The increasing complexity of cancer chemotherapy heightens the requirement that pharmacists be familiar with these highly toxic agents. This column will review various issues related to preparation, dispensing, and administration of cancer chemotherapy. It will also serve as a review of various agents, both commercially available and investigational, used to treat malignant diseases.
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References
1.
CabantchikZ.I., LinkG., GlicksteinH.. Deferasirox (Exjade, ICL670): a journey into labile iron centers of living cardiomyocytes. Proc Am Soc Hematol.2005 (abstract 824). Available at: http://www.hematology.org. Accessed February 19, 2006.
2.
DaarS., TaherA., PathareA.. Plasma LPI in beta-thalassemia patients before and after treatment with deferasirox (Exjade, ICL670). Proc Am Soc Hematol.2005 (abstract 2697). Available at: http://www.hematology.org. Accessed February 19, 2006.
3.
TaherA., El-BeshlawyA., Al JefriA.. Deferasirox (Exjade, ICL670) treatment in inadequately chelated beta-thalassemia patients from the Middle East: The ESCALATOR Trial. Proc Am Soc Hematol.2005(abstract 2697). Available at: http://www.hematology.org. Accessed February 19, 2006.
Nisbet-BrownE., OlivieriN.F., GiardinaP.J.. Effectiveness and safety of ICL670 in iron-loaded patients with thalassemia: a randomized, double-blind, placebo-controlled dose-escalation trial. Lancet.2003; 361: 1597–1602.
6.
GalanelloR., PigaA., AlbertiD., RouanM.C., BiglerH., SéchaudR.Safety, tolerability, and pharmacokinetics of ICL670, a new orally active iron-chelating agent in patients with transfusion-dependent iron overload due to beta-thalassemia. J Clin Pharmacol.2003; 43: 565–572.
7.
PorterJ., VichinskyE., RoseC.. A phase III study with ICL670 (Exjade), a once-daily oral iron chelator, in patients with various transfusion-dependent anemias and iron overload. Proc Am Soc Hematol.2004 (abstract 3193). Available at: http://www.hematology.org. Accessed February 19, 2006.
8.
CappelliniM., BejaouiM., PerrottaS.. Phase III evaluation of once-daily, oral therapy with ICL670 (Exjade) versus deferoxamine in patients with beta-thalassemia and transfusional hemosiderosis. Proc Am Soc Hematol.2004 (abstract 3619). Available at: http://www.hematology.org. Accessed February 19, 2006.
9.
AngelucciE., TurlinB., CanatanD.. Iron chelation therapy with deferasirox (Exjade, ICL670) or deferoxamine is effective in reducing iron overload in patients with advanced fibrosis and cirrhosis. Proc Am Soc Hematol.2005 (abstract 2696). Available at: http://www.hematology.org. Accessed February 19, 2006.
10.
BrissotP., TurlinB., ForniG.L.. Iron chelation therapy with deferasirox (Exjade, ICL670) or deferoxamine results in reduced hepatocellular inflammation and improved liver function in patients with transfusion-dependent anemia. Proc Am Soc Hematol.2005 (abstract 823). Available at: http://www.hematology.org. Accessed February 19, 2006.
11.
DeugnierY., TurlinB., RopertM.. Semi-quantitative assessment of hemosiderin distribution accurately reflects reductions in liver iron concentrations following therapy with deferasirox (Exjade, ICL670) or deferoxamine in patients with transfusion-dependent anemia. Proc Am Soc Hematol.2005 (abstract 2708). Available at: http://www.hematology.org. Accessed February 19, 2006.
12.
GreenbergP., DineG., GanserA.. Deferasirox (Exjade, ICL670) demonstrates dose-related effects on body iron levels related to transfusional iron intake in transfusion-dependent anemia. Proc Am Soc Hematol.2005 (abstract 2694). Available at: http://www.hematology.org. Accessed February 19, 2006.
13.
PorterJ., Borgna-PignattiC., BaccaraniM.. Iron chelation efficiency of deferasirox (Exjade, ICL670) in patients with transfusional hemosiderosis. Proc Am Soc Hematol.2005 (abstract 2690). Available at: http://www.hematology.org. Accessed February 19, 2006.
14.
