during the past 5 years. Collected variables: age, sex, ECOG, adjuvant chemotherapy, treatment line, dose reduction and adverse events (AE). Efficacy endpoints were progression-free survival (PFS) and overall survival (OS) obtained by the Kaplan-Meier method. Adverse effects (AE) were collected for safety profile assessment. Descriptive statistical analysis was performed using the SPSS Statistics program V22.0. Results Forty-seven patients (30 men and 17 women) were included. The median age was 59 years . At the beginning of the treatment, more than 80% presented ECOG 0-1: 23.4% had received previous adjuvant chemotherapy (gemcitabine and/or fluoropyrimidines). They were treated with nab-paclitaxel 125 mg/m 2 and gemcitabine 1000 mg/m 2 on days 1, 8 and 15 every 28 days. In 89.4% of the patients it was prescribed as first-line treatment. Dose reduction was performed in 68.1%. The median duration of treatment was 4.5 months (0.5-22.9), with four long survivors (longer than 15 months). The median PFS was 9.1 months (95% CI 8.36 to 9.73) and the median OS was 9.11 months (95% CI 4.0 to 14.2). Eighty-three per cent of patients (n=39) had AE of some grade and 17% (n=8) of grade 3-4. The most common AE were: asthaenia (n=17), neutropaenia (n=16), thrombocytopaenia (n=15), neuropathy (n=13), alopecia (n=5), diarrhoea (n=7), mucositis (n=3), vomiting (n=3), oedema (n=3) and dermatitis (n=2). These were grade 3-4: neutropaenia (n=7), thrombocytopaenia (n=4), mucositis (n=1), alopecia (n=1) and neuropathy (n=1). The causes of treatment discontinuation were mainly due to progression in 42.6% and deterioration of general health in 29.8%. At the end of the study, five patients continued treatment. ConclusionThe PFS obtained in our study is greater than those described in the pivotal trial MPACT or CA046. This difference may be due to the four patients with a considerably longer treatment than the average and a small sample. Regarding OS, there are no significant differences with the pivotal trial. The AE described were similar to those published in the literature REFERENCE AND/OR ACKNOWLEDGEMENTS BMC Cancer 2016;16:817. No conflict of interest.
BackgroundA 81-years-old female was admitted due to a surgical cleaning of an infected knee prosthesis and the administration of targeted antibiotics. After starting with daptomycin, the patient developed an acute eosinophilic pneumonia.PurposeTo analyse whether the symptomathology was related to antibiotic treatment and to establish the cause.Material and methodsA descriptive observational study design was carried out. The medical history was obtained from the digital clinical history (DIRAYA) and the optimised computerised order entry software from the Pharmacy Department (APD-PRISMA). A bibliographic research was conducted to find similar cases or if it was an uncommon adverse effect. Modified Karch–Lasagna’s algorithm was applied to assess the relationship between the acute eosinophilic pneumonia and daptomycin.ResultsAfter the surgical cleaning, fever appeared and the patient started with ceftazidime and linezolid treatment. In the intraoperative culture it was detected as methicillin-resistant Staphylococcus epidermidis showed most sensitivity to daptomycin. After 4 weeks with daptomycin 6 mg/kg/day, fever and dyspnea appeared. The x-ray study showed bilateral pneumonia with eosinophylia and the patient needed admission to an intensive care unit. A new culture was obtained and the results were negative. With the suspicion of an eosinophilic pneumonia and after being the EPAR-Product Information was consulted, daptomycin was switched to vancomycin 30 mg/kg/day for the treatment of prosthesis infection, empiric antibiotic therapy was suspended and methylprednisolone was prescribed to treat the eosinophilic pneumonia. Five days’ later, the patient was discharged with positive synovial fluid cultures and a prescription of a once-weekly dalbavancin. After 4 weeks of treatment, cultures were negative. In contrast with notified case series, Staphylococcus aureus was not the causative strain in our case.1 Modified Karch–Lasagna’s algorithm established a ‘probable’ relationship between daptomycin and eosinophilic pneumonia. Adverse effect was reported to the local pharmacovigilance centre.ConclusionOur data suggest that daptomycin could provoke serious adverse effects and prolongation of hospitalisation time. Hospital pharmacists must perceive possible drug adverse effects and establish reporting systems to contribute to appropriate pharmacotherapy management.Reference and/or Acknowledgements1. Uppal P, LaPlante KL, Gaitanis MM, Jankowich MD, Ward KE. Daptomycin-induced eosinophilic pneumonia: A systematic review. Antimicrob Resist & Infect Control [Internet] 2016;5(1):55.No conflict of interest
BackgroundEribulin has been approved for locally advanced or metastatic breast cancer after at least one previous chemotherapy regimen for advanced disease, including an anthracycline and a taxane.PurposeTo evaluate the effectiveness and safety of eribulin in a tertiary-level hospital.Material and methodsA retrospective observational study was conducted. We included patients treated with eribulin from 1 February 2014 to 11 October 2017.Following variables were recordedage, number of cycles, duration of treatment, number and type of previous chemotherapy regimens, progression-free survival (PFS), reported adverse events (AEs), dose reductions and dose delays between cycles.We obtained data from electronic clinical records and the chemotherapy management software.ResultsTwenty-four patients were included, mean age 50.9 years (SD 9.4, range 32–67). As the data analysis showed, four patients were still in treatment with eribulin and 20 had finished it, with a median duration of 3.15 months (4.5 cycles, range 1–8).Patients had a median of three previous chemotherapy lines in the locally advanced or metastatic stage, in the range 1–6. Most common regimens used before eribulin in metastatic disease were: albumin-bound paclitaxel (54.2%), non-pegylated liposomal doxorubicin (50%), paclitaxel +bevacizumab (37.5%), cisplatin +gemcitabine (20.8%), capecitabine (20.8%), vinorelbine (20.8%), docetaxel monotherapy (16.7%), pegylated liposomal doxorubicin (12.5%), epirubicin +docetaxel (12.5%) and paclitaxel monotherapy (8.3%), being less frequent than other regimens.Median PFS in the 17 patients who progressed during or after eribulin (but without having received a later treatment) was 2.8 months.62.5% of patients had an AE during treatment. The most frequent were: asthaenia (37.5%), neuropathy (33.3%), joint pain (20.8%), mucositis (12.5%), neutropaenia (12.5%), infection (8.3%), constipation (8.3%), sickness (8.3%) and epigastric pain (8.3%). one patient interrupted the treatment due to AEs.In patients who finished their treatment, there were two delays because of neutropenia and three dose reductions due to toxicity.ConclusionIn our patients, eribulin median PFS was lower than in the EMBRACE trial. This could be explained because our patients received more previous regimens of chemotherapy for metastatic disease. In addition, our sample size was smaller.Regarding safety, eribulin was well tolerated and in most cases the AEs did not force an interruption to treatment.No conflict of interest
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