A Study on Lung Cancer Chemotherapy Regimen Administration at Universitas Gadjah Mada Academic Hospital

Efel Erlambang Oktariyanto; Nanang Munif Yasin; Ika Puspitasari

doi:10.22146/ahj.v6i2.99663

A Study on Lung Cancer Chemotherapy Regimen Administration at Universitas Gadjah Mada Academic Hospital

https://doi.org/10.22146/ahj.v6i2.99663

Efel Erlambang Oktariyanto⁽¹⁾, Nanang Munif Yasin⁽²⁾, Ika Puspitasari^(3*)

(1) Faculty of Pharmacy, UGM
(2) Faculty of Pharmacy, UGM
(3) Department of Pharmacology& Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta Academic Hospital UGM
(*) Corresponding Author

Abstract

Background: One of the main ways to treat lung cancer is through chemotherapy regimens. Due to the complexity of lung cancer pathophysiology, the variability of chemotherapy given tends to cause drug interactions and toxicity in patients.

Objective: Based on this, this study aims to determine the characteristics of lung cancer patients and identify chemotherapy administration patterns based on the NCCN therapy guidelines, identify interactions and side effects of chemotherapy that occur in patients diagnosed with lung cancer who are undergoing outpatient therapy at the Universitas Gadjah Mada Academic Hospital.

Method: This research was carried out with a case-series design, namely by conducting a study using descriptive methods that provide an overview of patient characteristics, chemotherapy regimen patterns and their conformity to NCCN guidelines, potential drug-drug interactions (DDIs), and the incidence of side effects experienced by patients. Data was collected retrospectively through medical records of lung cancer patients undergoing outpatient treatment in the period April 2022 – April 2023 who met the inclusion and exclusion criteria.

Result: There were a total of 27 patients in this study with patient characteristics predominantly in the elderly age range (> 60 years), 18 patients (66.7%), with exon 19 mutation NSCLC lung cancer type (n = 13; 92.6%), stage IV (n = 25 ; 92.6%), as well as non-smoking patients (n = 15 ; 55.6%). Chemotherapy regimen patterns at Gadjah Mada University Academic Hospital for lung cancer patients included afatinib (n = 14; 51.9%), gefitinib (n = 12; 44.4%), and cisplatin pemetrexed (n = 1; 3.7 %) with conformity reaching 100% in the accuracy of indications, dosage and usage information. In this study, it was identified that there were 2 Potential DDIs that occurred in 1 patient (3.7%) with respective risks, namely C and B which included cisplatin-furosemide and cisplatin-ondansetron interactions. Side effects were known to occur in almost all patients (n = 23; 85.2%) where side effects in the form of skin toxicity and diarrhoea were the two most frequently identified types of side effects with a percentage of 59.3% (n = 16). and 40.7% (n = 11).

Conclusion: More than 90% of NSCLC showed exon 19 mutation. The most chemotherapy given to the patients was afatinib. There were a potential interaction between cisplatin and either furosemide or ondansetron.