KattamisC., KilincY., FattoumS.. Deferasirox (Exjade, ICL670) demonstrates iron chelating efficiency related to transfusional iron intake in pediatric patients. Proc Am Soc Hematol.2005 (abstract 2692). Available at: http://www.hematology.org. Accessed February 19, 2006.
15.
VicinskyE., FischerR., FungE.. A randomized, controlled phase II trial in sickle cell disease patients with chronic iron overload demonstrates that the once-daily oral iron chelator deferasirox (Exjade, ICL670) is well tolerated and reduces iron burden. Proc Am Soc Hematol.2005 (abstract 313). Available at: http://www.hematology.org. Accessed February 19, 2006.
16.
KleinertD.A., JonesE., SisonC.P., MarksP., GiardinaP.J.Left ventricular cardiac function during the course of a one year multicenter trial of the safety and efficacy with ICL 670 5-40 mg/kg/day and deferoxamine 209-60 mg/kg/day in beta-thalassemia patients with transfusional hemosiderosis. Proc Am Soc Hematol.2005 (abstract 3853). Available at: http://www.hematology.org. Accessed February 19, 2006.
17.
ZangariM., TricotG., ZeldisJ., EddlemonP., SaghafifarF., BarlogieB.Results of phase I study of CC-5013 for the treatment of multiple myeloma (MM) patients who relapse after high dose chemotherapy (HDCT) (abstract 3226). Blood.2001; 98(11, Part 1): 775a.
18.
RichardsonP.G., SchlossmanR.L., WellerE.. Immunomodulatory drug CC-5013 overcomes drug resistance and is well tolerated in patients with relapsed multiple myeloma. Blood.2002; 100: 3063–3067.
19.
BartlettJ.B., MichaelA., ClarkeI.A.. Phase I study to determine the safety, tolerability and immunostimulatory activity of thalidomide analogue CC-5013 in patients with metastatic malignant melanoma and other advanced cancers. Br J Cancer.2004; 90: 955–961.
20.
ListA.F., DewaldG., BennettJ.. Hematologic and cytogenetic (CTG) response to lenalidomide (CC-5013) in patients with transfusion-dependent (TD) myelodysplastic syndrome (MDS) and chromosome 5q31. Results of the multicenter MDS-003 study. Proc Am Soc Clin Oncol.2005 (abstract 5). Available at: http://www.asco.org. Accessed February 19, 2006.
21.
GiagounidisA.A., GermingU., StruppC., HildebrantB., HeinschM., AulC.Prognosis of patients with del(5q) MDS and complex karyotype and the possible role of lenalidomide in this patient subgroup. Ann Hematol.2005; 84: 569–571.
22.
ListA., KurtinS., RoeD.. Efficacy of lenalidomide in myelodysplastic syndromes. N Engl J Med.2005; 352: 549–557.
23.
CortesJ., ThomasD., VerstovsekS., GilesF., BeranM., KollerC., KantarjianH.Phase II study of lenalidomide (CC-5013, Revlimid) for patients (PTS) with myelofibrosis (MF). Proc Am Soc Hematol.2005 (abstract 377). Available at: http://www.hematology.org. Accessed February 19, 2006.
24.
TefferiA., MesaR.M., HoganW.J.. Lenalidomide (CC-5013) treatment for anemia associated with myelofibrosis with myeloid metaplasia. Proc Am Soc Hematol.2005 (abstract 2583). Available at: http://www.hematology.org. Accessed February 19, 2006.
MillerK.C., CzuczmanM.S., DimiceliL.. Antileukemic effects of novel immunomodulatory agent lenalidomide (L) with or without rituximab in patients (PTS) with relapsed (REL) or refractory (REF) chronic lymphocytic leukemia (CLL). Encouraging preliminary results of an ongoing phase II clinical study. Proc Am Soc Clin Oncol.2005 (abstract 6557). Available at: http://www.asco.org. Accessed February 19, 2006.
27.
DispenzieriA., LacyM.Q., ZeldenrustS.R.. Lenalidomide has activity in a phase II trial in patients with primary systemic amyloidosis. Proc Am Soc Hematol.2005 (abstract 252). Available at: http://www.hematology.org. Accessed February 19, 2006.
28.
DimopoulosM.A., SpencerA., AttalM.. Study of lenalidomide plus dexamethasone versus dexamethasone alone in relapsed or refractory multiple myeloma (MM): results of a phase 3 study (MM-010). Proc Am Soc Hematol.2005 (abstract 6). Available at: http://www.hematology.org. Accessed February 19, 2006.
