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  1. Artikel ; Online: A case of palmar-plantar erythrodysesthesia in a lung cancer patient receiving atezolizumab maintenance.

    Teymouri, Farzad / Dasanu, Constantin A

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2024  , Seite(n) 10781552241258175

    Abstract: Introduction: Immune checkpoint inhibitors (ICIs) are linked with various cutaneous side effects ranging from mild to life-threatening. Herein, we present a unique case of palmar-plantar erythrodysesthesia (PPE) in a patient treated with atezolizumab.!## ...

    Abstract Introduction: Immune checkpoint inhibitors (ICIs) are linked with various cutaneous side effects ranging from mild to life-threatening. Herein, we present a unique case of palmar-plantar erythrodysesthesia (PPE) in a patient treated with atezolizumab.
    Case report: A 72-year-old white man was diagnosed with Tumor, node, metastasis (TNM) stage IIIA lung adenocarcinoma in November 2022. He underwent right lower lobectomy and mediastinal lymphadenectomy followed by adjuvant cisplatin-pemetrexed. As of May 2023, he did not have any evidence of relapse. He then started switch maintenance therapy with atezolizumab. At 24 weeks, the patient developed erythematous palmar skin lesions, followed by blisters and peeling of both palms, which were associated with swelling and pain, consistent with grade 2 PPE.
    Management and outcome: Causality assessment between nivolumab and PPE via adverse drug reaction probability scale revealed a score of 5. Atezolizumab was continued, and he started on a cream consisting of trolamine and 75% water to palms twice daily. A follow-up visit 6 weeks later showed significant improvement in symptoms and appearance of palmar lesions.
    Discussion: Cutaneous side effects are commonly seen with ICIs. PPE is a common dermatologic toxicity of certain tyrosine kinase inhibitors (TKIs). This effect has been previously reported with combination therapies consisting of an ICI plus a TKIs, but not with ICI monotherapy. Awareness of this potential side effect of ICIs would prevent unnecessary work-up, and lead to its prompt diagnosis and treatment.
    Sprache Englisch
    Erscheinungsdatum 2024-05-30
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/10781552241258175
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Changing therapeutic landscape in advanced Kaposi sarcoma: Current state and future directions.

    Goff, Catherine B / Dasanu, Constantin A

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2023  Band 29, Heft 4, Seite(n) 917–926

    Abstract: Kaposi sarcoma is a malignant neoplasm arising from the endothelial cell lining of blood and lymphatic vessels. Herein, we discuss etiopathogenesis, clinical presentation, diagnostic criteria, updated guideline-based approach to its management and newer ... ...

    Abstract Kaposi sarcoma is a malignant neoplasm arising from the endothelial cell lining of blood and lymphatic vessels. Herein, we discuss etiopathogenesis, clinical presentation, diagnostic criteria, updated guideline-based approach to its management and newer experimental approaches. Given its efficacy and side effect profile, pegylated doxorubicin is the currently preferred first-line therapy in advanced disease. Paclitaxel remains an alternative first-line option. At the time of relapse, patients can be retreated with the same agents as they often maintain their clinical efficacy. New therapeutic options are on the rise, with pomalidomide being approved in 2020 as a second-line therapy. Optimal control of retroviral infection in human immunodeficiency virus (HIV) positive is instrumental in preventing disease occurrence in most patients. Suppressing human herpes virus type 8 (HHV-8) infection might also play a role in controlling Kaposi sarcoma growth, yet clinical trials are lacking. Unraveling the molecular and genetic intricacies of Kaposi sarcoma's pathogenesis might allow for the emergence of novel and effective therapeutic strategies. Clinical trials are currently underway to establish potential roles for various targeted agents, immune checkpoint inhibitors (ICIs) and experimental agents in the treatment of advanced Kaposi sarcoma.
    Mesh-Begriff(e) Humans ; Sarcoma, Kaposi/drug therapy ; Neoplasm Recurrence, Local/drug therapy ; Antineoplastic Agents/therapeutic use ; Doxorubicin ; Paclitaxel
    Chemische Substanzen Antineoplastic Agents ; Doxorubicin (80168379AG) ; Paclitaxel (P88XT4IS4D)
    Sprache Englisch
    Erscheinungsdatum 2023-01-30
    Erscheinungsland England
    Dokumenttyp Journal Article ; Review
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/10781552221148417
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Cures with B-Raf inhibitors as single agents in metastatic B-Raf mutated melanoma: Curb your enthusiasm?

