Publications (4)16.71 Total impact
Article: Antiemesis[Show abstract] [Hide abstract]
ABSTRACT: Chemotherapy-induced nausea and vomiting (emesis) can significantly affect a patient's quality of life, leading to poor adherence with further chemotherapy treatment. In addition, nausea and vomiting can result in other serious complications and deterioration of the patient's status. These guidelines explore the prevention, treatment, and management of various types of emesis experienced by cancer patients, such as breakthrough, radiation-induced, and anticipatory. The latest 2009 NCCN Guidelines include updated dosing recommendations for palonosetron and dexamethasone and the inclusion of the granisetron transdermal patch after FDA approval.
Article: Myeloid Growth Factors[Show abstract] [Hide abstract]
ABSTRACT: Neutropenia and resulting febrile neutropenia (FN) can be induced by myelosuppressive chemotherapy. FN is a major dose-limiting toxicity of chemotherapy, often requiring hospitalization to evaluate and treat. Further, these complications often result in dose reductions or treatment delays, which may compromise clinical outcomes. Although the prophylactic use of colony-stimulating factors (CSFs) can reduce the risk, severity, and duration of FN, they are not administered to all patients undergoing myelosuppressive chemotherapy because of the associated costs. Selective use, however, may enhance cost-effectiveness by directing treatment toward patients most likely to benefit. Filgrastim and pegfilgrastim, both granulocyte colony-stimulating factors (G-CSF), have FDA approval for use in the prevention of chemotherapy-induced neutropenia. In contrast, the labeled indication for sargramostim, a granulocyte-macrophage colony-stimulating factor (GM-CSF), is limited to use after induction therapy for acute myeloid leukemia and in various stem cell transplantation settings. These guidelines focus on the use of CSFs in the cancer setting; specifically addressing adult patients with solid tumors and nonmyeloid malignancies.
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ABSTRACT: Chemotherapy-induced neutropenia can cause complications that result in dose reductions or treatment delays that can, in turn, compromise clinical outcomes. Although the prophylactic use of colony-stimulating factors (CSFs) can reduce the risk, severity, and duration of severe and febrile neutropenia, they are not routinely administered to all patients undergoing myelosuppressive chemotherapy because of the costs. Selective use may, however, enhance their cost-effectiveness. These guidelines discuss the preventative or prophylactic use of recombinant human granulocyte-CSF to reduce the incidence, length, and severity of chemotherapy-related neutropenia and and prevent life-threatening complications.
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ABSTRACT: Chemotherapy-induced neutropenia is the major dose-limiting toxicity of systemic cancer chemotherapy, associated with substantial morbidity, mortality, and cost. Although prophylactic colony-stimulating factors (CSFs), can reduce this complication, their routine use in all patients on myelosuppressive chemotherapy is prohibitively costly. Selective use in patients most at risk for neutropenia may enhance cost-effectiveness, but determining the actual risk is complicated by issues in reporting myelosuppression and dose intensity, among other factors. For this reason, NCCN experts developed these guidelines to assist practitioners in the appropriate prophylactic use of CSFs.
University of Texas MD Anderson Cancer CenterHouston, Texas, United States