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Managing Issues: Tumor Lysis, Extravasation, Adverse Effects, and Others

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The Golden Guide to Oncologic Pharmacy

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Abstract

Modern medicine has contributed to enhance human longevity and quality of life. On the other hand, an elderly population inhabiting a continuously polluted environment certainly contributes to the raise of cancer development. In this context, anticancer drugs are in high demand in recent decades, and oncology pharmacology is one of the medical fields experiencing a remarkable research activity and development of new drugs. However, anticancer drugs are among the more toxic drugs legally available, and more than 750 different types of adverse reaction scan be attributed to cancer treatments. Adverse drug reactions (ADRs) are among the leading concerns when drug research and development are considered once they are potentially related to therapeutic failures, and consequently, drugs withdraw from the market. ADRs have been estimated to contribute up to 60% of the total costs involved in chemotherapy. The physicochemical drug features are highly related to the onset of ADRs. These drug features are directly involved in key aspects of drug metabolism, like absorption, distribution, efficacy, transformation, excretion, and drug promiscuity. Hepatotoxicity, kidney toxicity, cardiovascular toxicity, neurotoxicity, nausea and vomiting, diarrhea, alopecia, rheumatic manifestations, neutropenia, and thrombocytopenia are among the most common ADRs described in literature, and they are described in the context of the different anticancer drugs families.

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References

Adverse Effects

  1. Oun R, Moussa YE, Wheate NJ. The side effects of platinum-based chemotherapy drugs: a review for chemists. Dalton Trans. 2018;47(19):6645–53.

    Article  CAS  PubMed  Google Scholar 

  2. Malyszko J, Kozlowska K, Kozlowski L, Malyszko J. Nephrotoxicity of anticancer treatment. Nephrol Dial Transplant. 2017;32(6):924–36.

    CAS  PubMed  Google Scholar 

  3. Zhang X, Zhu Y, Dong S, Zhang A, Lu Y, Li Y, Lv S, Zhang J. Role of oxidative stress in cardiotoxicity of antineoplastic drugs. Life Sci. 2019;232:116526.

    Article  CAS  PubMed  Google Scholar 

  4. Moreau-Bachelard C, Coquan E, LE Tourneau C. N. Imputability of adverse events to anticancer drugs. Engl J Med. 2019;380(19):1873–4.

    Article  Google Scholar 

  5. Cavaletti G, Nicolini G, Marmiroli P. Neurotoxic effects of antineoplastic drugs: the lesson of pre-clinical studies. Front Biosci. 2008;3(1):3506–24.

    Article  Google Scholar 

  6. Cridland MD. Antineoplastic and immunosuppressive drugs. Adverse effects and therapeutic problems. Drugs. 1972;3(5):352–65.

    Article  CAS  PubMed  Google Scholar 

  7. Pearce A, Haas M, Viney R. Are the true impacts of adverse events considered in economic models of antineoplastic drugs? A systematic review. Appl Health Econ Health Policy. 2013;11(6):619–37.

    Article  PubMed  Google Scholar 

  8. Wang Z, Yang X, Wang J, Wang S, Mao X, Li M, Zhao Y, Wang W, Qi X, Wu T. Risk of serious adverse event and fatal adverse event with molecular target anticancer drugs in cancer patients: A meta-analysis. J Cancer Res Ther. 2019;15(7):1435–49.

    Article  CAS  PubMed  Google Scholar 

  9. Tchambaz L, Schlatter C, Jakob M, Krähenbühl A, Wolf P, Krähenbühl S. Dose adaptation of antineoplastic drugs in patients with liver disease. Drug Saf. 2006;29(6):509–22.

    Article  CAS  PubMed  Google Scholar 

  10. Kintzel PE, Dorr RT. Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function. Cancer Treat Rev. 1995;21(1):33–64.

    Article  CAS  PubMed  Google Scholar 

  11. Tuccori M, Montagnani S, Capogrosso-Sansone A, Mantarro S, Antonioli L, Fornai M, Blandizzi C. Adverse reactions to oncologic drugs: spontaneous reporting and signal detection. Expert Rev Clin Pharmacol. 2015;8(1):61–75.