    Dasanu, Constantin A

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2020  Band 27, Heft 1, Seite(n) 205–206

    Abstract: Development of brain metastases during treatment with B-raf/MEK inhibitors for malignant melanoma tends to be more frequent than during immune checkpoint inhibitor therapy. Long-term responders to B-Raf inhibitors with or without MEK inhibition should be ...

    Abstract Development of brain metastases during treatment with B-raf/MEK inhibitors for malignant melanoma tends to be more frequent than during immune checkpoint inhibitor therapy. Long-term responders to B-Raf inhibitors with or without MEK inhibition should be monitored very closely clinico-radiologically for a potential relapse. In addition to surgery and/or radiation therapy, single or dual immune checkpoint inhibitor therapy should be started without delay in this setting to ensure a favorable clinical outcome.
    Mesh-Begriff(e) Humans ; Melanoma/drug therapy ; Mutation ; Neoplasm Recurrence, Local ; Protein Kinase Inhibitors/therapeutic use ; Proto-Oncogene Proteins B-raf/genetics
    Chemische Substanzen Protein Kinase Inhibitors ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1)
    Sprache Englisch
    Erscheinungsdatum 2020-11-26
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/1078155220975079
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  4. Artikel ; Online: Late-onset Stevens-Johnson syndrome due to nivolumab use for hepatocellular carcinoma.

    Dasanu, Constantin A

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2019  Band 25, Heft 8, Seite(n) 2052–2055

    Abstract: Nivolumab is a fully human immunoglobulin G4 immune checkpoint inhibitor antibody approved for use in the treatment of several malignancies. Severe side effects such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) have only extremely ... ...

    Abstract Nivolumab is a fully human immunoglobulin G4 immune checkpoint inhibitor antibody approved for use in the treatment of several malignancies. Severe side effects such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) have only extremely rarely been reported with this drug. We present herein a patient who developed SJS after 16 weeks of therapy with nivolumab. A week prior to this event, he developed a pruriginous papulo-erythematous rash. Prompt recognition of this phenomenon, immune checkpoint inhibitor discontinuation and steroid therapy are necessary steps in order to avoid dismal outcomes.
    Mesh-Begriff(e) Aged ; Antineoplastic Agents, Immunological/administration & dosage ; Antineoplastic Agents, Immunological/adverse effects ; Carcinoma, Hepatocellular/drug therapy ; Exanthema/chemically induced ; Humans ; Immunoglobulin G/immunology ; Liver Neoplasms/drug therapy ; Male ; Nivolumab/administration & dosage ; Nivolumab/adverse effects ; Stevens-Johnson Syndrome/etiology
    Chemische Substanzen Antineoplastic Agents, Immunological ; Immunoglobulin G ; Nivolumab (31YO63LBSN)
    Sprache Englisch
    Erscheinungsdatum 2019-02-19
    Erscheinungsland England
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/1078155219830166
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: Cycle-dependent eosinophilia due to adjuvant nivolumab for malignant melanoma.

    Habibi, Shaghayegh / Soliman, Abram / Dasanu, Constantin A

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2023  Band 29, Heft 5, Seite(n) 1255–1258

    Abstract: Introduction: Immune checkpoint inhibitors (ICIs) have been widely used in the contemporary anticancer armamentarium. However, new side effects due to these agents have continued to emerge.: Case report: We describe herein a 71-year-old patient who ... ...

