescribed for the treatment of many tumoral diseases. Taxol must be used in non-polyvinyl chloride bags, diluted to concentrations of 0.3-1.2 mg/mL in 5% dextrose or in 0.9% sodium chloride. Under these conditions, Taxol is chemically and physically stable for 27 h at 25 degrees C. The aim of the study was to evaluate the 72-h stability of Taxol under common clinical use conditions. METHODS: Taxol was diluted with 5% dextrose and 0.9% sodium chloride to final concentrations of 0.3 and 1.2 mg/mL in four polyolefin bags (Viaflo, Freeflex, Ecoflac and Macoflex N). Taxol-stability, was assessed by turbidimetry and by high-performance liquid chromatography using solutions stored in the dark, over 72 h at +4 degrees C. RESULTS: No haze, turbidity, or precipitate was observed. Paclitaxel concentration remained above 95% of the initial value whatever the solvent or container used. CONCLUSION: Paclitaxel at 0.3 and 1.2 mg/mL in 5% dextrose and in 0.9% sodium chloride is stable in Viaflo, Freeflex, Ecoflac and Macoflex N non-PVC bags for 72 h in the dark at +4 degrees C. The longer stability should make the use of Taxol in clinical practice easier.