DOCSLIB.ORG

Immediate Management of an Extravasation

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Immediate Management of an Extravasation Immediate management of an extravasation Your nearest extravasation STOP: the injection or intravenous infusion immediately. kit is located at: LEAVE: the venous access device (VAD) in place. ASPIRATE: any residual drug from VAD. PLAN: call for assistance: notify medical officer, pharmacist or a senior nurse; collect the extravasation kit; assess the affected area, trace with a marker pen, photograph the area; remove the IV cannula or port needle, do not apply pressure; initiate appropriate drug specific management measures as per flowchart below. Vesicant – DNA Vesicant – non-DNA Irritant with Irritant with Irritant binding binding vesicant properties vesicant properties • Bortezomib • Amsacrine • Vinblastine • Bendamustine • Oxaliplatin • Busulfan • Dactinomycin • Vincristine • Cisplatin >0.5 mg/mL • Cabazitaxel (actinomycin D) • Vindesine • Docetaxel • Carboplatin • Daunorubicin* • Vinflunine • Doxorubicin • Carmustine Liposomal • Doxorubicin* • Vinorelbine • Cisplatin ≤0.5 mg/mL • Melphalan • Epirubicin* • Dacarbazine • Mitozantrone • Idarubicin* • Etoposide • Nab-paclitaxel • Mitomycin • Etoposide phosphate • Paclitaxel* • Fluorouracil • Fotemustine • Gemcitabine Localise and Disperse and dilute Localise No warm or • Ifosfamide • Irinotecan neutralise • Administer pain relief • Apply a COLD cold compress • Neutralise by applying a prior to starting if recommended • Irinotecan compress to the nanoliposomal thin layer of topical required affected area for 15 to DMSO 99% solution to • Reconstitute 20 minutes every 6 • Romidepsin the marked area as hyaluronidase 1500 IU hours for 48 hours. • Teniposide soon as possible in 2-5 mL of sterile * There have been some • Topotecan (ideally within 10 to 25 water or sodium clinical reports of positive minutes) and continue chloride 0.9% • Trastuzumab outcomes with using emtansine* every 6 hours for 7 days • Administer hyaluronidase as an - use a cotton bud or hyaluronidase solution antidote for paclitaxel • Zoledronic acid swab stick that has subcutaneously in 0.2 extravasation. If been soaked in to 0.4 mL volumes hyaluronidase is DMSO 99% solution around the marked area administered, no OR using the “pin cushion” compress is Localise - a glass dropper (4 technique at “2 hourly recommended. drops of DMSO 99% • Apply a COLD 2 intervals” on an solution per 10 cm of imaginary “clock face” compress to the affected area) affected area for • Gently massage area to comfort measures • Ensure skin is dry facilitate dispersal before applying DMSO only. 99% solution (to • Apply a WARM * There is no evidence for prevent blistering) compress to affected the use of either warm or area for 15 to 20 • Allow to air dry and do cold compress for minutes every 6 hours trastuzumab emtansine. not cover with a for 48 hours dressing • Elevate limb • Apply a COLD compress to the affected area for 15 to 20 minutes every 6 Consider referral to plastic surgeon hours for 48 hours • Elevate limb • Complete Antineoplastic Drug Extravasation Assessment Tool and incident form as per individual institutional guidelines *For large volume • Referral for an urgent surgical review should be discussed and organised if appropriate anthracycline • Educate patient and provide information with appropriate treatment guidelines including signs and symptoms to monitor for and extravasations consider when to present to emergency dexrazoxane (must be • Arrange patient follow up appointments to ensure extravasation injury is reviewed regularly – ranging from hours to weekly – based administered within 6 upon agent extravasated and degree of extravasation hours). Refer to • Replace items in the extravasation kit including drugs from pharmacy if required supporting document for • Please refer to the Supporting Document – ID 157 Extravasation Management for a comprehensive list of the references used to further information. develop this flow chart. Cancer Institute NSW cancer.nsw.gov.au t +61 (0)2 8374 5600 f +61 (0)2 8374 3600 e [email protected] © Cancer Institute NSW 2019. While every effort has been made to provide accurate information, this document is not intended as a substitute for medical advice. Contact your doctor if you have any concerns..