    Abstract Introduction: Immune checkpoint inhibitors (ICIs) have been widely used in the contemporary anticancer armamentarium. However, new side effects due to these agents have continued to emerge.
    Case report: We describe herein a 71-year-old patient who received nivolumab as adjuvant therapy for malignant melanoma of the skin. He developed eosinophilia starting at 4 weeks of therapy. Eosinophilia increased progressively during the first six nivolumab cycles, then stabilized. Cycle-dependent increments were observed. Subsequently, the patient experienced well-known side effects of ICIs such as grade 1 diarrhea, arthralgias, and erythematous papular rash.
    Management and outcome: Nivolumab was continued, and absolute eosinophil counts were monitored. Prednisone 10 mg PO daily was required for moderate gastroenteritis, dermatitis, and arthritis, which all subsequently improved. Eosinophil levels gradually downtrended after starting prednisone. Causality assessment between nivolumab and eosinophilia via adverse drug reaction (ADR) probability scale revealed a score of 9.
    Discussion: Physicians and pharmacists need to be aware of this important side effect of ICI therapy. Eosinophilia in the context of ICI use has been previously reported in clinical trials. Our case is unique as eosinophilia was cumulative, showed increments every 8 weeks, and exhibited a trend toward cycle dependency. Extensive and expensive workup does not appear warranted, and simple monitoring of complete blood count is appropriate in most patients. Further studies are necessary to assess the true incidence, pattern, and severity of eosinophilia related to ICIs as well as its association with clinical outcomes.
    Mesh-Begriff(e) Male ; Humans ; Aged ; Nivolumab/adverse effects ; Prednisone/therapeutic use ; Antineoplastic Agents, Immunological/adverse effects ; Melanoma/drug therapy ; Melanoma/pathology ; Eosinophilia/chemically induced ; Eosinophilia/complications ; Eosinophilia/drug therapy ; Melanoma, Cutaneous Malignant
    Chemische Substanzen Nivolumab (31YO63LBSN) ; Prednisone (VB0R961HZT) ; Antineoplastic Agents, Immunological
    Sprache Englisch
    Erscheinungsdatum 2023-01-03
    Erscheinungsland England
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/10781552221148968
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: Unusual encephalopathy with Wernicke-Korsakoff syndrome-like features due to adjuvant nivolumab for malignant melanoma.

    Malik, Saniya / White, Wendy / Dasanu, Constantin A

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2023  Band 30, Heft 2, Seite(n) 408–411

    Abstract: Introduction: Autoimmune encephalitis is a rare immune-related adverse event of PD-1 inhibitors, nivolumab and pembrolizumab. Autoimmune hypophysitis can also be seen with the use of these agents. The relationship between these two phenomena is ... ...

    Abstract Introduction: Autoimmune encephalitis is a rare immune-related adverse event of PD-1 inhibitors, nivolumab and pembrolizumab. Autoimmune hypophysitis can also be seen with the use of these agents. The relationship between these two phenomena is currently unknown.
    Case report: We describe a 79-year-old man with anterior scalp melanoma who received adjuvant nivolumab therapy. Sixteen weeks after the completion of nivolumab therapy, the patient presented to the hospital with altered mental status, anterograde amnesia, and symptoms of nausea and vomiting. The patient's encephalopathy was associated with confabulations. Workup identified increased CSF protein without increased cellularity, along with decreased serum cortisol and ACTH levels. This was consistent with encephalitis and central adrenal insufficiency.
    Management and outcome: The patient had a robust clinical response to steroids, with resolution of mental status changes and normalization of blood pressure. He continues to receive maintenance steroid therapy without any further symptoms six months later.
    Conclusions: We report herein a unique case of encephalopathy in the setting of nivolumab use for the treatment of melanoma. The condition resembled Korsakoff psychosis seen in the setting of alcoholism and was associated with central adrenal insufficiency. A prompt response to steroids was both diagnostic and therapeutic in our case, suggesting the resolution of autoimmune phenomena related to nivolumab.
    Mesh-Begriff(e) Male ; Humans ; Aged ; Nivolumab/adverse effects ; Melanoma/drug therapy ; Encephalitis/chemically induced ; Adrenal Insufficiency/chemically induced ; Korsakoff Syndrome/chemically induced ; Steroids/therapeutic use
    Chemische Substanzen Nivolumab (31YO63LBSN) ; Steroids
    Sprache Englisch
    Erscheinungsdatum 2023-11-19
    Erscheinungsland England
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/10781552231215088
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: Unusual stroke-like symptoms with oxaliplatin use.

