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Mir O, Ferrua M, Fourcade A, Mathivon D, Duflot-Boukobza A, Dumont S, Baudin E, Delaloge S, Malka D, Albiges L, Pautier P, Robert C, Planchard D, de Botton S, Scotté F, Lemare F, Abbas M, Guillet M, Puglisi V, Di Palma M, Minvielle E. Digital remote monitoring plus usual care versus usual care in patients treated with oral anticancer agents: the randomized phase 3 CAPRI trial. Nat Med 2022; 28:1224-1231. [PMID: 35469070 DOI: 10.1038/s41591-022-01788-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/16/2022] [Indexed: 01/02/2023]
Abstract
Strategies that individualize the care of cancer patients receiving oral anticancer agents offer opportunities to improve treatment adherence and patient care. However, the impact of digital remote monitoring systems in this setting has not been evaluated. Here, we report the results of a phase 3 trial (CAPRI, NCT02828462) to assess the impact of a nurse navigator-led program on treatment delivery for patients with metastatic cancer. Patients receiving approved oral anticancer agents were randomized (1:1) to an intervention combining a nurse navigator-led follow-up system and a web portal-smartphone application on top of usual care, or to usual symptom monitoring at the discretion of the treating oncologist, for a duration of 6 months. The primary objective included optimization of the treatment dose. Secondary objectives were grade ≥3 toxicities, patient experience, rates and duration of hospitalization, response and survival, and quality of life. In 559 evaluable patients the relative dose intensity was higher in the experimental arm (93.4% versus 89.4%, P = 0.04). The intervention improved the patient experience (Patient Assessment of Chronic Illness Care score, 2.94 versus 2.67, P = 0.01), reduced the days of hospitalization (2.82 versus 4.44 days, P = 0.02), and decreased treatment-related grade ≥3 toxicities (27.6% versus 36.9%, P = 0.02). These findings show that patient-centered care through remote monitoring of symptoms and treatment may improve patient outcomes and experience.
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Affiliation(s)
- Olivier Mir
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France. .,Division of Interdisciplinary Patients Care Pathways (DIOPP), Gustave Roussy, Villejuif, France.
| | - Marie Ferrua
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Aude Fourcade
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Delphine Mathivon
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France.,Division of Interdisciplinary Patients Care Pathways (DIOPP), Gustave Roussy, Villejuif, France
| | - Adeline Duflot-Boukobza
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France.,Division of Interdisciplinary Patients Care Pathways (DIOPP), Gustave Roussy, Villejuif, France
| | - Sarah Dumont
- Division of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - Eric Baudin
- Department of Endocrine Oncology, Gustave Roussy, Villejuif, France
| | | | - David Malka
- Division of Cancer Medicine, Gustave Roussy, Villejuif, France
| | | | | | - Caroline Robert
- Division of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - David Planchard
- Division of Cancer Medicine, Gustave Roussy, Villejuif, France
| | | | - Florian Scotté
- Division of Interdisciplinary Patients Care Pathways (DIOPP), Gustave Roussy, Villejuif, France
| | - François Lemare
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - May Abbas
- Division of Interdisciplinary Patients Care Pathways (DIOPP), Gustave Roussy, Villejuif, France
| | - Marilène Guillet
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Vanessa Puglisi
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France.,Division of Interdisciplinary Patients Care Pathways (DIOPP), Gustave Roussy, Villejuif, France
| | - Mario Di Palma
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France.,Division of Interdisciplinary Patients Care Pathways (DIOPP), Gustave Roussy, Villejuif, France
| | - Etienne Minvielle
- Division of Interdisciplinary Patients Care Pathways (DIOPP), Gustave Roussy, Villejuif, France.,i3-Centre de Recherche en Gestion, Institut Interdisciplinaire de l'Innovation (UMR 9217), École polytechnique, Palaiseau, France
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Desmaris RP, Bermudez E, Annereau M, Lemare F, Slimano F. Organization of chemotherapeutic preparations in advance: Do we save or waste money? J Oncol Pharm Pract 2020; 27:1699-1703. [PMID: 33108989 DOI: 10.1177/1078155220967981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The development of oncology day-hospital activities contributes to increase quality of life of patients and consequently have changed their perception about waiting. The extemporaneous preparation of antineoplastic has become difficult to achieve given the increasing activity, and hospital pharmacists have taken up the challenge by the implementation of the antineoplastic preparation in anticipation. Because anticipation can lead to an important number of preparations to be discarded, we also develop a recycled process for other patients to limit these waste extra costs. We aim to demonstrate the positive balance of anticipated preparation in this 4-year study report.Data sources: This prospective study was conducted in a major European oncology day-hospital from January, 2012 to December, 2015. The data were extracted from our software WinSimbad™ and updated as needed. The number and cost-associated of preparation ungiven chemotherapy doses (recycled or discarded) were compared to the global drug budget of our hospital in order to not exceed 2%.Data summary: 303,100 antineoplastic have been prepared. Approximately 35% of them were anticipated with an average of 5,431±984 that were finally ungiven. Two-third was recycled and the cost of the ungiven preparations finally discarded represents 1.7±0.15% of the global drug budget. CONCLUSIONS This study assesses the drug wastage and its associated cost of this concept through a prospective study and discusses the cost of ungiven antineoplastic preparations. With prior consideration of the need to define the acceptable rate of discarded ungiven preparation, the hospitals with an high oncology day-hospital activity should implement this approach.
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Affiliation(s)
| | - Elisabeth Bermudez
- Department of Clinical Pharmacy, Gustave Roussy Hospital, Rue Edouard Vaillant, France
| | - Maxime Annereau
- Department of Clinical Pharmacy, Gustave Roussy Hospital, Rue Edouard Vaillant, France
| | - François Lemare
- Department of Clinical Pharmacy, Gustave Roussy Hospital, Rue Edouard Vaillant, France
| | - Florian Slimano
- Department of Clinical Pharmacy, Gustave Roussy Hospital, Rue Edouard Vaillant, France
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Mir O, Ferrua M, Fourcade A, Mathivon D, Duflot-Boukobza A, Dumont SN, Baudin E, Delaloge S, Malka D, Albiges L, Pautier P, Robert C, Planchard D, de Botton S, Lemare F, Guillet M, Puglisi V, Abbas M, Di Palma M, Minvielle E. Intervention combining nurse navigators (NNs) and a mobile application versus standard of care (SOC) in cancer patients (pts) treated with oral anticancer agents (OAA): Results of CapRI, a single-center, randomized phase III trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.2000] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2000 Background: Various interventions aiming to improve a safe use of oral anti-cancer agents have previously been reported. These retrospective studies involved nurse-led follow-up and use of health technologies. However, the potential impact of these combined strategies is limited by a lack of rigorous methodology. Methods: We performed a randomized phase 3 trial comparing an intervention combining NNs and a mobile application vs. SOC in cancer pts treated with OAA (excluding hormonal therapy) in our tertiary cancer center. Pts initiating OAA (all types of cancer, PS < 3, life expectancy > 6 months), were randomized in a 1:1 basis. The intervention combined a nursing-led follow-up and a mobile application for patients. NNs provided regular phone follow-ups to manage symptoms and assess toxicities, adherence and supportive care needs. Pts had access to a mobile application to record tracking data, contact NNs via secure messaging or a dedicated phone line. The intervention lasted 6 months. The primary endpoint was the Relative Dose Intensity (RDI). Secondary endpoints included adherence, toxicity, response and survival, quality of life, pts experience (PACIC Score), end-of-life support, and economic estimation of the use of healthcare resources. Results: From October 2016 to May 2019, 609 pts (median age: 62 years, 20-92; PS2: 11.8%) were included. 39% were receiving oral chemotherapy, and 61% other OAA. The RDI was significantly higher in the CAPRI arm (93.4% ±0.26 vs. 89.4% ±0.19, p = 0.04). The CAPRI intervention also improved PACIC scores (mean: 2.94±0.83 vs. 2.67±0.89, p = 0.01), the number of unplanned hospitalizations (15.1% vs. 22.0%, p = 0.04), hospitalization duration (mean: 2.82±6.96 days vs. 4.44±9.60, p = 0.02), and treatment-related grade≥3 toxicities (27.6% vs. 36.9%, p = 0.02). Conclusions: Compared to SOC, the CAPRI intervention improved RDI, pts experience, hospitalizations and their duration, as well as the rate of treatment-related grade≥3 toxicities. This type of intervention should represent a new standard in pts receiving OAA. Clinical trial information: NCT02828462.
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Affiliation(s)
- Olivier Mir
- Gustave Roussy Cancer Institute, Villejuif, France
| | | | | | | | | | | | - Eric Baudin
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Suzette Delaloge
- Breast Cancer Unit, Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - David Malka
- Gustave Roussy, Université Paris-Saclay, Département de Médecine Oncologique, Villejuif, France
| | | | - Patricia Pautier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - Caroline Robert
- Gustave Roussy Comprehensive Cancer Center, Villejuif, France
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Bravo P, Bertin L, Pinon A, Tortolano L, Fleury T, Raimbault S, Chachaty E, Annereau M, Lemare F. Development and stability of an oral suspension of procarbazine in pediatrics. J Drug Deliv Sci Technol 2019. [DOI: 10.1016/j.jddst.2018.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Clairaz-Mahiou B, Nadjahi R, Lemare F, Chappuis A, Cortina F, Ducrocq JL. Thrombose et cancer, connaissances du pharmacien d’officine en Île-de-France. Actualités Pharmaceutiques 2018. [DOI: 10.1016/j.actpha.2018.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tortolano L, Matmati H, Bourhis M, Manerlax K, Lemare F, Saunier J, Yagoubi N. DinCH and ESBO actual migration from PVC infusion tubings used in an oncopediatric unit. J Appl Polym Sci 2018. [DOI: 10.1002/app.46649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Lionel Tortolano
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
- Groupe hospitalier Henri Mondor, Department of Pharmacy; Assistance Publique-Hôpitaux de Paris; Créteil F-94010 France
| | - Houssem Matmati
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
| | - Matthieu Bourhis
- Département de Pharmacie Clinique; Gustave Roussy, Université Paris-Saclay; Villejuif F-94805 France
| | - Katia Manerlax
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
| | - François Lemare
- Département de Pharmacie Clinique; Gustave Roussy, Université Paris-Saclay; Villejuif F-94805 France
- Chair of Clinical Pharmacy, Faculty of Pharmacy of Paris; Sorbonne-Paris University; Paris F-75006 France
- EA 7348 (MOS) de l'Ecole des Hautes Etudes de Santé Publique; Rennes F-35000 France
| | - Johanna Saunier
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
| | - Najet Yagoubi
- EA 401: Matériaux et santé; Université Paris-Saclay, UFR Pharmacie; Châtenay-Malabry F-92290 France
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Slimano F, Netzer F, Borget I, Lemare F, Besse B. Olanzapine as antiemetic drug in oncology: a retrospective study in non-responders to standard antiemetic therapy. Int J Clin Pharm 2018; 40:1265-1271. [PMID: 29744791 DOI: 10.1007/s11096-018-0649-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 05/04/2018] [Indexed: 12/13/2022]
Abstract
Background The role of olanzapine in the treatment of chemotherapy-induced nausea and vomiting (CINV) in addition to the antiemetic therapeutic combination with aprepitant, setrons, and corticosteroids has not been well defined. Objective To investigate the effectiveness of the addition of olanzapine to a standard triplet therapy for the prevention of CINV in patients who experienced CINV during their first chemotherapy course, despite receiving a well-managed prevention protocol. Setting One comprehensive cancer centre in France. Method In a retrospective study with comparator, patients with a high risk of emesis were assigned to two groups during two different 6-month periods, before and after the introduction of olanzapine in clinical practice, respectively. In the olanzapine group, the antiemetic protocol for the second course of chemotherapy was reinforced by the addition of olanzapine at 5 mg/day from day 1 to 5 in contrast with the control group. Main outcome measure The proportion of patients who experienced neither nausea nor emesis during the delayed phase (24-120 h). Results The 25 patients in each group exhibited comparable characteristics and emetic chemotherapy level. During the first course, no significant difference was observed. During the second course, nausea and vomiting were ameliorated in 12 patients in the olanzapine group and 4 patients in the control group (p < 0.05). Nausea (12 vs. 4, p < 0.05) and vomiting (18 vs. 11, p < 0.05) also significantly improved. In the OLZ group, no adverse event was linked to olanzapine use. Conclusion The addition of olanzapine was observed to effectively restore CINV prevention in patients who did not respond to standard antiemetic therapy.
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Affiliation(s)
- Florian Slimano
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, 114 rue Edouard-Vaillant, 94805, Villejuif, France.
- Faculty of Pharmacy, Reims University, 51 rue Cognacq-Jay, 51100, Reims, France.
| | - Florence Netzer
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, 114 rue Edouard-Vaillant, 94805, Villejuif, France
| | - Isabelle Borget
- Department of Biostatistic and Epidemiology, Gustave Roussy Cancer Campus, and INSERM U 1018, Paris-Sud, Paris-Saclay University, Châtenay-Malabry, France
- GRADES, Paris-Sud, Paris-Saclay University, 5 Rue Jean-Baptiste Clément, 92290, Châtenay-Malabry, France
| | - François Lemare
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, 114 rue Edouard-Vaillant, 94805, Villejuif, France
- Faculty of Pharmacy, Paris Descartes University, 4 rue de l'Observatoire, 75006, Paris, France
| | - Benjamin Besse
- Department of Medical Oncology, Gustave Roussy Cancer Campus, 114 rue Edouard-Vaillant, 94805, Villejuif, France
- Faculty of Medicine, Paris-Sud, Paris-Saclay University, 63 rue Gabriel Péri, 94276, Le Kremlin-Bicêtre Cedex, France
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Hamel C, Tortolano L, Bermudez E, Desmaris R, Klein S, Slimano F, Lemare F. Computerized pediatric oncology prescriptions review by pharmacist: A descriptive analysis and associated risk factors. Pediatr Blood Cancer 2018; 65. [PMID: 29251399 DOI: 10.1002/pbc.26897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND Systematic prescription analyses by clinical pharmacists result in pharmacist interventions (PIs) to reduce prescription errors and improve medication safety. PIs are particularly critical in oncology, because antineoplastic drugs are highly toxic with low therapeutic indexes especially in a pediatric population. The aim of this study is to describe PIs in a pediatric oncology department and to identify potential risk factors associated with prescription errors. PROCEDURE We conducted a 20-month observational study in a pediatric oncology department concerning electronic prescription of injectable chemotherapies was conducted. PIs were analyzed for drug-related problems (DRPs), type of intervention, population characteristics, involved drugs, and the potential risk factors. RESULTS Clinical pharmacists made 90 PIs for 10,214 antineoplastic prescriptions for a rate of 88 PIs per 10,000 prescriptions. The majority of DRPs were dosage errors (61.8%), imputable to measurements (weight and/or height) in 47.4% or unreported dose reduction. The most common patient ages were in the range 1-10 years and the most common time for medical double checks was 2-9 pm. There were statistically more prescription errors in standardized protocols (P < 0.001). CONCLUSIONS Not surprisingly, PIs were predominantly to correct dose errors, half of which related to height and weight measurements that were not updated. No significant risk factors for errors were identified for errors except in the standardized status of prescription, which appears to be linked in part to our software that did not automatically reflect dose reduction from one course to the next. Medical double-checking followed by a clinical pharmacist's double check were effective in order to prevent prescription errors.
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Affiliation(s)
- Claire Hamel
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, Villejuif Cedex, 94805, France
| | - Lionel Tortolano
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, Villejuif Cedex, 94805, France.,EA401, IFR141, Faculty of Pharmacy, Paris-sud, University, Chatenay-Malabry, 92296, France.,Assistance Publique-Höpitaux de Paris, Groupe hospitalier Henri Mondor, Department of Pharmacy, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, F-94010, France
| | - Elisabeth Bermudez
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, Villejuif Cedex, 94805, France
| | - Romain Desmaris
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, Villejuif Cedex, 94805, France
| | - Sébastien Klein
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif Cedex, 94805, France
| | - Florian Slimano
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, Villejuif Cedex, 94805, France.,MEDyC Research Unit, UMR CNRS/URCA no. 7369, Reims University, Reims, 51100, France.,Facuty of Pharmacy, Reims University, Reims, 51100, France
| | - François Lemare
- Department of Clinical Pharmacy, Gustave Roussy Cancer Campus, Villejuif Cedex, 94805, France.,Chair of Clinical Pharmacy, Faculty of Pharmacy of Paris, Sorbonne-Paris University, Paris, 75 270, France.,EA 7348 MOS, Ecole des Hautes Etudes en Santé Publique, Rennes, 35043, France
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Hébert G, Minvielle E, Di Palma M, Lemare F. [What are the expectations of coordination and accompaniment of French patients with cancer towards their community pharmacist?]. Bull Cancer 2018; 105:245-255. [PMID: 29486920 DOI: 10.1016/j.bulcan.2017.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/09/2017] [Accepted: 11/29/2017] [Indexed: 11/16/2022]
Abstract
PURPOSES Analyze the relationship and expectations of cancer patients towards the community pharmacist in a pharmaceutical care coordination project. METHODS In November 2014, a questionnaire was distributed to ambulatory patients of a university hospital specialized in oncology. Thirteen questions explored the consumption habits and the usage of the pharmacy (typology of consumers, use of goods and benefits consumed), and collected their expectations for pharmaceutical benefits in the context of the management of their cancer. RESULTS One thousand two hundred and seventy two patients were included for a final response rate of 78%. Characteristics of the respondents: 64% were women, 63% lived in Île-de-France and 49% took cancer-related treatments (anticancer drugs, supportive care medications). More than 84% of respondents went to pharmacies at least once a month and 95% reported resorting to a single pharmacy. 36% to be ready to share their hospital discharge report with their pharmacist and 61% to have their hospitalization order sent to their "referral" pharmacy to anticipate treatments. Discussion Community pharmacists were perceived positively by the respondents. Patients were willing to share information and be accompanied by this health professional in their cancer care. Their expectations were first and foremost the management of drug-related iatrogenic effects with a report of adverse effects to the hospital, and validated solutions for their management.
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Affiliation(s)
- Guillaume Hébert
- Gustave-Roussy, département de pharmacie clinique, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France; École de Hautes Études en Santé Publique (EHESP), équipe d'Accueil « Management des Organisations de Santé », 15, avenue du professeur Léon-Bernard, 35043 Rennes cedex, France.
| | - Etienne Minvielle
- École de Hautes Études en Santé Publique (EHESP), équipe d'Accueil « Management des Organisations de Santé », 15, avenue du professeur Léon-Bernard, 35043 Rennes cedex, France; Gustave-Roussy, Mission « Parcours de soins », 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - Mario Di Palma
- Gustave-Roussy, département ambulatoire, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - François Lemare
- Gustave-Roussy, département de pharmacie clinique, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France; École de Hautes Études en Santé Publique (EHESP), équipe d'Accueil « Management des Organisations de Santé », 15, avenue du professeur Léon-Bernard, 35043 Rennes cedex, France; PRES Sorbonne Paris-Cité, faculté de pharmacie de Paris Descartes, laboratoire de pharmacie clinique, 4, avenue de l'Observatoire, 75006 Paris, France
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Hébert G, Netzer F, Kouakou SL, Lemare F, Minvielle E. Development of a 'ready-to-use' tool that includes preventability, for the assessment of adverse drug events in oncology. Int J Clin Pharm 2018; 40:376-385. [PMID: 29446003 DOI: 10.1007/s11096-017-0542-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 09/26/2017] [Indexed: 11/30/2022]
Abstract
Background Adverse drug events (ADEs) occur frequently in oncology and justify continuous assessment and monitoring. There are several methods for detecting them, but the trigger tool method seems the most appropriate. Although a generic tool exists, its use for ADEs in oncology has not been convincing. The development of a focused version is therefore necessary. Objective To provide an oncology-focused trigger tool that evaluates the prevalence, harm, and preventability in a standardised method for pragmatic use in ADE surveillance. Setting Hospitals with cancer care in France. Method The tool has been constructed in two steps: (1) constitution of an oncology-centred list of ADEs; 30 pharmacists/practitioners in cancer care from nine hospitals selected a list of ADEs using a method of agreement adapted from the RAND/UCLA Appropriateness Method; and (2) construction of three standardised dimensions for the characterisation of each ADE (including causality, severity, and preventability). Main outcome measure The main outcome measure was validation of the tool, including preventability criteria. Results The tool is composed of a final list of 15 ADEs. For each ADE, a 'reviewer form' has been designed and validated by the panel. It comprises (1) the trigger(s), (2) flowcharts to guide the reviewer, (3) criteria for grading harm, and (4) a standardised assessment of preventability with 6-14 closed sentences for each ADE in terms of therapeutic management and/or prevention of side-effects. Conclusion A complete 'ready-to-use' tool for ADE monitoring in oncology has been developed that allows the assessment of three standardised dimensions.
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Affiliation(s)
- Guillaume Hébert
- Département de Pharmacie Clinique, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
- Research Team 'Management des Organisations de Santé' (EA 7348), École de Hautes Études en Santé Publique, 15 Avenue du Professeur Léon-Bernard, 35043, Rennes Cedex, France.
| | - Florence Netzer
- Département de Pharmacie Clinique, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | - Sylvain Landry Kouakou
- Département de Pharmacie Clinique, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | - François Lemare
- Département de Pharmacie Clinique, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
- Research Team 'Management des Organisations de Santé' (EA 7348), École de Hautes Études en Santé Publique, 15 Avenue du Professeur Léon-Bernard, 35043, Rennes Cedex, France
- Pharmacie Clinique, PRES Sorbonne Paris-Cité, Faculté de Pharmacie, 4 Avenue de l'Observatoire, 75006, Paris, France
| | - Etienne Minvielle
- Mission 'Innovative Pathways', Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
- Research Team 'Management des Organisations de Santé' (EA 7348), École de Hautes Études en Santé Publique, 15 Avenue du Professeur Léon-Bernard, 35043, Rennes Cedex, France
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Tortolano L, Yen-Nicolaÿ S, Rogliano PF, Alkhashnam H, Honart JF, Manerlax K, Rimareix F, Lemare F, Yagoubi N. Permeability of expander breast implants: In vitro and in vivo analyses. J Mech Behav Biomed Mater 2017; 78:427-432. [PMID: 29223731 DOI: 10.1016/j.jmbbm.2017.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/29/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The biocompatibility of the polysiloxane breast implant has been studied moderately. The aging of these implants due to lipid penetration and the release of polymerization impurities, such as Platine or octamethylcyclotetrasiloxane (named D4), has already been documented. Since these studies, manufacturing procedures have been improved; thus, the security of breast implants has also improved. Although polymerization and the choice of monomer influence the shell properties, few studies have compared these together in breast implants. Our study compares the permeability and mechanical resistance of 3 breast expander shells after in vivo and in vitro aging. RESULTS In vitro, all tested shells quickly sorbed linear molecules, such as fatty acids, and released siloxane impurities. The penetration of a molecule with steric hindrance, such as cholesterol, is slower. Allergan shells have the highest rates of molecule sorption and siloxane release. In vivo, after implantation, Allergan shells lost their initial mechanical properties over time. This observation was not found for mentor shells. For all brands, many biological molecules penetrate the shells, among which cholesterol and fatty acids are always present. DISCUSSION The aging of polysiloxane shells depends on the sorption of many biological molecules and the release of siloxane impurities. The siloxanes are impurities and / or degradation products that are due to aging. Moreover, according to our results, the shells act as matrices that separate molecules according to their chemical and physical properties. CONCLUSION Not all polysiloxane expander shells have the same properties during aging. The manufacturing procedures and the choice of siloxane monomers are the two most probative factors that explain the observed differences.
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Affiliation(s)
- Lionel Tortolano
- EA 401: Matériaux et santé, Université Paris-Saclay, UFR Pharmacie, Châtenay-Malabry F-92290, France; Assistance Publique-Hôpitaux de Paris, Groupe hospitalier Henri Mondor, Department of Pharmacy, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil F-94010, France.
| | - Stéphanie Yen-Nicolaÿ
- UMS IPSIT, SAMM and Trans-Prot facilities, Université Paris-Saclay, UFR Pharmacie, Châtenay-Malabry F-92290, France
| | - Pierre-François Rogliano
- EA 401: Matériaux et santé, Université Paris-Saclay, UFR Pharmacie, Châtenay-Malabry F-92290, France
| | - Heba Alkhashnam
- Gustave Roussy, Université Paris-Saclay, Département de Plastie, Villejuif F-94805, France
| | - Jean-François Honart
- Gustave Roussy, Université Paris-Saclay, Département de Plastie, Villejuif F-94805, France
| | - Katia Manerlax
- EA 401: Matériaux et santé, Université Paris-Saclay, UFR Pharmacie, Châtenay-Malabry F-92290, France
| | - Françoise Rimareix
- Gustave Roussy, Université Paris-Saclay, Département de Plastie, Villejuif F-94805, France
| | - François Lemare
- Gustave Roussy, Université Paris-Saclay, Département de Pharmacie Clinique, Villejuif F-94805, France; Chair of clinical pharmacy, Faculty of Pharmacy of Paris, Sorbonne-Paris University, Paris F-75006, France; EA 7348 (MOS) de l'Ecole des Hautes Etudes de Santé Publique, 35000 Rennes, France
| | - Najet Yagoubi
- EA 401: Matériaux et santé, Université Paris-Saclay, UFR Pharmacie, Châtenay-Malabry F-92290, France
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12
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Ferrua M, Di Palma M, Lemare F, Fourcade A, Lalloue B, Daumas - Yatim F, Guillet - Lacaze M, Minvielle E. Impact of a cancer care coordination program based on health information technologies for patients treated by oral anticancer therapy: The CAPRI randomized trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Kossmann CM, Annereau M, Thomas-Schoemann A, Nicco-Overney C, Chéreau C, Batteux F, Alexandre J, Lemare F. ADAM9 expression promotes an aggressive lung adenocarcinoma phenotype. Tumour Biol 2017; 39:1010428317716077. [PMID: 28675123 DOI: 10.1177/1010428317716077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
A disintegrin and metalloproteinase 9 (ADAM9) possesses potent metastasis-inducing capacities and is highly expressed in several cancer cells. Previous work has shown that ADAM9 participates in the adhesive-invasive phenotype in lung cancer cells in vitro. In this study, we evaluated whether ADAM9 expression plays a critical role in metastatic processes in vivo and in angiogenesis. We first found that high ADAM9 expression was correlated with poor lung adenocarcinoma patient prognosis on Prognoscan data base. In vivo model based on intravenous injection in nude mice showed that a stable downregulation of ADAM9 in A549 (TrA549 A9-) cells was associated with a lower number of nodules in the lung, suggesting lower potentials for extravasation and metastasis. On a subcutaneous xenograft we showed that TrA549 A9- produced significantly smaller tumours and exhibited fewer neovessels. In addition, in vitro human umbilical vein endothelial cells exposed to supernatant from TrA549 A9- could reduce the formation of more vessel-like structures. To further understand the mechanism, a human antibody array analysis confirmed that five cytokines were downregulated in TrA549 A9- cells. Interleukin 8 was the most significantly downregulated, and its interaction with CXCR2 was implicated in angiogenesis on an in vitro model. These results emphasize the critical influence of ADAM9 on lung cancer progression and aggressiveness. ADAM9 should at least be a marker of cancer aggressiveness and a potential therapeutic target for cancer treatment.
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Affiliation(s)
- Céline Mongaret Kossmann
- 1 Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris, France.,2 UFR Pharmacie EA4691, Service Pharmacie, Hôpital Robert Debré, Reims, France
| | - Maxime Annereau
- 1 Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris, France.,3 Département de Pharmacie Clinique, Gustave Roussy, Villejuif, France
| | - Audrey Thomas-Schoemann
- 4 Hôpitaux Universitaires Paris Centre, Assistance Publique Hôpitaux de Paris, Paris, France.,5 Faculté de Pharmacie Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Carole Nicco-Overney
- 1 Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris, France.,6 Cancer Research Personalized Medicine (CARPEM), Paris, France
| | - Christiane Chéreau
- 1 Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris, France.,6 Cancer Research Personalized Medicine (CARPEM), Paris, France
| | - Frédéric Batteux
- 1 Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris, France.,4 Hôpitaux Universitaires Paris Centre, Assistance Publique Hôpitaux de Paris, Paris, France.,6 Cancer Research Personalized Medicine (CARPEM), Paris, France
| | - Jérôme Alexandre
- 1 Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris, France.,4 Hôpitaux Universitaires Paris Centre, Assistance Publique Hôpitaux de Paris, Paris, France.,6 Cancer Research Personalized Medicine (CARPEM), Paris, France
| | - François Lemare
- 3 Département de Pharmacie Clinique, Gustave Roussy, Villejuif, France.,5 Faculté de Pharmacie Paris Descartes, Université Sorbonne Paris Cité, Paris, France
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14
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Gervès-Pinquié C, Daumas-Yatim F, Lalloué B, Girault A, Ferrua M, Fourcade A, Lemare F, Dipalma M, Minvielle E. Impacts of a navigation program based on health information technology for patients receiving oral anticancer therapy: the CAPRI randomized controlled trial. BMC Health Serv Res 2017; 17:133. [PMID: 28193214 PMCID: PMC5307879 DOI: 10.1186/s12913-017-2066-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 01/31/2017] [Indexed: 02/06/2023] Open
Abstract
Background The emergence of oral delivery in cancer therapeutics is expected to result in an increased need for better coordination between all treatment stakeholders, mainly to ensure adequate treatment delivery to the patient. There is significant interest in the nurse navigation program’s potential to improve transitions of care by improving communication between treatment stakeholders and by providing personalized organizational assistance to patients. The use of health information technology is another strategy aimed at improving cancer care coordination that can be combined with the NN program to improve remote patient follow-up. However, the potential of these two strategies combined to improve oral treatment delivery is limited by a lack of rigorous evidence of actual impact. Methods/design We are conducting a large scale randomized controlled trial designed to assess the impact of a navigation program denoted CAPRI that is based on two Nurse Navigators and a web portal ensuring coordination between community and hospital as well as between patients and navigators, versus routine delivery of oral anticancer therapy. The primary research aim is to assess the impact of the program on treatment delivery for patients with metastatic cancer, as measured by Relative Dose Intensity. The trial involves a number of other outcomes, including tumor response, survival, toxic side effects, patient quality of life and patient experience An economic evaluation adopting a societal perspective will be conducted, in order to estimate those health. care resources’ used. A parallel process evaluation will be conducted to describe implementation of the intervention. Discussion If the CAPRI program does improve treatment delivery, the evidence on its economic impact will offer important knowledge for health decision-makers, helping develop new follow-up services for patients receiving oral chemotherapy and/or targeted therapy. The process evaluation will determine the best conditions in which such a program might be implemented. Trial registration NCT 02828462. Registered 29 June 2016.
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Affiliation(s)
- Chloé Gervès-Pinquié
- Equipe d'Accueil Management des Organisations de Santé, Ecole des Hautes Etudes en Santé Publique, Avenue du Professeur Léon-Bernard, 35043, Rennes, France. .,Gustave Roussy, 114 Rue Edouard Vaillant - 1er étage zone B, 94805, Villejuif, France.
| | - Fatima Daumas-Yatim
- Equipe d'Accueil Management des Organisations de Santé, Ecole des Hautes Etudes en Santé Publique, Avenue du Professeur Léon-Bernard, 35043, Rennes, France.,Gustave Roussy, 114 Rue Edouard Vaillant - 1er étage zone B, 94805, Villejuif, France
| | - Benoît Lalloué
- Equipe d'Accueil Management des Organisations de Santé, Ecole des Hautes Etudes en Santé Publique, Avenue du Professeur Léon-Bernard, 35043, Rennes, France.,Gustave Roussy, 114 Rue Edouard Vaillant - 1er étage zone B, 94805, Villejuif, France
| | - Anne Girault
- Equipe d'Accueil Management des Organisations de Santé, Ecole des Hautes Etudes en Santé Publique, Avenue du Professeur Léon-Bernard, 35043, Rennes, France
| | - Marie Ferrua
- Gustave Roussy, 114 Rue Edouard Vaillant - 1er étage zone B, 94805, Villejuif, France
| | - Aude Fourcade
- Gustave Roussy, 114 Rue Edouard Vaillant - 1er étage zone B, 94805, Villejuif, France
| | - François Lemare
- Gustave Roussy, 114 Rue Edouard Vaillant - 1er étage zone B, 94805, Villejuif, France
| | - Mario Dipalma
- Gustave Roussy, 114 Rue Edouard Vaillant - 1er étage zone B, 94805, Villejuif, France
| | - Etienne Minvielle
- Equipe d'Accueil Management des Organisations de Santé, Ecole des Hautes Etudes en Santé Publique, Avenue du Professeur Léon-Bernard, 35043, Rennes, France.,Gustave Roussy, 114 Rue Edouard Vaillant - 1er étage zone B, 94805, Villejuif, France
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15
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Talarmin C, Herpin C, Bayle A, Fayard C, Le Cesne A, Mir O, Lemare F, Paret A, Netzer F. Prevention of chemotherapy-induced nausea and vomiting in patients receiving ifosfamide: High dose chemotherapy. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30582-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Annereau M, Willekens C, El Halabi L, Chahine C, Saada V, Auger N, Danu A, Bermudez E, Lazarovici J, Ghez D, Leary A, Pistilli B, Lemare F, Solary E, de Botton S, Desmaris RP, Micol JB. Use of 5-azacitidine for therapy-related myeloid neoplasms in patients with concomitant active neoplastic disease. Leuk Res 2017; 55:58-64. [PMID: 28131982 DOI: 10.1016/j.leukres.2017.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/31/2016] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients diagnosed with therapy-related myeloid neoplasms (TRMN) with concomitant active neoplastic disorder (CAND) are usually proposed for best supportive care (BSC). We evaluated the feasibility of using 5-azacytidine (AZA) in this setting. METHODS All patients referred to Gustave Roussy between 2010 and 2015 for TRMN diagnosis (less than 30% blast) and eligible for AZA treatment were included. Patients with CAND proposed for BSC were also described. Patient's outcomes were analyzed based on the presence or not of a CAND. RESULTS Fifty-two patients with TRMN were analyzed, including 19 patients with CAND (14 eligible for AZA) and 33 without CAND eligible for AZA. The 5 patients with CAND ineligible for AZA had a worst performance status (p=0.016) at diagnosis and a shorter overall survival (OS) (0.62 months). Baseline characteristics of patients eligible for AZA were similar in the 2 groups except a trend for best performance status in patients with CAND (p=0.06). Overall response rate (71.4% vs 60.3%), transfusion independence (50.0% vs 45.5%) and OS (12.7 months vs 10.8 months) were similar between patients with and without CAND respectively (p=ns). CONCLUSION Here we report the feasibility and efficacy of AZA for selected patients with TRMN and a CAND.
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Affiliation(s)
- M Annereau
- Gustave Roussy, Université Paris-Saclay, Département de Pharmacie, Villejuif F-94805, France
| | - C Willekens
- Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France
| | - L El Halabi
- Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France
| | - C Chahine
- Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France
| | - V Saada
- Gustave Roussy, Université Paris-Saclay, Département de biologie et pathologie médicales, Villejuif F-94805, France
| | - N Auger
- Gustave Roussy, Université Paris-Saclay, Département de biologie et pathologie médicales, Villejuif F-94805, France
| | - A Danu
- Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France
| | - E Bermudez
- Gustave Roussy, Université Paris-Saclay, Département de Pharmacie, Villejuif F-94805, France
| | - J Lazarovici
- Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France
| | - D Ghez
- Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France
| | - A Leary
- Gustave Roussy, Université Paris-Saclay, Département de médecine oncologique, Villejuif F-94805, France
| | - B Pistilli
- Gustave Roussy, Université Paris-Saclay, Département de médecine oncologique, Villejuif F-94805, France
| | - F Lemare
- Gustave Roussy, Université Paris-Saclay, Département de Pharmacie, Villejuif F-94805, France
| | - E Solary
- Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France; Inserm UMR1170, Gustave Roussy, Université Paris-Saclay, Villejuif F-94805, France
| | - S de Botton
- Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France; Inserm UMR1170, Gustave Roussy, Université Paris-Saclay, Villejuif F-94805, France
| | - R-P Desmaris
- Gustave Roussy, Université Paris-Saclay, Département de Pharmacie, Villejuif F-94805, France
| | - J-B Micol
- Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif F-94805, France; Inserm UMR1170, Gustave Roussy, Université Paris-Saclay, Villejuif F-94805, France.
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17
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Le Guen R, Madelaine I, Tournamille JF, Bellanger A, Astier A, Braguer D, Ollivier C, Bardin C, Lemare F, Daouphars M, Pinguet F, Latour JF, Vigneron J, Tilleul P. [Study impacto: Descriptive analyzis of pharmacist's clinical practice in onco-hematology]. Ann Pharm Fr 2015; 73:223-8. [PMID: 25934530 DOI: 10.1016/j.pharma.2014.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 10/10/2014] [Accepted: 10/10/2014] [Indexed: 11/29/2022]
Abstract
Pharmaceutical analyses of chemotherapy prescriptions by hospital pharmacists are activities codified by regulation and rules (bon usage). The involvement of the pharmacists in clinical pharmacy activities in the oncology setting is not clearly identified, justifying the development of a mapping of these activities from a questionnaire addressed to the professionals. One hundred and seven centers have participated to this study at the national level (overall participation rate of 32.4%). More than 95% of them used a computerized ordering system and three quarter of them submit the introduction of new compounds to an analysis by the drug therapeutic committee. Prescription analysis allowed detecting around 2% of errors from the current prescription. Clinical pharmacist participates to tumor boards of onco-hematology (RCP) at a level of 46% for senior pharmacist and 42% for junior pharmacist. This involvement in the RCP allowed anticipating protocol's modification and temporary used authorization. Ninety-two percent of the senior pharmacists estimate that they highlight the risk of no reimbursement for prescription out of the guideline during RCP, resulting to a modification of the prescription for 40% of them. This level of intervention is lower with respectively 64% and 10% for the juniors. This study underlines the expert value of the clinical pharmacist dedicated to oncology setting in pre and post analysis prescriptions. It could be targeted by a prospective analysis of both clinical and pharmacoeconomics impact of these interventions.
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Affiliation(s)
- R Le Guen
- Pharmacie Pitié-Salpêtrière, 47, boulevard de l'hôpital, 75013 Paris, France.
| | - I Madelaine
- Pharmacie St-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - J-F Tournamille
- Pharmacie Bretonneau, 2, boulevard Tonnelle, 37044 Tours, France
| | - A Bellanger
- Pharmacie Pitié-Salpêtrière, 47, boulevard de l'hôpital, 75013 Paris, France
| | - A Astier
- Pharmacie Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny 94100 Créteil, France
| | - D Braguer
- Université Aix-Marseille II, UMR 911-CRO2 faculté de médecine, 27, boulevard Jean-Moulin 13385 Marseille, France
| | - C Ollivier
- Pharmacie, CHU Caen, avenue de la Côte-de-Nacre, 14033 Caen, France
| | - C Bardin
- Pharmacie Cochin, 27, rue du Faubourg-St-Jacques, 75014 Paris, France
| | - F Lemare
- Pharmacie IGR, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Faculté de pharmacie, université Paris Descartes, 4, rue de l'Observatoire, 75006, Paris, France
| | - M Daouphars
- Pharmacie, CRLC Henri-Becquerel, rue d'Amiens, 76038 Rouen, France
| | - F Pinguet
- Pharmacie, CRLC Val-d'Aurelle-Parc Euromédecine 208, rue des Apothicaires, 34298 Montpellier, France
| | - J-F Latour
- Pharmacie, centre Léon-Bérard, 28, rue Laennec, 69373 Lyon, France
| | - J Vigneron
- Pharmacie, CHU Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | - P Tilleul
- Pharmacie Pitié-Salpêtrière, 47, boulevard de l'hôpital, 75013 Paris, France; Faculté de pharmacie, université Paris Descartes, 4, rue de l'Observatoire, 75006, Paris, France
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18
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van Harten W, Stanta G, Bussolati G, Riegman P, Hoefler G, Becker K, Folprecht G, Truini M, Haybaeck J, Buiga R, Dono M, Bagg A, López Guerrero J, Zupo S, Lemare F, de Lorenzo F, Goedbloed N, Razavi D, Lövey J, Cadariu P, Rollandi G, Paparo F, Pierotti M, Ciuleanu T, De Paoli P, Weiner G, Saghatchian M, Lombardo C. Report from the OECI Oncology Days 2014. Ecancermedicalscience 2014; 8:496. [PMID: 25624877 PMCID: PMC4303612 DOI: 10.3332/ecancer.2014.496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Indexed: 11/06/2022] Open
Abstract
The 2014 OECI Oncology Days was held at the 'Prof. Dr. Ion Chiricuta' Oncology Institute in Cluj, Romania, from 12 to 13 June. The focus of this year's gathering was on developments in personalised medicine and other treatment advances which have made the cost of cancer care too high for many regions throughout Europe.
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Affiliation(s)
- Wh van Harten
- The Netherlands Cancer Institute, Amsterdam,The Netherlands
| | - G Stanta
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - G Bussolati
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - P Riegman
- Erasmus Medical Centre, Rotterdam, The Netherlands
| | - G Hoefler
- Johannes Haybaeck, Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Kf Becker
- Institute of Pathology, Technische Universität München, München, Germany
| | - G Folprecht
- University Cancer Centre, University Hospital Carl Gustav Carus, Dresden, Germany
| | - M Truini
- IRCCS AOU San Martino/IST National Cancer Institute of Genoa, Genoa, Italy
| | - J Haybaeck
- Johannes Haybaeck, Institute of Pathology, Medical University of Graz, Graz, Austria
| | - R Buiga
- The Oncology Institute "Prof. Dr. Ion Chircuţă", Cluj-Napoca, Romania
| | - M Dono
- IRCCS AOU San Martino/IST, National Cancer Institute of Genoa, Italy
| | - A Bagg
- Hematology, University of Pennsylvania, PA, USA
| | | | - S Zupo
- IRCCS AOU San Martino/IST, National Cancer Institute of Genoa, Italy
| | - F Lemare
- Clinical Pharmacy Department, Gustave Roussy Comprehensive Cancer Centre, Villejuif, France
| | - F de Lorenzo
- European Cancer Patient Coalition, Brussels, Belgium
| | - N Goedbloed
- The Netherlands Cancer Institute, Amsterdam,The Netherlands
| | - D Razavi
- Institut Jules Bordet et Université Libre de Bruxelles, Clinique de Psycho-Oncologie et des Soins Supportifs, Brussels, Belgium
| | - J Lövey
- National Institute of Oncology, Budapest, Hungary
| | - Pa Cadariu
- The Oncology Institute "Prof. Dr. Ion Chircuţă", Cluj-Napoca, Romania
| | - Ga Rollandi
- Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine, Genoa, Italy
| | - F Paparo
- Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine, Genoa, Italy
| | - M Pierotti
- IRCCS Fondazione Istituto Nazionale Tumori Milan, Milan, Italy
| | - T Ciuleanu
- The Oncology Institute "Prof. Dr. Ion Chircuţă", Cluj-Napoca, Romania
| | - P De Paoli
- Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | | | - M Saghatchian
- Medical Oncology Department, Gustave Roussy Comprehensive Cancer Centre, Villejuif, France
| | - Claudio Lombardo
- Organisation of the European Cancer Institutes, C/o SOS Europe, Genoa, Italy
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19
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Hébert G, Netzer F, Ferrua M, Ducreux M, Lemare F, Minvielle E. Evaluating iatrogenic prescribing: development of an oncology-focused trigger tool. Eur J Cancer 2014; 51:427-35. [PMID: 25549531 DOI: 10.1016/j.ejca.2014.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/01/2014] [Accepted: 12/02/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Drug-related iatrogenic effects are common in oncology because chemotherapy is toxic. The evaluation of the application of the guidelines may be a way to understand the occurrence of adverse drug-related event (ADE). There is no specific method for identifying ADEs and measuring harm to patients in oncology. OBJECTIVE Our objective was to develop and test an Oncology Trigger Tool (OTT) for ADEs and to describe ADE characteristics and incidence. METHODS A clinical advisory panel identified situations at high risk of ADE occurrence and built 22 triggers with, in each case, an analysis flowchart to confirm or refute occurrence. The OTT was used to review 288 random admissions (Oct. 2010-Sept. 2011) and measure ADE incidence and severity (CTCAE 4.03 - Common Terminology Criteria for Adverse Events). Tool feasibility (time required), inter-rater (IR) reproducibility and positive predictive value (PPV) were measured. RESULTS Overall, 884 triggers were detected and 122 ADEs, with 42.4 ADEs/100 admissions or 46.0 ADEs/1000 patient-days, and a 31.1% rate of severe ADEs. The most common ADEs were hyperglycaemia (14.5%), unplanned drug-related admission within 30 days (13.7%) and opiate-induced constipation (12.1%). Unplanned drug-related admission was the most serious (82.4% incidence of severe harm). Mean time for OTT implementation was 21.8 min; IR reproducibility was high (κ=0.965 (trigger); κ=0.935 (ADE); κ=0.853 (harm)); PPV 22-trigger version was 20.7%. CONCLUSIONS ADE analysis flowcharts coupled with standardised grading of harm considerably reduced IR variability, thus providing a robust oncology-focused trigger tool for use in ADE audits and hospital comparisons. The involvement of a clinical advisory panel in tool development should help drive changes for improving practice. Further research on the OTT is warranted.
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Affiliation(s)
- Guillaume Hébert
- Gustave Roussy, Projet CAPRI, Villejuif F-94805, France; Equipe d'accueil "Management des organisations de santé", Ecoles de Hautes Etudes en Santé Publique, Rennes F-35000, France.
| | - Florence Netzer
- Gustave Roussy, Département de Pharmacie Clinique, Villejuif F-94805, France
| | - Marie Ferrua
- Gustave Roussy, Projet CAPRI, Villejuif F-94805, France; Equipe d'accueil "Management des organisations de santé", Ecoles de Hautes Etudes en Santé Publique, Rennes F-35000, France
| | - Michel Ducreux
- Gustave Roussy, Département d'Oncologie Médicale, Villejuif F-94805, France
| | - François Lemare
- Gustave Roussy, Département de Pharmacie Clinique, Villejuif F-94805, France; Département de pharmacie clinique, PRES Sorbonne Paris-Cité, Paris F-75006, France
| | - Etienne Minvielle
- Gustave Roussy, Projet CAPRI, Villejuif F-94805, France; Equipe d'accueil "Management des organisations de santé", Ecoles de Hautes Etudes en Santé Publique, Rennes F-35000, France
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Houot M, Poinsignon V, Mercier L, Valade C, Desmaris R, Lemare F, Paci A. Physico-chemical stability of busulfan in injectable solutions in various administration packages. Drugs R D 2014; 13:87-94. [PMID: 23549912 PMCID: PMC3627013 DOI: 10.1007/s40268-013-0003-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background and Objectives Busulfan is used as part of a conditioning regimen prior to hematopoietic stem cell transplantation for the treatment of certain cancers and immune deficiency syndromes. Due to its instability in aqueous preparations, busulfan for infusion is prepared from a concentrate and has a relatively short shelf life once prepared. The purpose of this study was to identify the most suitable storage container and temperature to maximize the shelf life of busulfan therapeutic infusions prepared from Busilvex®. Methods Busilvex® 6 mg/mL was diluted to 0.55 mg/mL with 0.9 % NaCl and aliquots dispensed into polypropylene syringes, polyvinyl chloride bags, and glass bottles. Three storage temperatures were evaluated: 2–8 °C, 13–15 °C (thermostatically controlled chamber), and room temperature (20 ± 5 °C). At set time points, samples were analysed for busulfan content, using a high-performance liquid chromatography (HPLC) system with ultraviolet detection. The change in pH and osmolarity on storage was also determined, and solutions were inspected visually for formation of a precipitate or colour change. To determine the contribution of precipitation to loss of busulfan content on storage, samples from one time series were treated with the solvent dimethylacetamide prior to HPLC separation and quantitation of busulfan. Results The results of the active substance content monitoring study over a 48-h period demonstrate that busulfan solution is stable at a 5 % threshold, at 2–8 °C for 16 h in syringes, 14 h in glass bottles, and 6 h in bags. In addition, the period of stability decreases as the temperature increases (4 h at 20 ± 5 °C). The solution is considered to be stable, subject to precipitation liable to be observed regardless of the temperature. Conclusion The best stability was observed for busulfan solutions placed at 2–8 °C in syringes. This study demonstrated that precipitation, in addition to hydrolysis, has a significant influence on the busulfan content.
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Affiliation(s)
- Mélanie Houot
- Pharmacology and Drug Analysis Department, Institut de Cancérologie Gustave Roussy, 114, rue Edouard Vaillant, 94805, Villejuif Cedex, France
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Hollebecque A, Levy A, Broutin S, Lemare F, Gazzah A, Desmaris R, Chenailler C, Elbaum M, Besse B, Paci A, Soria JC. First case report of intrathecal panitumumab for treatment of meningeal carcinomatousis in an EGFR mutant lung adenocarcinoma patient. Lung Cancer 2013; 80:113-4. [PMID: 23352031 DOI: 10.1016/j.lungcan.2012.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 12/16/2012] [Indexed: 10/27/2022]
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Thomas-Schoemann A, Batteux F, Mongaret C, Nicco C, Chéreau C, Annereau M, Dauphin A, Goldwasser F, Weill B, Lemare F, Alexandre J. Arsenic Trioxide Exerts Antitumor Activity through Regulatory T Cell Depletion Mediated by Oxidative Stress in a Murine Model of Colon Cancer. J I 2012; 189:5171-7. [DOI: 10.4049/jimmunol.1103094] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Thomas-Schoemann A, Lemare F, Mongaret C, Bermudez E, Chéreau C, Nicco C, Dauphin A, Weill B, Goldwasser F, Batteux F, Alexandre J. Bystander effect of vinorelbine alters antitumor immune response. Int J Cancer 2011; 129:1511-8. [DOI: 10.1002/ijc.25813] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 11/09/2010] [Indexed: 11/06/2022]
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Mongaret C, Alexandre J, Thomas-Schoemann A, Bermudez E, Chéreau C, Nicco C, Goldwasser F, Weill B, Batteux F, Lemare F. Tumor invasion induced by oxidative stress is dependent on membrane ADAM 9 protein and its secreted form. Int J Cancer 2010; 129:791-8. [PMID: 21064090 DOI: 10.1002/ijc.25746] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Accepted: 10/04/2010] [Indexed: 11/11/2022]
Abstract
Oxidative stress plays a role in the regulation of cancer cell metastasis which involves cell invasion and adhesion that could be supported by ADAM proteins through the activities of their metalloprotease and disintegrin domains. We hypothesized that oxidative stress could act through the induction of ADAM9 protein in some cancer cells. Indeed, Western blot analysis for ADAM9 performed on A549 cells exposed to H(2) O(2) reveals a dose-dependent induction of two proteins (80 and 68 kDa) correlated with a sharp increase of the ADAM protease activity measured in supernatant while the activity measured on the cell layer was slightly affected. The 80kDa protein corresponds to the mature form of ADAM9. Immunoprecipitation analysis performed on concentrated supernatants revealed that the 68 kDa protein is a secreted form of ADAM9. When exposed to H(2) O(2) , A549 cells cocultured with confluent endothelial vascular cells resulted in a 5.5 fold (p < 0.001) increase in the number of adherent cells. Similarly, matrigel assay revealed a 3.25 fold (p < 0.01) increase in the number of invasive cells. The suppression of ADAM9 expression by specific small interfering RNA reduced oxidative stress-induced invasiveness and adhesiveness. These functions could be mediated by an interaction between ADAM9 and β1 integrin because each of them were inhibited when the experiment is performed in presence of mAbs targeting ADAM9 ectodomain or β1-integrin. These results emphasize the importance of oxidative stress in the regulation of cancer cell metastasis and suggest that ADAM9 and its secreted isoform can be important determinants in the ability of cancer cells to disseminate.
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Affiliation(s)
- C Mongaret
- Université Paris Descartes, Faculté de Médecine, EA 1833, 75679 Paris cedex 14, France.
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Mir O, Ropert S, Alexandre J, Lemare F, Goldwasser F. High-dose intrathecal trastuzumab for leptomeningeal metastases secondary to HER-2 overexpressing breast cancer. Ann Oncol 2008; 19:1978-80. [PMID: 18845838 DOI: 10.1093/annonc/mdn654] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lemare F, Mateus C, Camps S, Montheil V, Henguelle E, Cacheux W, Bezian E, Di Loreto R, Dauphin A, Goldwasser F. Chemotherapy in non-selected elderly patients: Factors influencing dose-intensity and toxicity. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.19585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
19585 Background: Chemotherapy (CT) is the treatment of choice for most metastatic cancers. Frequent functional impairment and comorbidities in the elderly increase the risk of chemotherapy-related acute complications. The applicability of clinical trials data to the elderly population is exposed to multiple bias. Informations extracted from non-selected treated patients (pts) may be useful. Methods: A serie of consecutive elderly cancer pts (>73 years) treated over 3 years in the oncology outpatient unit, and receiving CT were included for analysis and assessed using prechemotherapy evaluation of cancer in the elderly (including performance status, comorbidities, glomerular filtration rate, liver tests, hemogram, nutritional status, inflammation tests). Relationship between preCT evaluation and acute complications, unscheduled hospitalisation, mortality were investigated by univariate analyses. Comparison between planned and realised dose- intensity of CT protocols could be extracted for the CT prescription software. Results: 108 pts with a median age of 78 years (73- 89; 44% over 80) were identified. Characteristics included performance status (PS) ≥ 2 (44%), chronic renal insufficiency (47%) ; ≥2 comorbidities (75%). Primary tumour was urologic (31%), gastro-intestinal (29%), mammary and gynaecologic (20%); pulmonary (16%) or other (4%). Disease stage was metastatic for 82% of pts. Most CT regimens contained a platinum derivative (55%), gemcitabine (25%), 5-FU (20%), taxanes (17%), vinorelbine (15%). Transfusion requirements were higher in PS≥2 pts (p<0.0001). Febrile neutropenia correlated with PS, lymphocytopenia and PINI =(CRP×AAG)/(albumin×pre-albumin)>10 (p<0. 05). Unscheduled hospitalisation correlated with PS, lymphocytopenia, PINI, more than 2 co-morbidities, more than 4 co-medications. Oxaliplatin- and paclitaxel-containing CT protocols were associated with significant reduction of dose-intensity because of reduced number of cycles due to neurosensory toxicity (p=0.01). Conclusions: Lymphocytopenia, PS, and PINI were the most relevant prognosticators of short-term CT outcome. Elderly pts characteristics are associated with higher risk of acute toxicity and increased sensitivity to neurosensory cumulative toxicity. No significant financial relationships to disclose.
