Medical oncologists’ clinical experiences and comfort levels with 20 recently approved agents.

Love, Neil; Anderson, Kenneth C.; Flaherty, Keith T.; Kantarjian, Hagop M.; Lynch, Thomas J.; O’Shaughnessy, Joyce; Sartor, A. Oliver; Venook, Alan P.; Zelenetz, Andrew D.; Moss, Jonathan R.; Kelly, Gloria; Ziel, Kathryn

doi:10.1200/jco.2013.31.15_suppl.e17570

Cited by 3 publications

(3 citation statements)

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“…There is a paucity of information available to oncologists regarding the incorporation of newly approved agents into clinical practice, including their potential AEs. A survey of medical oncologists, assessing their clinical experiences and comfort levels with 20 recently approved targeted agents in the USA, showed that 14% had prescribed cabozantinib for MTC, and that only 11% felt very confident about prescribing the medication . This is in contrast to vandetanib, which was prescribed by 30% of the oncologists for MTC, with 16% feeling comfortable prescribing the drug.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk of hand-foot skin reaction with cabozantinib, a novel multikinase inhibitor: a meta-analysis

Belum

Serna-Tamayo

et al. 2015

Clin Exp Dermatol

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Summary Background Cabozantinib is approved in the treatment of progessive, metastatic medullary thyroid cancer (MTC). It is a small molecule inhibitor, which targets multiple receptors including vascular endothelial growth factor receptor, tyrosine kinase with Ig and epidermal growth factor homology domains-2 and the proto-oncogenes MET (mesenchymal-epithelial transition factor) and RET (rearranged during transfection). The drug is currently in phase I/II/III clinical trials for a number of other solid tumours and haematological malignancies. The adverse event (AE) profile is similar to that of other newer angiogenesis inhibitors. Hand–foot skin reaction (HFSR) is an important dose-limiting dermatological adverse event of this class of drugs. Aim To ascertain the incidence and risk of HFSR in patients with cancer during treatment with cabozantinib. Methods Electronic databases (PubMed, Web of Science) and the American Society for Clinical Oncology website were queried from inception to July 2014. Only phase II/III studies investigating cabozantinib for the treatment of cancer were shortlisted. The incidence, relative risk (RR) and 95% CI were calculated using random- or fixed-effects models, depending on the heterogeneity of included studies. Results We included 831 patients treated with cabozantinib for various solid malignancies in the analysis. The overall incidence was 35.3% (95% CI 27.9–43.6%) for all-grade and 9.5% (95% CI 7.6–11.7%) for high-grade HFSR. The RR of all-grade and high-grade HFSR with cabozantinib, compared with controls, was increased for both all-grade (27.3; 95% CI 6.9–108.3; P < 0.001) and high-grade, 28.1; 95% CI 1.7–457; P < 0.02) HFSR, respectively. Conclusions The incidence and risk of developing HFSR with cabozantinib are high. Timely recognition of this dose-limiting AE is critical to direct supportive care efforts including patient counselling, and to institute preventative and/or treatment interventions.

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Section: Discussionmentioning

confidence: 99%

Incidence and risk of hand-foot skin reaction with cabozantinib, a novel multikinase inhibitor: a meta-analysis

Belum

Serna-Tamayo

et al. 2015

Clin Exp Dermatol

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“…Despite inducing durable responses with manageable toxicity in patients with PTCL, many oncologists are not aware of the role of romidepsin in the PTCL treatment paradigm. In a survey of 100 U.S.-based medical oncologists that assessed prescribing experiences with newer oncologic drugs, only 31% were very confident about prescribing romidepsin for T-cell Perform at baseline and consider periodic monitoring in patients with congenital QT prolongation or a history of significant cardiovascular disease and in patients taking drugs that can significantly prolong QT lymphoma [81]. In addition to the agents approved for treatment of PTCL (romidepsin, belinostat, pralatrexate, and brentuximab vedotin for the ALCL subtype), NCCN treatment guidelines for nearly all subtypes (ALK-positive ALCL being the exception) recommend that patients be considered for inclusion in clinical trials [10,29,31,32].…”

