ESMO open
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Cardiac toxicity after conventional antineoplastic drugs (eg, anthracyclines) has historically been a relevant issue. In addition, targeted therapies and biological molecules can also induce cardiotoxicity. Immune checkpoint inhibitors are a novel class of anticancer drugs, distinct from targeted or tumour type-specific therapies. ⋯ Here we describe the mechanisms of the most prominent checkpoint inhibitors, specifically ipilimumab (anti-CTLA-4, the godfather of checkpoint inhibitors) patient and monoclonal antibodies targeting PD-1 (eg, nivolumab, pembrolizumab) and PD-L1 (eg, atezolizumab). We also discuss what is known and what needs to be done about cardiotoxicity of checkpoint inhibitors in patients with cancer. Severe cardiovascular effects associated with checkpoint blockade introduce important issues for oncologists, cardiologists and immunologists.
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Chemotherapy (CT) in patients with advanced cancer (ACP) near the end of life is an increasing practice of oncology units. A closer integration with palliative care (PC) services could reduce the use of potentially harmful CT. This prospective study is aimed at assessing whether a more integrated care model could reduce CT use near the end of life and increase local PC service utilisation. ⋯ The implementation of an initial in-hospital consultation of oncologists and experienced home PC teams has not reduced the use of CT near the end of life but increased PC service utilisation and reduced in-hospital deaths.
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Various drugs are administered for the management of chemotherapy-induced peripheral neuropathy (CIPN) in Japan. However, there have been no surveys undertaken to identify these drugs or their frequency of prescription. Therefore, we administered a questionnaire survey to the diplomates of the Subspecialty Board of Japanese Society of Medical Oncology (JSMO) to investigate the frequency of administration of different drugs for the management of CIPN in Japan. ⋯ Various drugs are frequently administered for CIPN. In addition, it was found that marked differences exist between the drugs targeted on numbness and pain.