    Article  PubMed  CAS  Google Scholar 

  12. Chagas CM, Moss S, Alisaraie L. Drug metabolites and their effects on the development of adverse reactions: revisiting Lipinski's rule of five. Int J Pharm. 2018;549(1–2):133–49.

    Article  CAS  PubMed  Google Scholar 

  13. Tocchetti CG, Cadeddu C, di Lisi D, Femminò S, Madonna R, Mele D, Monte I, Novo G, Penna C, Pepe A, Spallarossa P, Varricchi G, Zito C, Pagliaro P, Mercuro G. From molecular mechanisms to clinical management of antineoplastic drug-induced cardiovascular toxicity: a translational overview. Antioxid Redox Signal. 2019;30(18):2110–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Hamnvik OPR. Thyroid dysfunction from antineoplastic agents. J Natl Cancer Inst. 2011;103(21):1572–87.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Tew KD. Alkylating agents. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 407–19.

    Google Scholar 

  16. Reed E. Cisplatin and its analogs. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 419–26.

    Google Scholar 

  17. Saif MW, Chu E. Antimetabolites. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 427–37.

    Google Scholar 

  18. Rasheed ZA, Rubin EH. Topoisomerase-interacting agents. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 437–47.

    Google Scholar 

  19. Lee JJ, Harris LN. Antimicrotubule agents. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 447–56.

    Google Scholar 

  20. Lorusso PM, Ryan AJ, Boerner SA, HERBST RS. Small-molecule tyrosine kinase inhibitors. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 457–68.

    Google Scholar 

  21. Cohen SJ, Cohen RB, Meropol NJ. Targeting signal transduction with antibodies. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 469–77.

    Google Scholar 

  22. Gore SD, Baylin SB, Herman JG. Histone deacetylase inhibitors and demethylating agents. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 477–85.

    Google Scholar 

  23. Molineaux CJ, Cews CM. Proteasome inhibitors. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 486–90.

    Google Scholar 

  24. Copur MS, Rose M, Gettinger SN. Miscellaneous chemotherapeutics agents. Chap. 25: Pharmacology of cancer chemotherapy. In: DeVita, Hellman and Rosenberg’s Cancer: principles & practice of oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 490–5.

    Google Scholar 

Tumor Lysis

  1. Howard SC, Jones DP, Pui CH. The tumor lysis syndrome. N Engl J Med. 2011a;364(19):1844–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Coiffier B, Altman A, Pui CH, Younes A, Cairo MS. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol. 2008a;26(16):2767–78.

    Article  CAS  PubMed  Google Scholar 

  3. Newton HB. Neurologic complications of systemic cancer. Am Fam Physician. 1999;59(4):878–86.

    CAS  PubMed  Google Scholar 

  4. Azoulay E, Moreau D, Alberti C, Leleu G, Adrie C, Barboteu M, et al. Predictors of short-term mortality in critically ill patients with solid malignancies. Intensive Care Med. 2000;26(12):1817–23.

    Article  CAS  PubMed  Google Scholar 

  5. Benoit DD, Hoste EA, Depuydt PO, Offner FC, Lameire NH, Vandewoude KH, et al. Outcome in critically ill medical patients treated with renal replacement therapy for acute renal failure: comparison between patients with and those without haematological malignancies. Nephrol Dial Transplant. 2005;20(3):552–8.

    Article  PubMed  Google Scholar 

  6. Lanore JJ, Brunet F, Pochard F, Bellivier F, Dhainaut JF, Vaxelaire JF, et al. Hemodialysis for acute renal failure in patients with hematologic malignancies. Crit Care Med. 1991;19(3):346–51.

    Article  CAS  PubMed  Google Scholar 

  7. Tanvetyanon T, Choudhury AM. Fatal acute tumor lysis syndrome, hepatic encephalopathy and flare phenomenon following combined androgen blockade. J Urol. 2004;171(4):1627.