Load more

Recommended publications
  • MASCC/ESMO ANTIEMETIC GUIDELINE 2016 with Updates in 2019
    1 ANTIEMETIC GUIDELINES: MASCC/ESMO MASCC/ESMO ANTIEMETIC GUIDELINE 2016 With Updates in 2019 Organizing and Overall Meeting Chairs: Matti Aapro, MD Richard J. Gralla, MD Jørn Herrstedt, MD, DMSci Alex Molassiotis, RN, PhD Fausto Roila, MD © Multinational Association of Supportive Care in CancerTM All rights reserved worldwide. 2 ANTIEMETIC GUIDELINES: MASCC/ESMO These slides are provided to all by the Multinational Association of Supportive Care in Cancer and can be used freely, provided no changes are made and the MASCC and ESMO logos, as well as date of the information are retained. For questions please contact: Matti Aapro at [email protected] Chair, MASCC Antiemetic Study Group or Alex Molassiotis at [email protected] Past Chair, MASCC Antiemetic Study Group 3 ANTIEMETIC GUIDELINES: MASCC/ESMO Consensus A few comments on this guideline set: • This set of guideline slides represents the latest edition of the guideline process. • This set of slides has been endorsed by the MASCC Antiemetic Guideline Committee and ESMO Guideline Committee. • The guidelines are based on the votes of the panel at the Copenhagen Consensus Conference on Antiemetic Therapy, June 2015. • Latest version: March 2016, with updates in 2019. 4 ANTIEMETIC GUIDELINES: MASCC/ESMO Changes: The Steering Committee has clarified some points: 2016: • A footnote clarified that aprepitant 165 mg is approved by regulatory authorities in some parts of the world ( although no randomised clinical trial has investigated this dose ). Thus use of aprepitant 80 mg in the delayed phase is only for those cases where aprepitant 125 mg is used on day 1. • A probable modification in pediatric guidelines based on the recent Cochrane meta-analysis is indicated.
    [Show full text]
  • A Phase II Study on the Role of Gemcitabine Plus Romidepsin
    Pellegrini et al. Journal of Hematology & Oncology (2016) 9:38 DOI 10.1186/s13045-016-0266-1 RESEARCH Open Access A phase II study on the role of gemcitabine plus romidepsin (GEMRO regimen) in the treatment of relapsed/refractory peripheral T-cell lymphoma patients Cinzia Pellegrini1, Anna Dodero2, Annalisa Chiappella3, Federico Monaco4, Debora Degl’Innocenti2, Flavia Salvi4, Umberto Vitolo3, Lisa Argnani1, Paolo Corradini2, Pier Luigi Zinzani1* and On behalf of the Italian Lymphoma Foundation (Fondazione Italiana Linfomi Onlus, FIL) Abstract Background: There is no consensus regarding optimal treatment for peripheral T-cell lymphomas (PTCL), especially in relapsed or refractory cases, which have very poor prognosis and a dismal outcome, with 5-year overall survival of 30 %. Methods: A multicenter prospective phase II trial was conducted to investigate the role of the combination of gemcitabine plus romidepsin (GEMRO regimen) in relapsed/refractory PTCL, looking for a potential synergistic effect of the two drugs. GEMRO regimen contemplates an induction with romidepsin plus gemcitabine for six 28-day cycles followed by maintenance with romidepsin for patients in at least partial remission. The primary endpoint was the overall response rate (ORR); secondary endpoints were survival, duration of response, and safety of the regimen. Results: The ORR was 30 % (6/20) with 15 % (3) complete response (CR) rate. Two-year overall survival was 50 % and progression-free survival 11.2 %. Grade ≥3 adverse events were represented by thrombocytopenia (60 %), neutropenia (50 %), and anemia (20 %). Two patients are still in CR with median response duration of 18 months. The majority of non-hematological toxicities were mild and transient.
