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Le Touquet – Paris-Plage, France

Scotte F.,European Hospital Georges Pompidou | Launay-Vacher V.,Service Icar | Rey J.-B.,Institute Jean Godinot
Targeted Oncology

Biosimilars are equivalent drugs for other biotechnological drugs for which patent has expired. These biopharmaceuticals are often looked upon as simple copies of parent drugs whose goal is solely to potentially generate costs savings. The expansion of available drugs is a subject of attention, criticism and quarrels, often related to a lack of product knowledge. These drugs are copies but need scientific development that must meet many strict rules. Many questions arise in connection with the marketing of several biosimilar drugs in the field of hematopoietic growth factors of white and red cells. Many of them should be discussed. © 2012 Springer-Verlag. Source

Scotte F.,Hopital Europeen Georges Pompidou | Rey J.B.,Institute Jean Godinot | Launay-Vacher V.,Service Icar
Supportive Care in Cancer

Background Venous thromboembolism (VTE) and renal insufficiency are common in cancer patients. Prompt treatment is necessary to reduce the high rates of VTE-related mortality and morbidity. VTE prophylaxis is underused in cancer patients. We review current recommendations for the treatment and prevention of VTE in cancer patients and discuss low molecular weight heparin (LMWH) use in cases of renal failure. Design This study is a retrospective literature review. Results There are few published recommendations for LMWH use in cancer patients with renal insufficiency. Treatment guidelines largely follow recommendations for other patients with renal failure. Enoxaparin therapy is complicated by the need for regular monitoring of renal function and anti-Xa levels and for dosage adjustment to prevent bleeding. Few data are available to support the systematic use of dalteparin. Tinzaparin is least likely to bioaccumulate in patients with renal failure. Conclusion VTE is the second most common cause of death in cancer patients. Renal insufficiency is present in 50-60 % of cancer patients. Data from renal patients suggest that tinzaparin may be safe and effective for VTE treatment and prevention in cancer patients with renal failure. © Springer-Verlag 2012. Source

Launay-Vacher V.,Service Icar
Cancer Chemotherapy and Pharmacology

Trastuzumab has deeply and radically changed the course of HER2-positive breast cancer disease. The recent development of a subcutaneous (SC) formulation of trastuzumab is an important step towards improved patients' care. SC trastuzumab at a fixed dose of 600 mg administered every 3 weeks for about 5 min provides a valid alternative to the IV, both in terms of efficacy and safety. This results in substantial time savings for patients, pharmacists, physicians and nursing staff, with a healthcare professionals' and patients' preference largely going to SC. In addition, the possibility to treat patients with poor venous access or to spare patients' venous capital when necessary may also be of interest. © 2013 Springer-Verlag Berlin Heidelberg. Source

Kidney disease has been shown to be highly prevalent in cancer patients in the IRMA studies (Renal Insufficiency and Anticancer Medications). Furthermore, anticancer drugs used in those patients, among which half have abnormal renal function, necessitate dosage adjustment in case of reduced renal function and/or is potentially toxic to the kidneys in the vast majority of cases. Observations performed in IRMA-2 showed that the survival rate at 2 years was significantly lower for patients with KD (aMDRD<60). This reduced survival has been hypothesized to be related to the cardiovascular complications of KD or as a consequence of inappropriate drug dosage adjustment. © 2010 Elsevier Inc. Source

Renal insufficiency is a common disease, in the general population as well as in some specific diseases such as HIV infection or cancer. The vast majority of medicines requires a dosage adjustment in case of renal dysfunction. It is thus of a crucial importance to know how to evaluate appropriately renal function, on one hand, but also to have access to reliable information sources on how to handle the drugs in such cases. Most often, the Summary of Drug Characteristics (SmPC) only provides partial information, wich may even be false in some cases. However, some information sources exist, reliable, updated, and easily accessible. Source

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