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Affiliation(s)
- F. Lemare
- APHP GH Cochin Saint Vincent de Paul, Paris, France
| | - C. Mateus
- APHP GH Cochin Saint Vincent de Paul, Paris, France
| | - S. Camps
- APHP GH Cochin Saint Vincent de Paul, Paris, France
| | - V. Montheil
- APHP GH Cochin Saint Vincent de Paul, Paris, France
| | - E. Henguelle
- APHP GH Cochin Saint Vincent de Paul, Paris, France
| | - W. Cacheux
- APHP GH Cochin Saint Vincent de Paul, Paris, France
| | - E. Bezian
- APHP GH Cochin Saint Vincent de Paul, Paris, France
| | - R. Di Loreto
- APHP GH Cochin Saint Vincent de Paul, Paris, France
| | - A. Dauphin
- APHP GH Cochin Saint Vincent de Paul, Paris, France
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Mir O, Alexandre J, Anract P, Lemare F, Babinet A, Enkaoua E, Guillevin L, Goldwasser F. Hyper-alkalinization instead of hyper-hydration for the prevention of high-dose methotrexate (HDMTX) induced nephrotoxicity in osteosarcoma patients. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- O. Mir
- Hosp Cochin - APHP, Paris, France; Hosp Paul Brousse - APHP, Villejuif, France
| | - J. Alexandre
- Hosp Cochin - APHP, Paris, France; Hosp Paul Brousse - APHP, Villejuif, France
| | - P. Anract
- Hosp Cochin - APHP, Paris, France; Hosp Paul Brousse - APHP, Villejuif, France
| | - F. Lemare
- Hosp Cochin - APHP, Paris, France; Hosp Paul Brousse - APHP, Villejuif, France
| | - A. Babinet
- Hosp Cochin - APHP, Paris, France; Hosp Paul Brousse - APHP, Villejuif, France
| | - E. Enkaoua
- Hosp Cochin - APHP, Paris, France; Hosp Paul Brousse - APHP, Villejuif, France
| | - L. Guillevin
- Hosp Cochin - APHP, Paris, France; Hosp Paul Brousse - APHP, Villejuif, France
| | - F. Goldwasser
- Hosp Cochin - APHP, Paris, France; Hosp Paul Brousse - APHP, Villejuif, France
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Goldwasser F, Mir O, Alexandre J, Lemare F, Babinet A, Enkaoua E, Guillevin L, Anract P. Concomitant administration of high-dose methotrexate (HDMTX) and ifosfamide in osteosarcoma patients: A clinico-pharmacological study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- F. Goldwasser
- Hosp Cochin, AP-HP, Paris, France; Hosp Paul Brousse, AP-HP, Villejuif, France
| | - O. Mir
- Hosp Cochin, AP-HP, Paris, France; Hosp Paul Brousse, AP-HP, Villejuif, France
| | - J. Alexandre
- Hosp Cochin, AP-HP, Paris, France; Hosp Paul Brousse, AP-HP, Villejuif, France
| | - F. Lemare
- Hosp Cochin, AP-HP, Paris, France; Hosp Paul Brousse, AP-HP, Villejuif, France
| | - A. Babinet
- Hosp Cochin, AP-HP, Paris, France; Hosp Paul Brousse, AP-HP, Villejuif, France
| | - E. Enkaoua
- Hosp Cochin, AP-HP, Paris, France; Hosp Paul Brousse, AP-HP, Villejuif, France
| | - L. Guillevin
- Hosp Cochin, AP-HP, Paris, France; Hosp Paul Brousse, AP-HP, Villejuif, France
| | - P. Anract
- Hosp Cochin, AP-HP, Paris, France; Hosp Paul Brousse, AP-HP, Villejuif, France
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Abstract
PURPOSE Cyclosporine administration is very effective in the case of immunological diseases of the cornea, conjunctive or uvea. Moreover, it is widely used in the case of high-risk rejection corneal transplantation. We present a preparation of cyclosporine 2% eye drops. METHODS Cyclosporine 2% eye drops are prepared following a particular formulation including one part commercially available cyclosporine oral solution (Sandimmun) diluted in four parts of sterile castor oil. Manufacturing procedures maintain the sterile state of the preparation with a laminar airflow hood placed in a particulate controlled room, with pharmacists, technicians and clerical personnel wearing sterile clothes. Physical and chemical monitoring during and after manufacture for each batch guarantees the process and minimizes the risk of batch rejection. Chemical analysis of cyclosporine is conducted using a validated stability-indicating high-performance liquid chromatographic assay (reverse-phase). Blood dosages taken after the first administration at the 24th hour (after administration of the 6th drop) check for systemic integration. RESULTS Cyclosporine 2% eye drops are fairly stable: 12 months after manufacturing, concentrations result in levels not statistically different from concentrations measured the day of preparation. After a daily regimen of six drops in the eye, cyclosporine 2% eye drops have a very low systemic bioavailability, because the blood concentrations only reach the detection limit of the fluorescence polarization immunoassay used for cyclosporine drug monitoring. This explains the absence of systemic toxicity. CONCLUSION Cyclosporine 2% eye drops can be available in the hospital pharmacy. The eye drops are stable at room temperature and can be delivered up to 12 months after manufacture. No local adverse effects have been noted, probably in relation with the very low concentration of ethanol in the ocular preparation.
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Affiliation(s)
- F Chast
- Service de Pharmacie, Pharmacologie et Toxicologie, Hôtel-Dieu, Paris.
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Lemare F, Steimberg N, Le Griel C, Demignot S, Adolphe M. Dedifferentiated chondrocytes cultured in alginate beads: restoration of the differentiated phenotype and of the metabolic responses to interleukin-1beta. J Cell Physiol 1998; 176:303-13. [PMID: 9648917 DOI: 10.1002/(sici)1097-4652(199808)176:2<303::aid-jcp8>3.0.co;2-s] [Citation(s) in RCA: 109] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chondrocytes cultivated in monolayer rapidly divide and lose their morphological and biochemical characteristics, whereas they maintain their phenotype for long periods of time when they are cultivated in alginate beads. Because cartilage has a low cellularity and is difficult to obtain in large quantities, the number of available cells often becomes a limiting factor in studies of chondrocyte biology. Therefore, we explored the possibility of restoring the differentiated properties of chondrocytes by cultivating them in alginate beads after two multiplication passages in monolayer. This resulted in the reexpression of the two main markers of differentiated chondrocytes: Aggrecan and type II collagen gene expression was strongly reinduced from day 4 after alginate inclusion and paralleled protein expression. However, 2 weeks were necessary for total suppression of type I and III collagen synthesis, indicators of a modulated phenotype. Interleukin-1beta, a cytokine that is present in the synovial fluid of rheumatoid arthritis patients, induces many metabolic changes on the chondrocyte biology. Compared with cells in primary culture, the production of nitric oxide and 92-kDa gelatinase in response to interleukin-1beta was impaired in cells at passage 2 in monolayer but was fully recovered after their culture in alginate beads for 2 weeks. This suggests that the effects of interleukin-1beta on cartilage depend on the differentiation state of chondrocytes. This makes the culture in alginate beads a relevant model for the study of chondrocyte biology in the presence of interleukin-1beta and other mediators of cartilage destruction in rheumatoid arthritis and osteoarthrosis.
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Affiliation(s)
- F Lemare
- Laboratoire de Pharmacologie Cellulaire de l'Ecole Pratique des Hautes Etudes, Centre de Recherches Biomédicales des Cordeliers, Paris, France
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Borge L, Lemare F, Demignot S, Adolphe M. Restoration of the differentiated functions of serially passaged chondrocytes using staurosporine. In Vitro Cell Dev Biol Anim 1997; 33:703-9. [PMID: 9358286 DOI: 10.1007/s11626-997-0128-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Among the various directions explored in order to have a large number of differentiated articular chondrocytes easily available, the restoration of the differentiated properties after cell multiplication in monolayer has been proposed. It has been clearly shown that the synthesis of cartilage proteoglycans and type II collagen synthesis is coincident with the presence of a faint microfibrillar architecture but is absent in chondrocytes showing well-defined actin cables. Staurosporin, mainly described as a protein kinase C inhibitor, has also been shown to rapidly induce the disruption of the actin microfilaments. The purpose of this paper was to investigate whether properties of differentiated chondrocytes were reinitiated upon staurosporin treatment of serially passaged chondrocytes. Results showed, after staurosporine treatment of cells at Passage two for 5 d, complete suppression of type I and type III collagen synthesis and induction of type II collagen synthesis and of Alcian blue stainable matrix. Additionally, we showed that staurosporin restored metabolic responses that chondrocytes in primary culture exhibit upon interleukin-1 beta treatment (decrease of Alcian blue- positive cells, induction of expression of the 92 kDa gelatinase, nitric oxide production). We conclude that staurosporin is a potent redifferentiating agent of articular chondrocytes that have been subcultured up to Passage two for multiplication. Taking into account that the cellularity of cartilage is very low, staurosporine-treated chondrocytes could be useful as an alternative cellular model to evaluate pharmacotoxicological effects of drugs.
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Affiliation(s)
- L Borge
- Laboratoire de Pharmacologie Cellulaire de l'Ecole Pratique des Hautes Etudes, Centre de Recherches Biomédicales des Cordeliers, Paris, France
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