    [Show full text]
  • Combining Paclitaxel and Lapatinib As Second-Line Treatment for Patients with Metastatic Transitional Cell Carcinoma: a Case Series
    ANTICANCER RESEARCH 32: 3949-3952 (2012) Combining Paclitaxel and Lapatinib as Second-line Treatment for Patients with Metastatic Transitional Cell Carcinoma: A Case Series STÉPHANE CULINE, ZINEB SELLAM, LINDA BOUAITA, ELIAS ASSAF, CATHERINE DELBALDO, MURIEL VERLINDE-CARVALHO and DAMIEN POUESSEL Department of Medical Oncology, Henri Mondor Hospital, Créteil, France Abstract. Background: Current first-line cisplatin-based trial comparing vinflunine with best supportive care (BSC) combination chemotherapy regimens provide interesting to BSC alone, an estimated difference in overall survival response rates but limited impact on survival for patients with (OS) of 2 months was reached in the intent-to-treat metastatic transitional cell carcinoma of the urothelium. Such population. However, a significant difference in OS was only results leave a significant patient population in need of salvage seen after removing patients who had major protocol therapy. Patients and Methods: As the epidermal growth factor violations (2). Therefore therapy for patients who fail first- receptors 1 and 2 (EGFR and HER2) are frequently line cisplatin-based chemotherapy remains a highly unmet overexpressed in urothelial carcinoma, we explored the medical need. feasibility of a combination of paclitaxel (80 mg/m2/week) and In a phase II study led by the French Genito-Urinary lapatinib (1,500 mg orally daily) for six patients who were Tumor group (GETUG), the activity of weekly paclitaxel as treated after failure of first-line platinum-based chemotherapy. second-line chemotherapy was assessed in 45 patients with Results: Only one out of six patients was able to receive the MTCCU. A low objective response rate (9%) along with a full doses during the first six weeks of treatment, while grade high rate of stabilization (38%) suggested limited impact as 2 or 3 diarrhea events required lapatinib dose reduction (one a single agent (3).
    [Show full text]
  • CTCL Treatment Algorithms How I Treat Advanced Stage CTCL
    CTCL Treatment Algorithms How I treat advanced stage CTCL Francine Foss MD Professor of Medicine Hematology and Bone Marrow Transplantation Yale University School of Medicine New Haven, CT USA DISCLOSURES • SEATTLE GENETICS, SPECTRUM- consultant, speaker • MIRAGEN- consultant • MALLINRODT- consultant • KYOWA – investigator, consultant WHO-EORTC Classification of Cutaneous T-cell and NK Lymphomas- Incidence in US by SEER Registry Data Mycosis fungoides MF variants and subtypes (3836) Folliculotropic MF Pagetoid reticulosis Granulomatous slack skin Sézary syndrome (117) Adult T-cell leukemia/lymphoma Primary cutaneous CD30+ lymphoproliferative disorders (858) Primary cutaneous anaplastic large cell lymphoma Lymphomatoid papulosis Subcutaneous panniculitis-like T-cell lymphoma Extranodal NK/T-cell lymphoma, nasal type Primary cutaneous peripheral T-cell lymphoma, pleomorphic (1840) Primary cutaneous aggressive epidermotropic CD8+ T-cell lymphoma (provisional) Cutaneous γ/δ T-cell lymphoma Willemze R, et al. Blood. 2005;105:3768-3785. Skin manifestations and outcomes Patches, papules and T1 plaques covering < 10% of the skin T1 surface Patches, papules or T2 plaques covering ≥ T3 10% of the skin surface Tumors (≥ 1) T3 T2 Confluence of T4 erythematous lesions covering ≥ 80% BSA Skin stage 10 Yr relative survival T4 T1 100 % T2 67 % T3 39 % T4 41 % *Observed/expected survival x 100 for age-, sex-, and race- matched controls Zackheim HS, et al. J Am Acad Dermatol. 1999;40:418-425. Revisions to TNMB Classification, ISCL/EORTC Consensus Document
    [Show full text]
  • Istodax Refusal AR EPAR Final
    15 November 2012 EMA/CHMP/27767/2013 Committee for Medicinal Products for Human Use (CHMP) Assessment report Istodax International non-proprietary name: romidepsin Procedure No. EMEA/H/C/002122 Note Assessment report as adopted by the CHMP with all information of a commercially confidential nature deleted. 7 Westferry Circus ● Canary Wharf ● London E14 4HB ● United Kingdom Telep one +44 (0)20 7418 8400 Facsimile +44 (0)20 7523 7455 E -mail [email protected] Website www.ema.europa.eu An agency of the European Union Product information Name of the medicinal product: Istodax Applicant: Celgene Europe Ltd. 1 Longwalk Road Stockley Park UB11 1DB United Kingdom Active substance: romidepsin International Nonproprietary Name/Common Name: romidepsin Pharmaco-therapeutic group Other antineoplastic agents (ATC Code): (L01XX39) Treatment of adult patients with peripheral T-cell Therapeutic indication: lymphoma (PTCL) that has relapsed after or become refractory to at least one prior therapy Pharmaceutical forms: Powder and solvent for concentrate for solution for infusion Strength: 5 mg/ml Route of administration: Intravenous use Packaging: powder: vial (glass); solvent: vial (glass) Package sizes: 1 vial + 1 vial Istodax CHMP assessment report Page 2/92 Table of contents 1. Background information on the procedure .............................................. 7 1.1. Submission of the dossier ...................................................................................... 7 Information on Paediatric requirements ........................................................................
    [Show full text]
  • ISTODAX (Romidepsin) Must Be Fetus [See Use in Specific Populations (8.1)]
    HIGHLIGHTS OF PRESCRIBING INFORMATION • Electrocardiographic (ECG) changes have been observed. Consider These highlights do not include all the information needed to use cardiovascular monitoring precautions in patients with congenital long ISTODAX safely and effectively. See full prescribing information for QT syndrome, a history of significant cardiovascular disease, and ISTODAX. patients taking medicinal products that lead to significant QT prolongation (5.3). ISTODAX® (romidepsin) for injection • Based on its mechanism of action, ISTODAX may cause fetal harm For intravenous infusion only when administered to a pregnant woman. Advise women of potential Initial US Approval: 2009 harm to the fetus (5.4, 8.1). • ISTODAX binds to estrogen receptors. Advise women of childbearing ---------------------------INDICATIONS AND USAGE---------------------------- potential that ISTODAX may reduce the effectiveness of estrogen- containing contraceptives (5.5). ISTODAX is a histone deacetylase (HDAC) inhibitor indicated for: • Treatment of cutaneous T-cell lymphoma (CTCL) in patients who have -------------------------------ADVERSE REACTIONS------------------------------ received at least one prior systemic therapy (1). The most common adverse reactions in Study 1 were nausea, fatigue, infections, vomiting, and anorexia, and in Study 2 were nausea, fatigue, -----------------------DOSAGE AND ADMINISTRATION----------------------- anemia, thrombocytopenia, ECG T-wave changes, neutropenia, and • 14 mg/m2 administered intravenously (IV) over a 4-hour period on days lymphopenia (6). 1, 8 and 15 of a 28-day cycle. Repeat cycles every 28 days provided that the patient continues to benefit from and tolerates the drug (2.1). To report SUSPECTED ADVERSE REACTIONS, contact Gloucester • Treatment discontinuation or interruption with or without dose reduction Pharmaceuticals, Inc. at 1-866-223-7145 or the FDA at 1-800-FDA-1088 to 10 mg/m2 may be needed to manage adverse drug reactions (2.2).
    [Show full text]
  • BC Cancer Benefit Drug List September 2021
    Page 1 of 65 BC Cancer Benefit Drug List September 2021 DEFINITIONS Class I Reimbursed for active cancer or approved treatment or approved indication only. Reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to Restricted Funding (R) provide the appropriate clinical information for each patient. NOTES 1. BC Cancer will reimburse, to the Communities Oncology Network hospital pharmacy, the actual acquisition cost of a Benefit Drug, up to the maximum price as determined by BC Cancer, based on the current brand and contract price. Please contact the OSCAR Hotline at 1-888-355-0355 if more information is required. 2. Not Otherwise Specified (NOS) code only applicable to Class I drugs where indicated. 3. Intrahepatic use of chemotherapy drugs is not reimbursable unless specified. 4. For queries regarding other indications not specified, please contact the BC Cancer Compassionate Access Program Office at 604.877.6000 x 6277 or [email protected] DOSAGE TUMOUR PROTOCOL DRUG APPROVED INDICATIONS CLASS NOTES FORM SITE CODES Therapy for Metastatic Castration-Sensitive Prostate Cancer using abiraterone tablet Genitourinary UGUMCSPABI* R Abiraterone and Prednisone Palliative Therapy for Metastatic Castration Resistant Prostate Cancer abiraterone tablet Genitourinary UGUPABI R Using Abiraterone and prednisone acitretin capsule Lymphoma reversal of early dysplastic and neoplastic stem changes LYNOS I first-line treatment of epidermal
    [Show full text]
  • Romidepsin (Istodax) Reference Number: ERX.SPA
    Clinical Policy: Romidepsin (Istodax) Reference Number: ERX.SPA. 267 Effective Date: 12.01.18 Last Review Date: 11.20 Line of Business: Commercial, Medicaid Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description Romidepsin (Istodax®) is a histone deacetylase inhibitor. FDA Approved Indication(s) Istodax is indicated for the treatment of: • Cutaneous T-cell lymphoma (CTCL) in adult patients who have received at least one prior systemic therapy; • Peripheral T-cell lymphoma (PTCL) in adult patients who have received at least one prior therapy. o This indication is approved under accelerated approval based on response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. Policy/Criteria Provider must submit documentation (such as office chart notes, lab results or other clinical information) supporting that member has met all approval criteria. Health plan approved formularies should be reviewed for all coverage determinations. Requirements to use preferred alternative agents apply only when such requirements align with the health plan approved formulary. It is the policy of health plans affiliated with Envolve Pharmacy Solutions™ that Istodax and romidepsin injection solution are medically necessary when the following criteria are met: I. Initial Approval Criteria A. Cutaneous T-Cell Lymphoma (must meet all): 1. Diagnosis of CTCL (see Appendix D for examples of CTCL subtypes); 2. Prescribed by or in consultation with an oncologist or hematologist; 3. Age ≥ 18 years; 4. Request meets one of the following (a or b):* a. Dose does not exceed 14 mg/m2 for three days of a 28-day cycle; b.