    Article  PubMed  Google Scholar 

  8. Vaisban E, Braester A, Mosenzon O, et al. Spontaneous tumor lysis syndrome in solid tumors: really a rare condition? Am J Med Sci. 2003;325(1):38–40.

    Article  PubMed  Google Scholar 

  9. Howard SC, Jones DP, Pui CHN. The tumor lysis syndrome. Engl J Med. 2011b;364(19):1844–54.

    Article  CAS  Google Scholar 

  10. Coiffier B, Altman A, Pui CH, Younes A, Cairo MS. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol. 2008b;26(16):2767–78.

    Article  CAS  PubMed  Google Scholar 

  11. Rahmani B, Patel S, Seyam O, Gandhi J, Reid I, Smith N, Khan SA. Current understanding of tumor lysis syndrome. Hematol Oncol. 2019;37(5):537–47.

    Article  PubMed  Google Scholar 

  12. Williams SM, Killeen AA. Tumor lysis syndrome. Arch Pathol Lab Med. 2019;143(3):386–93.

    Article  CAS  PubMed  Google Scholar 

  13. Criscuolo M, Fianchi L, Dragonetti G, Pagano L. Tumor lysis syndrome: review of pathogenesis, risk factors and management of a medical emergency. Expert Rev Hematol. 2016;9(2):197–208.

    Article  CAS  PubMed  Google Scholar 

  14. Russell TB, Kram DE. Tumor lysis syndrome. Pediatr Rev. 2020;41(1):20–6.

    Article  PubMed  Google Scholar 

  15. Mcbride A, Trifilio S, Baxter N, Gregory TK, Howard SC. Managing tumor lysis syndrome in the era of novel cancer therapies. J Adv Pract Oncol. 2017;8(7):705–20.

    PubMed  PubMed Central  Google Scholar 

  16. Greguska C. Managing tumor lysis syndrome. JAAPA. 2021;34(1):10–3.

    Article  PubMed  Google Scholar 

  17. Klemencic S, Perkins J. Diagnosis and Management of Oncologic Emergencies. West J Emerg Med. 2019;20(2):316–22.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Abu-Alfa AK, Younes A. Tumor lysis syndrome and acute kidney injury: evaluation, prevention, and management. Am J Kidney Dis. 2010;55(5 Suppl 3):S1–13; quiz S14–9.

    Article  PubMed  Google Scholar 

  19. Giammarco S, Chiusolo P, Piccirillo N, Di Giovanni A, Metafuni E, Laurenti L, Sica S, Pagano L. Hyperleukocytosis and leukostasis: management of a medical emergency. Expert Rev Hematol. 2017;10(2):147–54.

    Article  CAS  PubMed  Google Scholar 

  20. Findakly D, Luther RD III, Wang J. Tumor lysis syndrome in solid tumors: A comprehensive literature review, new insights, and novel strategies to improve outcomes. Cureus. 2020;12(5):e8355.

    PubMed  PubMed Central  Google Scholar 

  21. Durani U, Hogan WJ. Emergencies in haematology: tumour lysis syndrome. Br J Haematol. 2020;188(4):494–500.

    Article  PubMed  Google Scholar 

Tumor Extravasation

  1. Strilic B, Offermanns S. Intravascular survival and extravasation of tumor cells. Cancer Cell. 2017;32(3):282–93.

    Article  CAS  PubMed  Google Scholar 

  2. Boulanger J, Ducharme A, Dufour A, Fortier S, Almanric K. Management of the extravasation of anti-neoplastic agents. Comité de l’évolution de la pratique des soins pharmaceutiques (CEPSP); Comité de l’évolution des pratiques en oncologie (CEPO). Support Care Cancer. 2015;23(5):1459–71.

    Article  CAS  PubMed  Google Scholar 

  3. Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines.; ESMO Guidelines Working Group. Ann Oncol. 2012;23(Suppl 7):vii167–73.

