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Review Article

Multidrug regimens have become a staple in oncology, thanks to their ability to overcome multiple areas of treatment resistance by the tumor. The use of multidrug regimens facilitates different mechanisms of attack against the tumor.1 This multidrug regimen method frequently leads to the question of how to sequence chemotherapies or monoclonal antibodies. This is an important question that is asked of oncology pharmacists, because of findings that demonstrate greater toxicity and/or efficacy, depending on the sequencing of the agents.1-5 A common misconception in oncology pharmacy is that these agents have been tested as part of a chemotherapy regimen and are therefore safe and effective, but this belief has been disproved by several studies.2-4
Biologic drugs play an important role in healthcare and represent $232 billion in global revenue. Biologic drugs represent 25% of the total global pharmaceutical market. The number of biologic drugs approved by the US Food and Drug Administration (FDA) continues to increase, with 12 biologic drugs included in the 46 new molecular entities approved by the FDA in 2017. In addition, 10 new biologics were approved by the FDA in 2018, 40% of which were for the treatment of cancer. Biologic drugs are an important therapeutic option for patients with cancer and are used for the treatment of malignancies as well as for supportive care management.
Many approaches for improving outcomes in patients with acute myeloid leukemia (AML) have been investigated over the years. AML is molecularly complex, and its multiple genetic aberrations are critical pathophysiologic and prognostic features that can influence therapy. Mutations in the FMS-like tyrosine kinase 3 (FLT3) gene, identified in approximately 30% of adults with AML, likely confer the largest single-gene impact on overall survival; the FLT3 internal tandem duplication (ITD) mutation is an independent predictor of a high relapse rate and poor overall survival.
Acute lymphoblastic leukemia (ALL) is a relatively rare cancer affecting 1.7 cases per 100,000 people annually in the United States, with a slightly higher incidence in males than females.
Nausea and vomiting are common side effects of anticancer agents and can have significant negative impact on patients’ quality of life and on their ability to tolerate and adhere to cancer treatment. “Despite advances in the prevention and management of chemotherapy-induced nausea and vomiting (CINV), these side effects remain among the most distressing for patients,” Rao and Faso noted in their review of CINV prevention and management.
Immune checkpoint inhibitors, including programmed-cell death (PD)-1 and cytotoxic T-lymphocyte–associated protein (CTLA)-4 inhibitors, have proved to be effective in treating many cancers, but in rare cases, have been reported to cause fatal and life-threatening immune-mediated adverse events (AEs).
The American Cancer Society estimates that approximately 63,990 patients will be diagnosed with renal cancer in the United States in 2017. In addition, approximately 14,400 patients are projected to die in 2017 from renal cancer. Renal cancer is one of the 10 most common malignancies in men and women in the United States. In recent years, the incidence of this disease has been on the rise.
Prostate cancer is the second leading cause of cancer-related mortality, and accounts for 10% of cancer-related deaths in American men. It is estimated that 1 in 9 men will have prostate cancer during their lifetime, and an estimated 161,363 new cases and 26,730 prostate cancer–related deaths are expected in the United States in 2017.
Lung cancer is the leading cause of cancer-related death in men and women in the United States.
The chronic lymphocytic leukemia (CLL) development landscape is one of the most dynamic areas in oncology clinical research. During the writing of this manuscript, there were new approvals made, and guidelines were updated.
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