29.
RichardsonP., SchlossmanR., MunshiN.. A phase 1 trial of lenalidomide (Revlimid) with bortezomib (Velcade) in relapsed and refractory multiple myeloma. Proc Am Soc Hematol.2005 (abstract 365). Available at: http://www.hematology.org. Accessed February 19, 2006.
30.
Chanan-KhanA.A., MillerK.C., DiMiceliL.. Results of phase II study of lenalidomide (L) (Revlimid) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). Proc Am Soc Hematol.2005 (abstract 447). Available at: http://www.hematology.org. Accessed February 19, 2006.
31.
NiesvizskyR., PekleK., GelbshteinU.. BIRD (Biaxin/Revlimid/dexamethasone) combination therapy (Rx) results in high complete remissions (CR) and overall responses in myeloma (MM) with poor prognostic features. Proc Am Soc Hematol.2005 (abstract 642). Available at: http://www.hematology.org. Accessed February 19, 2006.
32.
TreonS.P., PattersonC.J., HunterZ.R., BranaganA.R.Phase II study of CC-5013 (Revlimid) and rituximab in Waldenström's macroglobulinemia: preliminary safety and efficacy results. Proc Am Soc Hematol.2005 (abstract 2443). Available at: http://www.hematology.org. Accessed February 19, 2006.
33.
BazR., ChoueiriT.K., JawdeR.A., McGowanB., EllisY., BrandC., HusseinM.A.Doxil (D), vincristine (V), reduced frequency dexamethasone (D) and Revlimid) (DVD-R) results in a high response rate in patients with refractory multiple myeloma (RMM). Proc Am Soc Hematol.2005 (abstract 2559). Available at: http://www.hematology.org. Accessed February 19, 2006.
34.
QuerfeldC., KuzelT.M., GuitartJ.. Preliminary results of a Phase II study of CC-5013 (lenalidomide, Revlimid) in patients with cutaneous T-cell lymphoma. Proc Am Soc Hematol.2005 (abstract 3351). Available at: http://www.hematology.org. Accessed February 19, 2006.
35.
ZonderJ.A., DurieB.G.M., McCoyJ.. High incidence of thrombotic events observed in patients receiving lenalidomide (L) + dexamethasone (D) (LD) as first-line therapy for multiple myeloma (MM) without aspirin (ASA) prophylaxis. Proc Am Soc Hematol.2005 (abstract 3455). Available at: http://www.hematology.org. Accessed February 19, 2006.
36.
RajkumarS.V., HaymanS.R., LacyM.Q.. Combination therapy with lenalidomide plus dexamethasone (Rev/Dex) for newly diagnosed myeloma. Blood.2005; 106: 4050–4053.
37.
PalumboA., FalcoP., MustoP.. Oral Revlimid plus melphalan and prednisone (R-MP) for newly diagnosed multiple myeloma. Proc Am Soc Hematol.2005 (abstract 785). Available at: http://www.hematology.org. Accessed February 19, 2006.
38.
GereckeC., KnopS., ToppM.S.. A multicenter phase I/II trial evaluating the safety and efficacy of lenalidomide [Revlimidä), CC-5013] in combination with doxorubicin and dexamethasone (RAD) in patients with relapsed or refractory multiple myeloma. Proc Am Soc Hematol.2005 (abstract 5136). Available at: http://www.hematology.org. Accessed February 19, 2006.
39.
RichardsonP.G., JagannathS., SchlossmanR.. A multi-center, randomized phase 3 study to evaluate the efficacy and safety of 2 CDC-5013 dose regimens when used alone or in combination with dexamethasone (DEX) for the treatment of relapsed or refractory multiple myeloma (MM). Proc Am Soc Hematol.2005 (abstract 825). Available at: http://www.hematology.org. Accessed February 19, 2006.
40.
RichardsonP., JagannathS., HusseinM.. A multicenter, single-arm, open-label study to evaluate the efficacy and safety of single-agent lenalidomide in patients with relapsed and refractory multiple myeloma; preliminary results. Proc Am Soc Hematol.2005 (abstract 1565). Available at: http://www.hematology.org. Accessed February 19, 2006.
41.
BarlogieB., ShaughnessyJ., TricotG.. Treatment of multiple myeloma. Blood.2004; 103: 20–32.
