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New perspectives in oncology


Ray Fitzpatrick

Consultant Editor

In this edition of Hospital Pharmacy Europe we focus on oncology. It is not the first time the journal has given special attention to this subject, but this is not surprising given the fact that each year cancer is diagnosed in approximately nine million people and causes five million deaths worldwide. In developed countries it is the second main cause of death after cardiovascular disease and it is the cause of 10% of all deaths worldwide. However, on a more positive note it is estimated that about one-third of all cancers are ­preventable and one-third curable. Furthermore, mortality due to cancer has been falling in the USA over the last few years. In terms of prevention, lifestyle, diet and environmental factors are clearly important. ­However, it is the development of new treatment strategies that is central to the improved survival rates of those ­diagnosed with cancer.

Several articles in this issue focus on these new treatment strategies. Filippo Montemurro discusses the role of tyrosine kinase inhibitors in HER2-positive breast cancer, particularly where other treatments such as ­trastuzumab have failed. Ana Leandro and Gisela Costa clinically review cetuximab in irinotecan-­refractory colorectal cancer patients. Meanwhile, Giuseppe di Lorenzo discusses the status of therapeutic options in the management of hormone refractory prostate cancer and Dirk Bauerschlag et al describe the use of liposomal doxorubicin in advanced ovarian cancer.

One of the strengths of Hospital Pharmacy Europe is its breadth of coverage, and although this edition focuses on cancer, it links this with the care of the patient as a whole. Examples of this holistic approach include the articles by Lisa Schulmeister on dexrazoxane in treating anthracycline extravasation, and by George Rodgers on the role of erythropoietin-stimulating agents in anaemia of cancer.

In a previous edition of Hospital Pharmacy Europe, I highlighted the strengths of the pharmacist’s broad-based scientific education. In the current edition, this sound scientific background comes to the fore once again, as we have a number of articles with a scientific theme directed at the safety of staff caring for cancer patients. Healthcare workers can easily become exposed to cytotoxics when caring for patients, and this fact is highlighted in Yaakov Cass and Menahem Kraus’s article on using a closed system to prevent occupational exposure to cytotoxics during preparation. Paolo Baldo and Renzo Lazzarini present an overview of specific sources of information and international documents on the safe handling of cytotoxic and hazardous drugs, whilst Roberta Turci’s article describes the development of various analytical methods for the determination of cytotoxics in environmental and biological samples.

The richness of this mixture of science, therapeutics and clinical knowledge indicates the importance of the role hospital pharmacists play in medicines management. The latter is often considered primarily in the ­context of prescription of medicines. However, the content of this issue of Hospital Pharmacy Europe reminds us that there is more to medicines management than this: it is about safe, rational and cost-effective ­prescribing, but also the safe and secure handling of medicines throughout the medicines supply chain.

Our strength as hospital ­pharmacists lies in the breadth and depth of knowledge we possess on all aspects of medicines use. We must strive to maintain that breadth of expertise within our workforce so we can ensure that patients get the best treatment and staff are protected from the potential adverse effects of these ­treatments.

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