    [Show full text]
  • Transitional Cell Carcinoma: Options Beyond Nsaids Julie Marie Gillem, DVM, DACVIM (Oncology) Overview
    Transitional Cell Carcinoma: Options Beyond NSAIDs Julie Marie Gillem, DVM, DACVIM (Oncology) Overview ✦ Background ✦ Surgical Options ✦ Pathology ✦ Medical Options ✦ Location and staging ✦ Radiation Therapy ✦ Behavior Options ✦ Etiology and risk factors ✦ Palliative care ✦ Work up and diagnosis ✦ What about cats? Objectives ✦ How do we determine when NSAIDs fail? ✦ When should we intervene with surgery, chemotherapy, radiation therapy, and additional palliative care? Pathology ✦ ~2% of canine cancer ✦ Invasive transitional cell carcinoma (TCC) most common ✦ Others: SCC, adenocarcinoma, undifferentiated carcinoma, rhabdomyosarcoma, fibroma, and other mesenchymal tumors Location and Staging ✦ TCC in dogs most often found in the trigone of the bladder ✦ Series of 102 dogs at PUVTH ✦ Urethra and bladder in 56% ✦ Prostate involvement in 29% male dogs ✦ Lymph node mets in 16% at diagnosis ✦ Distant mets in 14% at diagnosis ✦ Distant mets in 50% at death Location ✦ TCC in dogs most often is found in the trigone region of the bladder. ✦ In a series of dogs with TCC examined at the PUVTH, the tumor involved the urethra as well as the bladder in 57 of 102 dogs (56%), and it involved the prostate in 11 of 38 (29%) male dogs. WHO Staging ✦ 78% T2 tumors ✦ 20% T3 tumors Biological Behavior ✦ At diagnosis: ✦ Regional lymph node metastasis in 12-46 % (Norris et al 1992, Knapp et al 2000, Blackburn et al 2013) ✦ Distant metastasis in 16- 23% (Norris et al 1992, Blackburn et al 2013) ✦ Distant metastasis in 50% at death (Norris et al 1992, Knapp et al
    [Show full text]
  • Peripheral T-Cell Lymphomas
    Critical Reviews in Oncology/Hematology 99 (2016) 214–227 CORE Metadata, citation and similar papers at core.ac.uk Provided by Elsevier - Publisher Connector Contents lists available at ScienceDirect Critical Reviews in Oncology/Hematology jo urnal homepage: www.elsevier.com/locate/critrevonc Panoptic clinical review of the current and future treatment of relapsed/refractory T-cell lymphomas: Peripheral T-cell lymphomas a,∗ b c c d Pier Luigi Zinzani , Vijayveer Bonthapally , Dirk Huebner , Richard Lutes , Andy Chi , e,f Stefano Pileri a Institute of Hematology ‘L. e A. Seràgnoli’, Policlinico Sant’Orsola-Malpighi, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy b 1 Global Outcomes and Epidemiology Research (GOER), Millennium Pharmaceuticals Inc., 40 Lansdowne Street, Cambridge, MA 02139, USA c 1 Oncology Clinical Research, Millennium Pharmaceuticals Inc., 35 Lansdowne Street, Cambridge, MA 02139, USA d 1 Department of Biostatistics, Millennium Pharmaceuticals Inc., 40 Lansdowne Street, Cambridge, MA 02139, USA e Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Via Massarenti 8, 40138 Bologna, Italy f Unit of Hematopathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy Contents 1. Introduction . 214 2. Methodology. .215 3. Treatment of relapsed/refractory PTCL . 215 3.1. Conventional chemotherapy in relapsed/refractory PTCL. .215 3.2. Approved therapies in relapsed/refractory PTCL . 216 3.3. Investigational and off-label therapies in relapsed/refractory PTCL . 222 4. Concluding remarks . 224 Conflict of interest . 224 Funding . 224 Acknowledgments. .224 References . 224 Biography . 227 a r t i c l e i n f o a b s t r a c t Article history: Peripheral T-cell lymphomas (PTCLs) tend to be aggressive and chemorefractory, with about 70% of Received 29 June 2015 patients developing relapsed/refractory disease.