Section: Role Of Expert Hematopathologists and Specialty Treatment Cementioning

confidence: 99%

Romidepsin for the Treatment of Peripheral T-Cell Lymphoma

Iyer

Foss

2015

The Oncologist

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Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of non-Hodgkin lymphomas associated with poor prognosis in most subtypes. Diagnosis of this rare disease by expert hematopathologists improves accuracy of subtyping, and referral to academic or specialty centers is recommended. Many patients, however, will receive treatment in the community, and knowledge of approved agents is key to optimizing therapeutic approaches forall patients.There is no current standard ofcare for patients with PTCL and no approved therapies for first-line treatment. Although many patients initially respond to induction chemotherapy, responses are often brief, and many patients relapse or become treatment refractory. For patients with relapsed or refractory PTCL, achievement of durable responses is challenging,andthere are few treatment options.Romidepsinis a histone deacetylase inhibitor approved by the U.S. Food and Drug Administration for the treatment of patients with cutaneous T-cell lymphoma who have received one prior systemic therapy or more and patients with PTCL who have received one prior therapy or more. Approval of romidepsin for PTCL was based on a pivotal phase II study of patients with relapsed or refractory PTCL (n 5 131) that demonstrated an objective response rate of 25% including 15% with complete response; responses lasted a median of .2 years. Long-term responses to romidepsin were achieved in patients regardless of baseline characteristics, including subtype, heavy pretreatment, response to prior therapy, oradvanced disease. Common adverse events included hematologic abnormalities, gastrointestinal or asthenic conditions, and infections; romidepsin was not correlated with clinically meaningful QT prolongation or electrocardiogram abnormalities. The Oncologist 2015;20:1084-1091 Implications for Practice: Due to the rarity, severity, and heterogeneous nature of peripheral T-cell lymphoma (PTCL), diagnosis by expert hematopathologists is preferred, and referral to specialty centers is recommended. Many patients, however, will receive treatment in the community, and community oncologists play a key role in the recognition and treatment of PTCL. Knowledge of approved agents is key for optimizing therapeutic approaches. This review provides an overview of PTCL and an in-depth examination of romidepsin, a histone deacetylase inhibitor approved for the treatment of relapsed or refractory PTCL, and highlights difficulties of diagnosis and optimization of treatment modalities for patients with PTCL.

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“…Since ALK inhibitors will be used by a multidisciplinary team in a specific subgroup of patients, physicians are likely to have limited experience in their use. 1 It is therefore essential that physicians and caregivers are aware of treatment-related adverse events (AEs) in order to optimise their management and thus enhance the patient's quality of life. This article will focus on the management of AEs in ALK-positive NSCLC receiving targeted therapy.…”

mentioning

confidence: 99%

Adverse Event Management in Anaplastic Lymphoma Kinase-positive Non-small Cell Lung Cancer

Rolfo¹,

Gil-Bazo²,

Peters³

2015

European Oncology &Amp; Haematology

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The development of oncogene-directed targeted therapies represents a new paradigm in the treatment of non-small cell lung cancer (NSCLC), offering improved outcomes compared with chemotherapy. Rearrangements of the anaplastic lymphoma kinase (ALK) gene are major oncogenic drivers in a subset of NSCLC patients. Since its launch in 2011, the ALK inhibitor crizotinib has become the standard of care inALK-positive NSCLC, but resistance inevitably develops. Ceritinib and alectinib have received regulatory approval: the former in Europe, US and elsewhere in the world, the latter in Japan. ALK inhibitors target multiple pathways, and may therefore be associated with a wide range of adverse events (AEs), including gastrointestinal AEs, hepatotoxicity and, in the case of crizotinib and ceritinib, cardiac effects. While the majority of these AEs are reversible, manageable and not severe, it is important that both physician and patients are aware of toxicities to ensure prompt treatment. This article discusses the management of AEs in patients receiving currently approved ALK inhibitors, including treatment, regular monitoring, drug discontinuation or dose reduction and physician/patient education. Proactive management of AEs enhances patient quality of life and optimises the therapeutic index of these agents.

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Medical oncologists’ clinical experiences and comfort levels with 20 recently approved agents.

Cited by 3 publications

References 0 publications

Incidence and risk of hand-foot skin reaction with cabozantinib, a novel multikinase inhibitor: a meta-analysis

Incidence and risk of hand-foot skin reaction with cabozantinib, a novel multikinase inhibitor: a meta-analysis

Romidepsin for the Treatment of Peripheral T-Cell Lymphoma

Adverse Event Management in Anaplastic Lymphoma Kinase-positive Non-small Cell Lung Cancer

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