PMID- 24222148
OWN - NLM
STAT- MEDLINE
DCOM- 20140107
LR  - 20220318
IS  - 1791-7530 (Electronic)
IS  - 0250-7005 (Linking)
VI  - 33
IP  - 11
DP  - 2013 Nov
TI  - Management of adverse events in patients with metastatic renal cell carcinoma 
      treated with sunitinib and clinical outcomes.
PG  - 5043-50
AB  - Patients with progressive renal cell carcinoma who undergo sunitinib treatment, 
      experience many adverse events (AEs), including thrombopenia and hypertension. 
      Dose reduction or treatment discontinuation due to AEs makes it difficult to 
      control the clinical condition. Therefore, patients' understanding regarding the 
      basics of blood pressure (BP) measurement and how to deal with each AE are 
      particularly important. Here we report whether or not pharmacist instructions 
      help in order to increase patients' awareness of early AE management results in 
      an improvement of treatment outcomes. The present study included 15 patients who 
      were administered sunitinib. From the start of sunitinib treatment, pharmacists 
      continuously provided drug administration guidance to the patients and confirmed 
      their awareness and knowledge regarding AEs, symptom management, and drug 
      adherence. The relative dose intensity (RDI) of 15 patients from week 1 to 24 
      after sunitinib treatment was calculated. Pharmaceutical interventions 
      significantly improved patients' understanding of BP measurements and reference 
      values, etc. Although the RDI was 67.3%-78.7%, there were no cases of 
      discontinuation of administration or reduction of the dose caused by e.g. 
      hypertension, hand and foot syndrome (HFS) and stomatitis. Pharmaceutical 
      interventions improved patients' awareness of the management of AEs and adherence 
      to sunitinib therapy. As a result, a high RDI was maintained, which may lead to 
      prolonged survival. Therefore, our results suggest that early AE management 
      provided by pharmacists is particularly important to assure the safety and 
      efficacy of sunitinib therapy.
FAU - Arakawa-Todo, Maki
AU  - Arakawa-Todo M
AD  - Department of Hospital Pharmacy, Aichi Medical University School of Medicine, 
      Karimata, Yazako, Nagakute, Aichi 480-1195, Japan. arakawa3@aichi-med-u.ac.jp.
FAU - Yoshizawa, Takahiko
AU  - Yoshizawa T
FAU - Zennami, Kenji
AU  - Zennami K
FAU - Nishikawa, Genya
AU  - Nishikawa G
FAU - Kato, Yoshiharu
AU  - Kato Y
FAU - Kobayashi, Ikuo
AU  - Kobayashi I
FAU - Kajikawa, Keishi
AU  - Kajikawa K
FAU - Yamada, Yoshiaki
AU  - Yamada Y
FAU - Matsuura, Katsuhiko
AU  - Matsuura K
FAU - Tsukiyama, Ikuto
AU  - Tsukiyama I
FAU - Saito, Hiroko
AU  - Saito H
FAU - Hasegawa, Takaaki
AU  - Hasegawa T
FAU - Nakamura, Kogenta
AU  - Nakamura K
FAU - Sumitomo, Makoto
AU  - Sumitomo M
LA  - eng
PT  - Journal Article
PL  - Greece
TA  - Anticancer Res
JT  - Anticancer research
JID - 8102988
RN  - 0 (Indoles)
RN  - 0 (Pyrroles)
RN  - V99T50803M (Sunitinib)
SB  - IM
MH  - Aged
MH  - Blood Pressure Determination
MH  - Carcinoma, Renal Cell/complications/*drug therapy/secondary
MH  - Disease Management
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension/etiology/*prevention & control
MH  - Indoles/*adverse effects
MH  - Kidney Neoplasms/complications/*drug therapy/pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Neoplasm Staging
MH  - Patient Compliance
MH  - Prognosis
MH  - Pyrroles/*adverse effects
MH  - Sunitinib
OTO - NOTNLM
OT  - Sunitinib
OT  - adherence
OT  - adverse events
OT  - blood pressure
OT  - early management
OT  - pharmacist
EDAT- 2013/11/14 06:00
MHDA- 2014/01/08 06:00
CRDT- 2013/11/14 06:00
PHST- 2013/11/14 06:00 [entrez]
PHST- 2013/11/14 06:00 [pubmed]
PHST- 2014/01/08 06:00 [medline]
AID - 33/11/5043 [pii]
PST - ppublish
SO  - Anticancer Res. 2013 Nov;33(11):5043-50.