    Article  PubMed  Google Scholar 

  4. Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, O’neil SEMLERR, O’sullivan M, Truini-Pittman L, Cunningham TA, Roman-Fischetti L, Costantinou E, Rimkus C, Banavage AJ, Dietz B, Colussi CJ, Catania K, Wasko M, Schreffler KA, West C, Siefert ML, Rice RD. Chemotherapy extravasation: establishing a National Benchmark for incidence among cancer centers. Clin J Oncol Nurs. 2017;21(4):438–45.

    PubMed  Google Scholar 

  5. Harrold K. Managing cytotoxic chemotherapy extravasation: use of saline washout. Br J Nurs. 2015;24(8):S36–7.

    Article  PubMed  Google Scholar 

  6. Yadavalli S, Jayaram S, Manda SS, Madugundu AK, Nayakanti DS, Tan TZ, Bhat R, Rangarajan A, Chatterjee A, Gowda H, Thiery JP, Kumar P. Data-driven discovery of extravasation pathway in circulating tumor cells. Sci Rep. 2017;7:43710.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Bahrami M, Karimi T, Yadegarfar G, Norouzi A. Assessing the quality of existing clinical practice guidelines for chemotherapy drug extravasation by appraisal of guidelines for research and evaluation II. Iran J Nurs Midwifery Res. 2019;24(6):410–6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Zach L, Guez D, Last D, Daniels D, Grober Y, Nissim O, Hoffmann C, Nass D, Talianski A, Spiegelmann R, Cohen ZR, Mardor Y. Delayed contrast extravasation MRI for depicting tumor and non-tumoral tissues in primary and metastatic brain tumors. PLoS One. 2012;7(12):e52008.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. De Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, Mayer-Steinacker R, Bokemeyer C, Jordan K. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie. 2013;36(3):127–35.

    Article  PubMed  Google Scholar 

  10. Harrold K, Gould D, Drey N. The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice. Eur J Cancer Care (Engl). 2015;24(6):771–800.

    Article  CAS  Google Scholar 

Others

  1. Morgan C, Tillett T, Braybrooke J, Ajithkumar T. Management of uncommon chemotherapy-induced emergencies. Lancet Oncol. 2011;12(8):806–14.

    Article  PubMed  Google Scholar 

  2. Wagner J, Arora S. Oncologic metabolic emergencies. Hematol Oncol Clin North Am. 2017;31(6):941–57.

    Article  PubMed  Google Scholar 

  3. Mccurdy MT, Shanholtz CB. Oncologic emergencies. Crit Care Med. 2012;40(7):2212–22.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Associação Paulista de Cirurgiões Dentistas School of Dentistry (FAOA), São Paulo, Brazil

    Lucio Frigo

  2. Periodontology Department, School of Dentistry, Universidade Guarulhos, São Paulo, Brazil

    Guilherme Aparecido Monteiro Duque da Fonseca

  3. General Biology Department, Universidade Estadual de Ponta Grossa, Parana, Brazil

    Giovani Marino Favero

  4. Molecular Biology Laboratory, Instituto Butantan, São Paulo, Brazil

    Durvanei Augusto Maria

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  1. Lucio Frigo
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  2. Guilherme Aparecido Monteiro Duque da Fonseca
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  3. Giovani Marino Favero
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  4. Durvanei Augusto Maria
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Editor information

Editors and Affiliations

  1. Pediatric Oncology Pharmacist & Writer, Curitiba, Paraná, Brazil

    Carolina Witchmichen Penteado Schmidt

  2. Jesus Maria José Maternity Hospital, Quixadá, Ceará, Brazil

    Kaléu Mormino Otoni

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Frigo, L., da Fonseca, G.A.M.D., Favero, G.M., Maria, D.A. (2022). Managing Issues: Tumor Lysis, Extravasation, Adverse Effects, and Others. In: Schmidt, C.W.P., Otoni, K.M. (eds) The Golden Guide to Oncologic Pharmacy. Springer, Cham. https://doi.org/10.1007/978-3-030-98596-7_11

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  • DOI: https://doi.org/10.1007/978-3-030-98596-7_11

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