Management of ibrutinib treatment in patients with B-cell malignancies: clinical practice in Portugal and multidisciplinary recommendations.

Autor: Carda JP; Serviço de Hematologia Clínica, Faculdade de Medicina da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal., Santos L; Centro Hospitalar Universitário de São João, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.; Nephrology and Infectious Diseases R&D, I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal., Mariz JM; Onco-Haematology Clinic, Instituto Português de Oncologia do Porto, EPE/IPOFG - CRO, Porto, Portugal., Monteiro P; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Gonçalves HM; Serviço Farmacêutico, Instituto Português de Oncologia de Lisboa, Francisco Gentil, Lisboa, Portugal., Raposo J; Centro Hospitalar Universitário Lisboa Norte, EPE, Lisboa, Portugal., Gomes da Silva M; Instituto Português de Oncologia de Lisboa, Francisco Gentil, EPE, Lisbon, Portugal.
Jazyk: angličtina
Zdroj: Hematology (Amsterdam, Netherlands) [Hematology] 2021 Dec; Vol. 26 (1), pp. 785-798.
DOI: 10.1080/16078454.2021.1980690
Abstrakt: Objectives: Ibrutinib, a potent inhibitor of the Bruton tyrosine kinase, has revolutionized the treatment of many B-cell malignancies. Ibrutinib has an established favorable toxicity profile with up to 8 years of experience in clinical trials; however, despite ibrutinib's favorable toxicity profile, dose reductions and treatment discontinuations are becoming more evident in clinical practice, particularly in the setting of specific clinical contexts and patient characteristics. This manuscript is set to provide practical recommendations on the management of patients treated with this agent in daily practice.
Methods: A group of multidisciplinary experts from Portugal met to discuss and highlight practical recommendations, supported on both literature and clinical insights, for the management of the treatment with ibrutinib.
Results/discussion: Handling of both toxicities and drug-drug interactions during ibrutinib treatment poses several challenges to healthcare providers and can benefit from a multidisciplinary approach. The involvement of specialties, such as cardiology, infectiology and pharmacology, can bring an added value to patient care, not only in anticipating/managing safety issues and dose adjustments but also in enhancing adherence to treatment, ultimately improving the risk/benefit balance.
Conclusion: By involving a multidisciplinary group of experts, this work provides a set of key recommendations to optimize care and outcomes for ibrutinib-treated patients. Despite not being a fully comprehensive review on the topic, it is intended as a framework to hematologists and other healthcare professionals who manage these patients in their daily clinical practice.
Databáze: MEDLINE
Externí odkaz: