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JHOP - March 2019 Vol 9, No 1

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.
Recognizing the difference between “self” and “nonself” is a crucial role of the immune system; to regulate this recognition process, the immune system uses complex pathways, including several immune checkpoints. Recent understanding of these checkpoints, and how they affect T-cell activation, has led to therapeutic targets for cancer treatment.
Tumor lysis syndrome (TLS) is a life-threatening complication of hematologic malignancies and some solid tumors. This syndrome occurs after tumor cells break down spontaneously or after exposure to radiation or chemotherapy. Lysis of tumor cells will release intracellular contents into the bloodstream, leading to hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia.
  • Tisagenlecleucel Shows High, Durable Responses in Relapsed/Refractory Diffuse Large B-Cell Lymphoma
  • Olaparib Maintenance Extends Progression-Free Survival in Advanced Ovarian Cancer
  • Ibrutinib Superior to Standard Chemoimmunotherapy in Older Patients with Chronic Lymphocytic Leukemia
The use of a closed-system transfer device (CSTD) has been accepted as a standard of practice to minimize exposure to harmful materials when compounding hazardous medications. Several reports indicate that CSTDs also preserve the sterility of unpreserved (ie, single-use) medication vials for up to 1 week. Taking advantage of prolonged sterility of nonpreserved vials with an appropriate CSTD attached offers the possibility of significant cost-savings through reduced drug waste.
Patients with relapsed, refractory, or high-risk hematologic malignancies obtained durable benefits with the combined checkpoint inhibition with nivolumab and ipilimumab as consolidation therapy after stem-cell transplant, according to results of a small prospective study presented at ASH 2018.
A 2-year duration of combination immunotherapy with ven­etoclax and rituximab improved survival compared with standard-of-care chemoimmunotherapy combination with bendamustine plus rituximab in patients with relapsed or refractory chronic lymphocytic leukemia (CLL), according to follow-up data from the MURANO clinical trial presented at ASH 2018. Early results were first presented at ASH 2017.
The BCL2 Gly101Val mutation is the first genomic alteration to be identified as responsible for resistance to venetoclax, a potent and effective medication indicated for the treatment of chronic lymphocytic leukemia (CLL). The BCL2 Gly101Val mutation is unique to CLL and so far has not been described in other cancers.
Although chimeric antigen receptor (CAR) T-cell therapy has achieved remarkable long-lasting remissions in B-cell malignancies, in approximately 60% of the cases, the initial response wanes over time because of “immune exhaustion.” The use of a checkpoint inhibitor to boost immune response to CAR T-cell therapy is gaining traction as an attractive approach, according to 2 early studies presented at ASH 2018.
Longer-term follow-up of 2 large pivotal clinical trials in B-cell malignancies has demonstrated continuing remissions after chimeric antigen receptor (CAR) T-cell therapy: the ELIANA study in pediatric patients and young adults with relapsed or refractory B-acute lymphoblastic leukemia (B-ALL) and the JULIET study in adult patients with diffuse large B-cell lymphoma (DLBCL). Both updates were presented at a press conference at ASH 2018.
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