    [Show full text]
  • Oxaliplatin, 5-Fluorouracil and Leucovorin (FOLFOX) As Second- Line Therapy for Patients with Advanced Urothelial Cancer
    www.impactjournals.com/oncotarget/ Oncotarget, Vol. 7, No. 36 Clinical Research Paper Oxaliplatin, 5-fluorouracil and leucovorin (FOLFOX) as second- line therapy for patients with advanced urothelial cancer Sheng Zhang1, Hongxi Xue2, Qiang Chen3 1Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China 2Rizhao City Hospital of Traditional Chinese Medicine, Rizhao, China 3Department of Clinical Biochemistry, School of Public Health, Taishan Medical University, Tai’an, China Correspondence to: Sheng Zhang, email: [email protected] Keywords: urothelial cancer, oxaliplatin, leucovorin, 5-fluorouracil, clinical trial Received: February 08, 2016 Accepted: June 30, 2016 Published: July 07, 2016 ABSTRACT There is currently no standard treatment for metastatic urothelial cancer after failure of cisplatin-based therapy. The present retrospective study investigated the efficacy and safety of oxaliplatin plus 5-fluorouracil (5-FU) and leucovorin (LV) (FOLFOX) in locally advanced or metastatic urothelial cancer patients following cisplatin-based treatment. Thirty-three patients who had received one or two cisplatin-based regimens were treated with oxaliplatin (85 mg/m2) as a 2-h infusion on day 1, LV (200 mg/m2) as a 2-h infusion followed by bolus 5-FU (400 mg/m2) on day 1, or a 44-h continuous 5-FU (1,200 mg/m2) infusion. Patients were a mean of 67 years old with two involved organs. Metastases were mostly in the lung (43%), lymph nodes (51%) and liver (46%). Based on an intention-to-treat analysis, nine patients achieved a partial response, with an overall response rate of 27%. Eight (24%) patients had stable disease.
    [Show full text]
  • Maintenance Therapy in Lymphoma
    Getting the Facts Helpline: (800) 500-9976 [email protected] Maintenance Therapy in Lymphoma Overview Maintenance therapy refers to the ongoing treatment of patients • What side effects might I experience? Are the side effects whose disease has responded well to frontline or firstline (initial) expected to increase as I continue on maintenance therapy? treatment. More and more cancer treatments have emerged that are • Does my insurance cover this treatment? effective at helping to place the cancer into remission (disappearance Is maintenance therapy better for me than active surveillance of signs and symptoms of lymphoma). Maintenance regimens are • followed by this same therapy if the lymphoma returns? used to keep the cancer in remission. Will the use of maintenance therapy have any impact on any Maintenance therapy typically consists of nonchemotherapy drugs • given at lower doses and longer intervals than those used during future therapies I may need? induction therapy (initial treatment). Depending on the type of Treatments Under Investigation lymphoma and the medications used, maintenance therapy may last for weeks, months, or even years. Brentuximab vedotin (Adcetris), Many agents are being studied in clinical trials as maintenance lenalidomide (Revlimid), and rituximab (Rituxan) are examples of therapy for different subtypes of lymphoma, either alone or as part of treatments used as maintenance therapy in various lymphomas. As a combination therapy regimen, including: new effective treatments with limited toxicity are developed, more • Bortezomib (Velcade) drugs are likely to be used as maintenance therapies. • Ibrutinib (Imbruvica) Although the medications used for maintenance treatments generally have fewer side effects than chemotherapy, patients may still • Ixazomib (Ninlaro) experience adverse events.
    [Show full text]