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Clear guidelines on oral chemotherapy needed
January 12, 2007Oral chemotherapy safety practices at US cancer centers: questionnaire survey BMJ Online First
Current practices around the use of oral chemotherapy in US cancer centres need to be improved, say doctors in a study on bmj.com.
Common malignancies can be treated with oral chemotherapy - a treatment which is increasingly used across the USA and internationally.
Researchers from Boston set out to analyse the guidelines and practices used by comprehensive cancer centres for the provision of oral chemotherapy. Forty-two centres took part in the study. Variations in practice emerged in the prescribing methods, consent requests and the coordination and monitoring of treatment. They found that few of the safeguards which are routinely used for infusion chemotherapy were adopted for oral chemotherapy treatment.
Most of the 42 organisations which took part in the study had no required elements for prescribing oral chemotherapy and few requested patients' written consent for off protocol prescribing. Only one in three organisations required a clinician to note the body surface area or calculation of dose on the prescription, and only one in four required the patients' diagnosis or protocol.
Nearly a quarter of the centres had no formal process for monitoring patients' adherence. In the past year respondents at 10 centres reported at least one serious adverse drug event related to oral chemotherapy and respondents at 13 centres reported a 'serious near miss'.
The authors conclude that 'prescribing, monitoring and coordination, pharmacy practices and education of patients for oral chemotherapy vary substantially. Despite clinicians' concerns about oral chemotherapies, there is no apparent consensus among oncology professionals about safe practices for these drugs. The oncology community must define safe medication practices appropriate for oral chemotherapy, develop practice guidelines and accelerate their adoption.\\\
BMJ-British Medical Journal
Researchers from Boston set out to analyse the guidelines and practices used by comprehensive cancer centres for the provision of oral chemotherapy. Forty-two centres took part in the study. Variations in practice emerged in the prescribing methods, consent requests and the coordination and monitoring of treatment. They found that few of the safeguards which are routinely used for infusion chemotherapy were adopted for oral chemotherapy treatment.
Most of the 42 organisations which took part in the study had no required elements for prescribing oral chemotherapy and few requested patients' written consent for off protocol prescribing. Only one in three organisations required a clinician to note the body surface area or calculation of dose on the prescription, and only one in four required the patients' diagnosis or protocol.
Nearly a quarter of the centres had no formal process for monitoring patients' adherence. In the past year respondents at 10 centres reported at least one serious adverse drug event related to oral chemotherapy and respondents at 13 centres reported a 'serious near miss'.
The authors conclude that 'prescribing, monitoring and coordination, pharmacy practices and education of patients for oral chemotherapy vary substantially. Despite clinicians' concerns about oral chemotherapies, there is no apparent consensus among oncology professionals about safe practices for these drugs. The oncology community must define safe medication practices appropriate for oral chemotherapy, develop practice guidelines and accelerate their adoption.\\\
BMJ-British Medical Journal
Oral Chemotherapy Current Events and Oral Chemotherapy News RSSCompliance and cost: Bitter pills to swallow in the age of oral chemotherapy
Though the growing shift toward oral chemotherapy agents offers cancer patients greater freedom and independence during their treatment, physicians say use of the new medications also poses more chances for patients to skip doses, miss prescription refills, and take their drugs in a dangerous way.
HER2 levels may aid in treatment selection for metastatic breast cancer
Findings published in the December 1, 2008, issue of Clinical Cancer Research, a journal of the American Association for Cancer Research, show lapatinib benefits women with HER2-positive breast cancer, while women with HER2-negative breast cancer or those who express EGRF alone derive no incremental benefit.
18F-DG PET/CT can highly increase the detection of colorectal cancer
Combined positron emission tomography and computed tomography (PET/CT) is currently widely used in the clinical diagnosis of cancer to provide functional and morphological imaging.
Tablet is better all round for cancer patients
A drug to treat colon cancer is proving much more convenient than traditional chemotherapy, has fewer side effects - and a study of almost 2,000 patients has shown it is giving them a better chance of surviving the disease.
Survey reveals need for standardized oral chemotherapy prescribing practices, safeguards
Despite the widespread use of prescribing safeguards for infusion chemotherapy, few of those measures have been implemented with oral chemotherapy, according to a study led by researchers at Dana-Farber Cancer Institute.
Researchers announce new predictor for lung cancer treatment and survival
Research from the Ireland Cancer Center of University Hospitals of Cleveland has found a promising, novel biomarker that may be used to predict the survival of patients with advanced lung cancer and their response to treatment.
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