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Lei S, Wang N, Ren B, Lin S, Feng B. Safety analysis of antineoplastic drugs for lung cancer: a retrospective analysis based on Shaanxi Province in Western China. Expert Opin Drug Saf 2024; 23:99-105. [PMID: 36929779 DOI: 10.1080/14740338.2023.2193394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND China has the highest proportion of lung cancer-related deaths. Drug therapy is the main tool of comprehensive anticancer treatment. However, most studies to date have focused on certain types of targets or immunotherapeutic modalities for drug safety; few studies have addressed the factors that influence ADRs for each type of drug in patients with lung cancer, and even fewer studies have explored the risk factors for certain types of ADRs. Based on it, we comprehensively evaluate the drug safety of patients and provide a clinical reference with a focus on lung cancer. RESEARCH DESIGN AND METHODS We examined 767 reports of adverse drug reactions (ADRs) in patients with lung cancer and conducted a logistic regression analysis on the risk factors that may cause different types of organ system damage and serious ADRs. RESULTS The logistic regression identified various independent risk factors for system organ damage, and ADRs involving erythrocyte abnormalities (P < 0.001), respiratory system damage (P < 0.001), and leukocyte and reticuloendothelial system abnormalities (P < 0.001) were more likely to be severe. CONCLUSIONS Rare adverse reactions and different Clinical medication guidelines for molecular-targeted drugs were identified. These findings had certain practical significance in clinical safe drug use.
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Affiliation(s)
- Shuang Lei
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ningsheng Wang
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Biqi Ren
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shuzhi Lin
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bianling Feng
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- The Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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2
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Yao K, Li S, Liu Q, Wu F. The emerging role of cross-resistance between taxanes and AR-targeting therapy in metastatic prostate cancer. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221088689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: To date, the number of prostate cancer ranked first among newly diagnosed malignant tumors in men from multiple countries. Localized prostate cancer could be controlled by curative therapy. However, for patients with metastatic prostate cancer (mPC), the prognosis is poor. As among first-line treatments of systemic therapies for mPC, docetaxel and androgen receptor (AR)-targeted therapies have been widely used. However, mPC patients inevitably developed resistance to the current therapy. More importantly, there is a cross-resistance between docetaxel-based chemotherapy and AR-targeting therapy during the treatment process, which could impair the overall survival benefits without proper administration. Objective: Therefore, it is urgent to elucidate the mechanism of cross-resistance and explore the optimal sequential strategy. Methods: Here, in this review, we systematically reviewed and summarised the updated literature on clinical evidence and mechanistic research of treatment resistance in mPC. Results: Emerging evidence indicated that AR splice variants, AR overexpression or mutations, AR nuclear translocation, as well as AR signaling reactivation collectively contributed to the cross-resistance. With the current understanding of cross-resistance, multiple solutions are promising for improving the benefits, including refining the sequencing of available therapies for mPC, in combination with potential targeted inhibitors or immune checkpoint inhibitors. Further studies are needed to explore the combination of emerging strategies and eventually control the progression of prostate cancer. Conclusions: This review defined the mutual and unique resistant mechanism of these treatments, which might help to focus and accelerate therapeutic research that may ultimately improve clinical outcomes for patients with prostate cancer. Level of evidence: Not applicable
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Affiliation(s)
- Kang Yao
- Department of Urology, Shandong Provincial Qianfoshan Hospital, Shandong University, P.R. China
| | - Shun Li
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, P.R. China
| | - Qingyong Liu
- Department of Urology, Shandong Provincial Qianfoshan Hospital, Shandong University, P.R. China
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, P.R. China
| | - Fei Wu
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, P.R. China
- Shandong Provincial Key Laboratory of Radiation Oncology, Cancer Research Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, P.R. China
