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癌症、免疫抑制与 2019 冠状病毒病(COVID-19):需要管理药物安全性(法国肿瘤药学学会 [SFPO] 指南)。

Cancer, immune suppression and Coronavirus Disease-19 (COVID-19): Need to manage drug safety (French Society for Oncology Pharmacy [SFPO] guidelines).

机构信息

Department of Pharmacy, CHU Reims, France; Faculty of Pharmacy, Université de Reims Champagne-Ardenne, 51100 Reims, France.

Department of Pharmacy, Groupement Hospitalier Sud - Hospices Civils de Lyon, Lyon, France.

出版信息

Cancer Treat Rev. 2020 Aug;88:102063. doi: 10.1016/j.ctrv.2020.102063. Epub 2020 Jun 23.

Abstract

The Coronavirus disease (COVID-19) pandemic is disrupting our health environment. As expected, studies highlighted the great susceptibility of cancer patients to COVID-19 and more severe complications, leading oncologists to deeply rethink patient cancer care. This review is dedicated to the optimization of care pathways and therapeutics in cancer patients during the pandemic and aims to discuss successive issues. First we focused on the international guidelines proposing adjustments and alternative options to cancer care in order to limit hospital admission and cytopenic treatment in cancer patients, most of whom are immunocompromised. In addition cancer patients are prone to polypharmacy, enhancing the risk of drug-related problems as adverse events and drug-drug interactions. Due to increased risk in case of COVID-19, we reported a comprehensive review of all the drug-related problems between COVID-19 and antineoplastics. Moreover, in the absence of approved drug against COVID-19, infected patients may be included in clinical trials evaluating new drugs with a lack of knowledge, particularly in cancer patients. Focusing on the several experimental drugs currently being evaluated, we set up an original data board helping oncologists and pharmacists to identify promptly drug-related problems between antineoplastics and experimental drugs. Finally additional and concrete recommendations are provided, supporting oncologists and pharmacists in their efforts to manage cancer patients and to optimize their treatments in this new era related to COVID-19.

摘要

冠状病毒病(COVID-19)大流行正在扰乱我们的健康环境。正如预期的那样,研究强调了癌症患者极易感染 COVID-19 和更严重的并发症,这促使肿瘤学家重新深入思考患者的癌症护理。这篇综述专门讨论了在大流行期间优化癌症患者的护理途径和治疗方法,并旨在讨论连续的问题。首先,我们关注了国际指南,这些指南提出了调整和替代癌症护理的方案,以限制癌症患者的住院治疗和细胞减少症的治疗,因为他们中的大多数人免疫功能低下。此外,癌症患者容易出现多种药物治疗,增加了药物相关问题的风险,如不良反应和药物相互作用。由于 COVID-19 的风险增加,我们报告了 COVID-19 与抗肿瘤药物之间所有药物相关问题的综合审查。此外,在缺乏针对 COVID-19 的批准药物的情况下,感染患者可能会被纳入评估新药的临床试验中,而对这些新药缺乏了解,特别是在癌症患者中。我们专注于目前正在评估的几种实验药物,建立了一个原始数据板,帮助肿瘤学家和药剂师迅速识别抗肿瘤药物和实验药物之间的药物相关问题。最后,我们提供了额外的具体建议,支持肿瘤学家和药剂师努力管理癌症患者,并在与 COVID-19 相关的新时代优化他们的治疗。

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