Laura Boehnke Michaud, PharmD

Ipilimumab (Yervoy, Bristol-Myers Squibb) is a recombinant, human monoclonal antibody which binds to cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4). CTLA-4 functions as a negative regulator of T-cell activation, and, when bound to a specific receptor on antigen-presenting cells, sends inhibitory signals that downregulate T-cell activation. Ipilimumab is an IgG1 kappa immunoglobulin which blocks the inhibitory signal of CTLA-4, allowing T-cell activation and proliferation to persist.

During the past several decades, significant advances in breast cancer management have led to increased OS for patients with this disease.

The year 2010 was an encouraging time for prostate cancer patients, as significant strides in research led to the FDA approval of two new agents, sipuleucel-T and cabazitaxel.

Tamoxifen has been used for the treatment of hormone receptor-positive breast cancer for more than 3 decades.

Appropriate drug dosing requires an estimation of kidney function that is reliable and consistent across many clinical scenarios and laboratory settings. Historically, many methods have been utilized to estimate renal function, all of which have advantages and disadvantages.

Angiogenesis has long been recognized as an important target for anticancer therapy. During the last decade, several new targeted therapies have been developed and demonstrate clinical efficacy in a variety of cancers — for example, renal cell, lung, breast and colon cancers.

During the past several years, the Oncology Nursing Society developed and maintained Chemotherapy and Biotherapy Guidelines and Recommendations for Practice, providing a unique and vital source of authoritative information for practicing oncology clinicians specifically related to complications of anticancer drug administration. In March, the third edition of this guideline was published, including updated information on management of extravasations.

Over the past two decades, serotonin antagonists have revolutionized the way we prevent and manage chemotherapy-induced nausea and vomiting, among other types of nausea/vomiting, with few serious adverse effects.

Oral chemotherapy drug development has significantly increased during the past several years and is anticipated to continue to grow, with an estimated one quarter of the 400 antineoplastics in the pipeline planned as oral drugs. Cancer patients currently have increasingly diverse treatment options comprised of oral therapy, intravenous therapy or both. This new treatment paradigm is shifting treatment responsibility from the medical infusion facilities and physician’s offices into the patient’s home. Many institutions and prescribers are realizing our health care system is unprepared to handle the challenges associated with oral treatment regimens and incorporating these agents into regimens, both alone and with intravenous therapies poses numerous risks to the patients.

Since being used for chemical warfare in the First World War, alkylating agents have become the workhorses of therapy for a wide variety of malignancies. Although this class of agents includes many drugs with differing chemical structures, they generally have a similar mechanism of action, which is to bind directly to DNA, leading to cross-linking and breaking DNA strands, preventing cell division and ultimately leading to cell death. Resistance to alkylating agents occurs through several well-described mechanisms, including enhanced DNA repair mechanisms, decreased activation by cytochrome P450 enzymes, increased deactivation through enzymes such as aldehyde dehydrogenases (ALDHs), increased cellular thiol levels, and an altered cellular apoptotic response to DNA repair.