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Yu Y, Ruddy K, Mansfield A, Zong N, Wen A, Tsuji S, Huang M, Liu H, Shah N, Jiang G. Detecting and Filtering Immune-Related Adverse Events Signal Based on Text Mining and Observational Health Data Sciences and Informatics Common Data Model: Framework Development Study. JMIR Med Inform 2020; 8:e17353. [PMID: 32530430 PMCID: PMC7320306 DOI: 10.2196/17353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/13/2020] [Accepted: 04/15/2020] [Indexed: 01/30/2023] Open
Abstract
Background Immune checkpoint inhibitors are associated with unique immune-related adverse events (irAEs). As most of the immune checkpoint inhibitors are new to the market, it is important to conduct studies using real-world data sources to investigate their safety profiles. Objective The aim of the study was to develop a framework for signal detection and filtration of novel irAEs for 6 Food and Drug Administration–approved immune checkpoint inhibitors. Methods In our framework, we first used the Food and Drug Administration’s Adverse Event Reporting System (FAERS) standardized in an Observational Health Data Sciences and Informatics (OHDSI) common data model (CDM) to collect immune checkpoint inhibitor-related event data and conducted irAE signal detection. OHDSI CDM is a standard-driven data model that focuses on transforming different databases into a common format and standardizing medical terms to a common representation. We then filtered those already known irAEs from drug labels and literature by using a customized text-mining pipeline based on clinical text analysis and knowledge extraction system with Medical Dictionary for Regulatory Activities (MedDRA) as a dictionary. Finally, we classified the irAE detection results into three different categories to discover potentially new irAE signals. Results By our text-mining pipeline, 490 irAE terms were identified from drug labels, and 918 terms were identified from the literature. In addition, of the 94 positive signals detected using CDM-based FAERS, 53 signals (56%) were labeled signals, 10 (11%) were unlabeled published signals, and 31 (33%) were potentially new signals. Conclusions We demonstrated that our approach is effective for irAE signal detection and filtration. Moreover, our CDM-based framework could facilitate adverse drug events detection and filtration toward the goal of next-generation pharmacovigilance that seamlessly integrates electronic health record data for improved signal detection.
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Affiliation(s)
- Yue Yu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Kathryn Ruddy
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN, United States
| | - Aaron Mansfield
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN, United States
| | - Nansu Zong
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Andrew Wen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Shintaro Tsuji
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Ming Huang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Hongfang Liu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Nilay Shah
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Guoqian Jiang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
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Cherri S, Prochilo T, Rota L, Mutti S, Garatti M, Liserre B, Zaniboni A. Neutropenic Enterocolitis in the Treatment of Solid Tumors: A Case Report and Review of the Literature. Case Rep Oncol 2020; 13:442-448. [PMID: 32399014 PMCID: PMC7204860 DOI: 10.1159/000506896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 02/27/2020] [Indexed: 12/14/2022] Open
Abstract
Neutropenic enterocolitis is a clinical condition characterized by inflammation of the colic mucosa, usually the caecum, associated with bowel wall thickening in patients with compromised immune system due to chemotherapy treatments. It can occur as well in other clinical conditions that lead to immunosuppression. Clinically, patients present with abdominal pain, fever, and neutropenia on blood tests. A number of major and minor criteria have been suggested for the clinical diagnosis of typhlitis. The most sensitive radiological investigation is represented by a computed tomography scan. There are no guidelines for treatment, but some factors may lead the clinician to medical treatments or prompt surgery as the best choice in that particular patient. The most implicated chemotherapeutic regimens are those based on taxanes. Here, we present a clinical case of a young patient with breast cancer and a review of the state of the art of knowledge regarding neutropenic enterocolitis in adult patients undergoing chemotherapy for the treatment of solid tumors.
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Affiliation(s)
- Sara Cherri
- Department of Oncology, Fondazione Poliambulanza, Brescia, Italy
| | - Tiziana Prochilo
- Department of Oncology, Fondazione Poliambulanza, Brescia, Italy
| | - Luigina Rota
- Department of Oncology, Fondazione Poliambulanza, Brescia, Italy
| | - Stefano Mutti
- Department of Surgery, Fondazione Poliambulanza, Brescia, Italy
| | - Marco Garatti
- Department of Surgery, Fondazione Poliambulanza, Brescia, Italy
| | - Barbara Liserre
- Department of Pathology, Fondazione Poliambulanza, Brescia, Italy
| | - Alberto Zaniboni
- Department of Oncology, Fondazione Poliambulanza, Brescia, Italy
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