    Soliman, Abram / Habibi, Shaghayegh / Dasanu, Constantin A

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2023  Band 29, Heft 7, Seite(n) 1766–1769

    Abstract: Introduction: Oxaliplatin has become the mainstay of treatment for many cancers, but its use can be accompanied by unusual side effects.: Case report: We describe herein a 74-year-old patient with pancreatic cancer who developed severe motor weakness ...

    Abstract Introduction: Oxaliplatin has become the mainstay of treatment for many cancers, but its use can be accompanied by unusual side effects.
    Case report: We describe herein a 74-year-old patient with pancreatic cancer who developed severe motor weakness affecting lower extremities after starting treatment with oxaliplatin on three separate occasions. Our patient also experienced slurred speech, with decreased ability to phonate and word-finding difficulty. Brain imaging studies did not suggest recent brain ischemia, and the symptoms resolved within 15-20 h.
    Management and outcome: Oxaliplatin had to be discontinued due to suboptimal tolerance and a short-lived clinical response. After discontinuation of oxaliplatin, she did not experience any more similar symptoms. A score of 9 on the Naranjo nomogram supported a definite causality relationship between oxaliplatin and the observed neurologic toxicity.
    Discussion: Rare reports of stroke-like events have previously been described with oxaliplatin. While the exact mechanism of these phenomena is not known, alterations in neuronal sodium channels might be involved. Clinicians, pharmacists, and patients need to be aware of these rare but important side effects of oxaliplatin. Nonetheless, work-up for a cerebrovascular accident is still warranted as hypercoagulability related to malignancy can also predispose the patients to strokes.
    Mesh-Begriff(e) Female ; Humans ; Aged ; Oxaliplatin/adverse effects ; Antineoplastic Agents/adverse effects ; Pancreatic Neoplasms/drug therapy ; Stroke/chemically induced ; Stroke/drug therapy
    Chemische Substanzen Oxaliplatin (04ZR38536J) ; Antineoplastic Agents
    Sprache Englisch
    Erscheinungsdatum 2023-06-15
    Erscheinungsland England
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/10781552231181525
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Erythematous skin lesions with necrotic centers on lower extremities due to the use of ruxolitinib for primary myelofibrosis.

    Dasanu, Constantin A

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2018  Band 25, Heft 4, Seite(n) 990–992

    Abstract: Ruxolitinib is a small molecule JAK-2 inhibitor approved for the treatment of certain myeloproliferative neoplasms. Ruxolitinib-related skin toxicity is extremely rare. We report herein an unusual erythematous skin eruption with necrotic centers ... ...

    Abstract Ruxolitinib is a small molecule JAK-2 inhibitor approved for the treatment of certain myeloproliferative neoplasms. Ruxolitinib-related skin toxicity is extremely rare. We report herein an unusual erythematous skin eruption with necrotic centers involving lower extremities in a patient with primary myelofibrosis treated with ruxolitinib. Awareness of this unusual skin toxicity with ruxolitinib becomes even more important as JAK-2 inhibition might soon find clinical applications in dermatology.
    Mesh-Begriff(e) Aged ; Erythema/chemically induced ; Humans ; Janus Kinase 2/antagonists & inhibitors ; Lower Extremity/pathology ; Male ; Necrosis ; Primary Myelofibrosis/drug therapy ; Protein Kinase Inhibitors/therapeutic use ; Pyrazoles/adverse effects
    Chemische Substanzen Protein Kinase Inhibitors ; Pyrazoles ; ruxolitinib (82S8X8XX8H) ; Janus Kinase 2 (EC 2.7.10.2)
    Sprache Englisch
    Erscheinungsdatum 2018-04-13
    Erscheinungsland England
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/1078155218768875
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel ; Online: Severe arthritic syndrome due to ibrutinib use for chronic lymphocytic leukemia.

