Impact of pharmacist’s intervention on decreasing erlotinib interactions in the treatment of lung cancer patients in low resource settings

2020 ◽  
pp. 107815522092154
Author(s):  
Tijana Kovacevic ◽  
Sandra Vezmar Kovacevic ◽  
Mirko Stanetic ◽  
Pedja Kovacevic ◽  
Branislava Miljkovic

Background This study aimed to demonstrate that having clinical pharmacist as a member of oncology team in low and middle income countries might lead to significant reduction in the number of erlotinib interactions in the treatment of non-small cell lung cancer patients. Methods A group of 44 patients was labeled as intervention group and they were analyzed prospectively in the period from 1 January 2017 to 1 May 2018 during clinical pharmacist’s participation in regular weekly multidisciplinary oncology team meetings. The control group consisted of 44 out of 110 patients treated with erlotinib before the involvement of a clinical pharmacist in oncology team, match paired with 44 patients in intervention group. Results Clinically significant interactions were identified in two-thirds of studied patients (57 out of 88). Most drug interactions, 38%, potentially result in decrease of serum concentration of erlotinib. Clinical pharmacist provided therapy modification suggestions for 32 out of 44 (72.72%) patients in the intervention group, most of which were accepted by doctors. In the intervention group, there were significantly less clinically significant interactions compared to the control group (10 versus 24, p = 0.002). Progression-free survival was significantly longer in the pharmacist’s intervention group (p = 0.001). Conclusions Clinical pharmacist’s intervention led to significant decrease in erlotinib interactions which may result in treatment optimization of lung cancer patients.

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Ruxia Guo ◽  
Hui Wang

In order to explore the influence of intelligent imaging diagnosis systems on comprehensive nursing intervention for patients with late-stage lung cancer, the system uses ITK and VTK toolkit to realize image reading, display, image marking, and interactive functions. The optimal threshold method and regional connectivity algorithm were used to segment the lung region, and then, the cavity filling algorithm and repair algorithm were used to repair the lung region. A variable ring filter was used to detect suspected shadows in the lungs. Finally, the classifier proposed in this paper is used to classify benign and malignant. The system has good sensitivity by detecting the images of real patients. 100 patients with advanced lung cancer were randomly divided into control group and nursing intervention group 50 cases each. Patients in the control group received routine radiotherapy and chemotherapy and routine nursing intervention. Patients in the nursing intervention group were given comprehensive nursing intervention on the basis of routine intervention in the control group for 2 consecutive months. Pittsburgh sleep quality index, pain degree, quality of life, and complications after intervention were compared between the 2 groups before and after intervention. The experimental results showed that the sleep quality, pain degree, quality of life, and complications in 2 groups were significantly improved after intervention ( P < 0.05 ), and the improvement degree in the nursing intervention group was higher than that in the control group ( P < 0.05 ). It is proved that comprehensive nursing intervention has a good effect on improving sleep quality, relieving physical pain, improving the quality of life, and reducing complications of lung cancer patients and can effectively improve the quality of life of lung cancer patients.


2018 ◽  
Vol 2 (2) ◽  
pp. 37-46
Author(s):  
Dedeh Komalawati

Myalgia can be occured by side effect of chemotherapy. The purpose of this study was to identify the effect of PMR against myalgia in lung cancer patients undergoing chemotherapy. This study design was a quasi experiment, used pre and post test with control group. Samples were 32 patients, recruited by consecutive sampling. Measuring pain assessment used numeric rating scale. The intervention group had been provided PMR fifteen minutes twice a day for five days post chemotherapy. The results showed significantly different reduction of pain intensity before and after providing PMR in the intervention group and control group as well (p value = 0,001). There was a significantly different reduction of myalgia intensity between both group after giving intervention with mean difference 0,81 (p value = 0,001). It can be concluded that PMR can reduce myalgia in lung cancer patients undergoing chemotherapy. Suggestion, PMR becomes one of the complementary therapies to overcome myalgia


Immunotherapy ◽  
2021 ◽  
Author(s):  
Antonello Veccia ◽  
Vincenzo Sforza ◽  
Emanuela Vattemi ◽  
Alessandro Inno ◽  
Stefania Kinspergher ◽  
...  