Keywords

Chemotherapy Regimen; Lung Cancer; Tyrosine Kinase Inhibitors

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References

REFERENCES 1. Boucher, J., Olson, L., & Piperdi, B. (2011). Preemptive management of dermatologic toxicities associated with epidermal growth factor receptor inhibitors. Clinical journal of oncology nursing, 15(5). (n.d.). 2. Brown, T. J., & Gupta, A. (2020). Management of Cancer Therapy–Associated Oral Mucositis. JCO Oncology Practice, 16(3), 103–109. https://doi.org/10.1200/JOP.19.00652 3. Dela Cruz, C. S., Tanoue, L. T., & Matthay, R. A. (2011). Lung cancer: Epidemiology, etiology, and prevention. Clinics in Chest Medicine, 32(4), 605–644. https://doi.org/10.1016/j.ccm.2011.09.001 4. Ergun, Yakup & Yıldırım Özdemir, Nuriye & Toptas, Serife & Kurti̇pek, Ali̇can & Eren, Tulay & yazıcı, Ozan & Sendur, Mehmet & Akıncı, Muhammed & Uçar, Gökhan & Oksuzoglu, Berna & Uncu, Dogan. (2019). Drug-drug interactions in patients using tyrosine kinase inhibitors: A multicenter retrospective study. Journal of B.U.ON.: official journal of the Balkan Union of Oncology. 24. 1719-1726. 5. Gondhowiardjo, S., et al, et al, & et al, et al.,, (n.d.). Gondhowiardjo, S., Nurhidayat, W., Zhafirah, N. F., Jayalie, V. F., Sekarutami, S. M. ., Priharto, R. K., & Widyastuti, W. (2023). Cancer Profile in Jakarta: A 5-year Descriptive Study. Open Access Macedonian Journal of Medical Sciences, 11(E), 17–22 6. Hanafi, A. R., Hanif, M. A., Pangaribuan, M. T. G., Ariawan, W. P., Sutandyo, N., Kurniawati, S. A., Setiawan, L., Cahyanti, D., Rayhani, F., & Imelda, P. (2024). BMC Pulmonary Medicine, 24(1), 43 7. International Agency For Research on Cancer. (2020). Indonesia. https://gco.iarc.fr/today/data/factsheets/populations/360-indonesia-fact- sheets.pdf 8. IRESSA, 2019, Gefitinib Assessment Report. Retrieved Mei, 2024, from https://registrasiobat.pom.go.id/daftar-produk/assesment-report/DKI1235300217A1 9. Jayanti E., 2013, Evaluasi Penggunaan Kemoterapi Pada Pasien Kanker Paru di Instalasi Rawat Inap RS”X”, Skripsi, Fakultas Farmasi Universitas Muhammadiyah Surakarta 10. KEMENKES, 2024, Profil Rumah Sakit. RS Online (kemkes.go.id) accessed 05 Juni 2024 11. Lam, D. C.-L., Liam, C.-K., Andarini, S., Park, S., Tan, D. S. W., Singh, N., Jang, S. H., Vardhanabhuti, V., Ramos, A. B., Nakayama, T., Nhung, N. V., Ashizawa, K., Chang, Y.-C., Tscheikuna, J., Van, C. C., Chan, W. Y., Lai, Y.-H., & Yang, P.-C. (2023). Lung Cancer Screening in Asia: An Expert Consensus Report. Journal of Thoracic Oncology, 18(10), 1303–1322. https://doi.org/10.1016/j.jtho.2023.06.014 12. Laconi, E., Marongiu, F., & DeGregori, J. (2020). Cancer as a disease of old age: Changing mutational and microenvironmental landscapes. British Journal of Cancer, 122(7), 943–952. https://doi.org/10.1038/s41416-019-0721-1 13. Lexicomp. (2024). Afatinib : Drug information. UpToDate. Retrieved Mei, 2024 , from https://online.lexi.com/ 14. Lexicomp. (2024). Gefitinib: Drug information. UpToDate. Retrieved Mei, 2024, from https://online.lexi.com/ 15. Komite Penanggulangan Kanker Nasional. (2024). Kanker Paru. KEMENKES RI 16. National Comprehensive Cancer Network. (2023). Non Small Cell Lung cancer. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1450 17. National Comprehensive Cancer Network. (2024). Small Cell Lung Cancer. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1462 18. Shyam Sunder, S., Sharma, U. C., & Pokharel, S. (2023). Adverse effects of tyrosine kinase inhibitors in cancer therapy: Pathophysiology, mechanisms and clinical management. Signal Transduction and Targeted Therapy, 8(1), 262. https://doi.org/10.1038/s41392-023-01469-6 19. Venuta, F., Diso, D., Onorati, I., Anile, M., Mantovani, S., & Rendina, E. A. (2016). Lung cancer in elderly patients. Journal of Thoracic Disease, 8(Suppl 11), S908–S914. https://doi.org/10.21037/jtd.2016.05.20 20. Wulandari, L., Febriani, A., Fatmawati, F., & Soegiarto, G. (2018). Evaluation of Patients with Lung Cancer Treated with Epidermal Growth Factor Receptor–Tyrosine Kinase Inhibitor. Asian Journal of Oncology, 04, 048– 053. https://doi.org/10.1055/s-0038-1676872 21. WHO. (2020). Indonesia Cancer Country Profile. https://www.who.int/publicati 22. Zhang, P., Chen, P.-L., Li, Z.-H., Zhang, A., Zhang, X.-R., Zhang, Y.-J., Liu, D., & Mao, C. (2022). Association of smoking and polygenic risk with the incidence of lung cancer: A prospective cohort study. British Journal of Cancer, 126(11), 1637–1646. https://doi.org/10.1038/s41416-022-01736-3

DOI: https://doi.org/10.22146/ahj.v6i2.99663