    Dasanu, Constantin A

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2018  Band 25, Heft 4, Seite(n) 1003–1005

    Abstract: Although newer targeted agents improve survival in cancer patients, they have also been linked with unusual side effects. The most common side effects of Bruton tyrosine kinase inhibitors include fatigue, nausea, diarrhea, bruising, and cytopenias. We ... ...

    Abstract Although newer targeted agents improve survival in cancer patients, they have also been linked with unusual side effects. The most common side effects of Bruton tyrosine kinase inhibitors include fatigue, nausea, diarrhea, bruising, and cytopenias. We describe herein a case of an unusually severe articular syndrome with the use of ibrutinib in a patient with 17 p minus chronic lymphocytic leukemia. The severity of this side effect led to permanent discontinuation of this agent. As the causality ibrutinib-arthralgia seems legitimate, we expect further similar cases to surface in patients treated with Bruton tyrosine kinase inhibitors.
    Mesh-Begriff(e) Agammaglobulinaemia Tyrosine Kinase/antagonists & inhibitors ; Aged ; Arthritis/chemically induced ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy ; Male ; Protein Kinase Inhibitors/adverse effects ; Pyrazoles/adverse effects ; Pyrimidines/adverse effects
    Chemische Substanzen Protein Kinase Inhibitors ; Pyrazoles ; Pyrimidines ; ibrutinib (1X70OSD4VX) ; Agammaglobulinaemia Tyrosine Kinase (EC 2.7.10.2)
    Sprache Englisch
    Erscheinungsdatum 2018-05-03
    Erscheinungsland England
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/1078155218772327
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Artikel ; Online: Immune checkpoint inhibition in advanced colorectal cancer with inherited and acquired microsatellite instability: Current state and future directions.

    Dasanu, Constantin A / Alani, Mohammed / Habibi, Shaghayegh / Codreanu, Ion

    Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

    2023  , Seite(n) 10781552231178293

    Abstract: Objective: This paper reviews comprehensively the most relevant data on single-agent and combination therapies for advanced colorectal cancer with inherited and acquired microsatellite instability (MSI).: Data sources: We performed a systematic ... ...

    Abstract Objective: This paper reviews comprehensively the most relevant data on single-agent and combination therapies for advanced colorectal cancer with inherited and acquired microsatellite instability (MSI).
    Data sources: We performed a systematic search on PubMed and MEDLINE articles published from inception to December 2022. We have also searched independent websites including U.S. Food and Drug Administration and ClinicalTrials.gov.
    Data summary: Performing microsatellite stability testing, tumor mutational burden (TMB), and germline mutation analysis could identify patients with metastatic colorectal cancer that benefit from immune checkpoint inhibitor (ICI) therapy. Single-agent pembrolizumab has proven superiority over traditional chemotherapy in these patients. The nivolumab-ipilimumab is the only combination ICI therapy approved in this space. Recently, the anti-PD-1 antibody dostarlimab was granted Food and Drug Administration approval in refractory tissue-agnostic advanced solid cancers with deficient mismatch repair (dMMR). ICIs are also being studied in the adjuvant/neoadjuvant setting in colon cancer patients with dMMR. Newer agents are being scrutinized in this space as well. More solid data on biomarkers predicting responses in patients with MSI-high or TMB-H to various therapies are needed. Given its both clinical and financial toxicity, it is imperative to determine the optimal duration of ICI therapy in individual patients.
    Conclusions: Overall, the outlook in advanced colorectal cancer patients with MSI appears optimistic as new and efficacious ICI drugs and combinations are being added to the existing therapeutic armamentarium.
    Sprache Englisch
    Erscheinungsdatum 2023-05-29
    Erscheinungsland England
    Dokumenttyp Journal Article ; Review
    ZDB-ID 1330764-2
    ISSN 1477-092X ; 1078-1552
    ISSN (online) 1477-092X
    ISSN 1078-1552
    DOI 10.1177/10781552231178293
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