Background: To investigate the role of pretreatment lung immune prognostic index (LIPI) as biomarker in PD-L1 ≥50% non-small-cell lung cancer patients receiving pembrolizumab. Patients & methods: We retrospectively identified 117 patients, divided into 3 prognostic groups according to LIPI score. For each patient, we evaluated 1-year overall survival (OS) and progression-free survival rate. C-statistic and survival receiver operating characteristic curves were used to study discrimination of LIPI. Results: After a median follow-up of 11.7 months, 1-year OS rate was 60.1%, 35.3% and 28.6%, while 1-year progression-free survival rate was 39.1%, 20.6% and 14.3% in good, intermediate and poor LIPI groups, respectively (p < 0.001). The c-statistic and area under the curve of LIPI were 0.63 and 0.662 for OS and 1-year OS, respectively. Conclusions: Higher LIPI score is related to worse survival in advanced non-small-cell lung cancer patients treated with first-line pembrolizumab. However, based on c-statistic and area under the curve, LIPI does not represent a good prognostic survival model.


2016 ◽  
Vol 11 (1) ◽  
pp. 264 ◽  
Author(s):  
Youchao Jia ◽  
Aimin Zang ◽  
Yanguang Feng ◽  
Xiao-Fang Li ◽  
Ke Zhang ◽  
...  

<p class="Abstract">It was aimed to explore the expression level of miRNA-486 and miRNA-499 in the plasma of lung cancer patients and analysis their differences in expre-ssion. The expression level of both miRNA-486 and miRNA-499 in the plasma of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) were lower than that of the control group (p&lt;0.05) and the decrease was more obvious in NSCLC. Compare with the miRNA-499,expression quantity in NSCLC patients plasma. There was statistical significance difference (p&lt;0.05) between III~Ⅳstage and I~II stage. The expression quantity of miRNA in plasma of patients with extensive-stage SCLC was lower than that of patients with limited-stage SCLC (p&lt;0.05). The sensitivity and specificity of plasms miRNA-486 respectively were 88.5% and 83.3%. The expression of miRNA-499 and miRNA-486 in lung cancer patients were up-regulated, and might be closely related to the occurrence and prognosis of lung cancer, and might be used as potential screening and prognosis index for lung cancer.</p><p> </p>


2018 ◽  
Vol 5 (4) ◽  
pp. 285-289
Author(s):  
Xiao-Jing Guo ◽  
Li-Li Wei ◽  
Xin-Hui Li ◽  
Ning- Ning Yu ◽  
Shao-Bo Gao ◽  
...  

Abstract Objective The aim of this study was to explore the safe and effective method of expectoration in the preoperative period of patients with lung cancer resection and to promote the rehabilitation of patients. Methods A total of 100 cases of lung cancer patients undergoing elective surgery were divided into the observation group and the control group, with 50 cases in each group. The control group was treated with vibration expectoration vest for expectoration during the perioperative period, and the observation group was treated with respiratory function exerciser that has expectoration function in the perioperative period, three times a day, and the effect was evaluated after 5 days. Results The number of patients in the observation group after the first expectoration time was significantly less than that of the control group (P<0.001). Pain score, pulmonary atelectasis, and pulmonary infection rate of the observation group were significantly lower than those of the control group; the hospitalization time was significantly shorter than that of the control group; and the difference was statistically significant (P<0.05). Conclusions Lobectomy for lung cancer patients with perioperative respiratory training for respiratory function exercise, compared with conventional methods, is helpful for postoperative expectoration and to reduce the incidence of adverse events.


2019 ◽  
Vol 18 ◽  
pp. 153473541986949 ◽  
Author(s):  
Ming-Szu Hung ◽  
Min-Chun Chuang ◽  
Yi-Chuan Chen ◽  
Chuan-Pin Lee ◽  
Tsung-Ming Yang ◽  
...  

Background: Metformin use reportedly reduces cancer risk and improves survival in lung cancer patients. This study aimed to investigate the effect of metformin use in patients with diabetes mellitus (DM) and lung cancer receiving epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. Methods: A nationwide, population-based cohort study was conducted using the Taiwan National Health Insurance Research Database. From January 1, 2004, to December 31, 2012, a total of 373 metformin and 1260 non-metformin lung cancer cohorts with type 2 DM and EGFR-TKI treatment were studied. Results: Metformin use was significantly associated with a reduced risk of death (hazard ratio: 0.73, 95% confidence interval [CI]: 0.62-0.85, P < .001), as well as a significantly longer median progression-free survival (9.2 months, 95% CI: 8.6-11.7, vs 6.4 months, 95% CI: 5.9-7.2 months, P < .001) and median overall survival (33.4 months, 95% CI: 29.4-40.2, vs 25.4 months, 95% CI: 23.7-27.2 months, P < 0.001). Conclusions: In conclusion, metformin may potentially enhance the therapeutic effect and increase survival in type 2 DM patients with lung cancer receiving EGFR-TKI therapy.


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