Introduction
With the growing number of oral targeted therapies being approved for use in cancer therapy, the potential for long-term administration of these drugs to cancer patients is expanding. The use of these drugs in the home setting has the potential to expose family members and caregivers to them either through direct contact with the drugs or indirectly by exposure to the parent compounds and/or their active metabolites in contaminated patient's waste.
Methods
A systematic literature review was performed and the known adverse health effect of 32 oral targeted therapeutics is summarized. In particular, the carcinogenicity, genotoxicity, and embryo-foetal toxicity, along with the route of excretion were evaluated.
Results
Carcinogenicity testing has not been performed on most of the oral targeted therapeutics and the genotoxicity data are mixed. However, the majority of these drugs exhibit adverse reproductive effects, some of which are severe. Currently available data does not permit the possibility of a health hazard from inappropriate handling of drugs and contaminated patients waste to be ignored, especially in a long-term home setting. Further research is needed to understand these issues.
Conclusions
With the expanding use of targeted therapies in the home setting, family members and caregivers, especially those of reproductive risk age, are, potentially at risk. Overall basic education and related precautions should be taken to protect family members and caregivers from indirect or direct exposure from these drugs. Further investigations and discussion on this subject is warranted.
Cyber information warfare (IW) is a double-edged sword. States use IW to shape the hearts and minds of foreign societies and policy makers. However, states are also prone to foreign influence through IW. This assumption applies mainly to liberal democratic societies. The question examined in this article is how Russia uses IW on other countries but protects itself from the same activities. The authors’ main argument is that while Russia executes influence operations and IW in cyberspace, it strives for uncompromising control over its domestic cyberspace, thus restricting undesirable informational influence over its population.
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