AimThis study comprehensively assesses the incidence and profiles of treatment-related adverse events (trAEs) of immune checkpoint inhibitor (ICI)-based therapies across cancer at various sites.MethodsWe systematically searched the PubMed, Embase, and Cochrane databases for trials investigating ICI-based therapies published between their inception and August 2023.ResultsIn total, 147 studies involving 45,855 patients met the inclusion criteria. Among them, patients treated with ICIs reported 39.8% and 14.9% of all-grade and grade ≥3 immune-related adverse events (irAEs), respectively. The most common all-grade irAEs were dermatological and gastrointestinal issues, diarrhea, and pruritus, whereas patients who received ICIs showed most common grade ≥3 irAEs, including gastrointestinal events, diarrhea, increased aspartate aminotransferase and alanine transaminase levels, and hepatic and dermatological events. The overall trAE incidence in patients treated with ICIs was 83.2% for all-grade trAEs and 38.2% for grade ≥3 trAEs. TrAE incidence was highest for patients treated with cytotoxic T lymphocyte antigen-4 inhibitors for all-grade and grade ≥3 trAEs, with incidences of 86.4% and 39.2%, respectively. ICIs combined with targeted therapy showed the highest all-grade and grade ≥3 trAEs, with incidences of 96.3% and 59.4%, respectively. The most common all-grade trAEs were anemia, decrease in white blood cell count, decrease in neutrophil count, nausea, fatigue, diarrhea, and alopecia; patients who received ICIs presented relatively high incidences of grade ≥3 trAEs.ConclusionThis study provided comprehensive data regarding irAEs and trAEs in patients receiving ICIs. These results should be applied in clinical practice to provide an essential reference for safety profiles of ICIs.Systematic review registrationINPLASY platform, identifier INPLASY202380119.

目的 探讨临床药师参与乳腺癌药物治疗管理的策略和关注点.方法 回顾分析2019年1月至2020年12月中国医学科学院北京协和医学院肿瘤医院内科乳腺病区和特需病区接受化疗的老年早期乳腺癌患者的药学服务记录.结果 共收集144例(均为女性)患者的用药重整和医嘱审核记录.疾病主要包括糖尿病(占83％)、高血压(占63％)和肝炎(占9％)等.140例患者存在219个用药相关问题(DRP).其中,186(占84.9％)个DRP得到了医师或患者认可,成功干预124个(占57％)DRP,5个(占2％)DRP医师拒绝修改,155个(占70％)问题在治疗过程中重复出现.糖尿病(占83％)、高血压(占63％)和肝炎(占9％)是住院乳腺癌患者最常见的3种合并疾病,平均每位患者使用(2.5±1.4)种药品.药师发现的DRP,主要包括药物选择、用药剂量、用药依从性以及用药监测等问题.最常见的DRP是用药剂量,占总DRP的34.7％,其次,患者未规律监测血糖、血压值占所有DRP的24％.结论 用药干预对促进合理用药效果良好.临床药师的用药干预有利于患者用药的有效性和安全性.

目的:筛选中药亚微乳制剂的最佳处方.方法:通过单因素试验筛选,确定油相为大豆油,乳化剂为卵磷脂,助乳化剂为吐温80和丙二醇.以乳剂中大豆油的用量(X1)、卵磷脂的用量(X2)、吐温80的用量(X3)、丙二醇的用量(X4)为因素.以粒径(Y)为效应.采用JMP软件进行定制试验设计,确定各因素试验水平,生成试验表,依次试验取得结果输入表格,计算各回归方程和影响因素的P值,通过预测刻画器预测关键因素最佳数值,确定最佳处方.结果:选用定制试验设计法安排试验,筛选出用于治疗靶向药物皮疹的最佳处方:大豆油为15 ml,卵磷脂为3.75 g,吐温80为3 ml,丙二醇为8 ml时,预测最小粒径为103.72 nm.结论:采用定制试验设计的方法进行中药亚微乳制剂处方筛选,试验效率高,结果可靠.

目的 降低急诊药房单人值班工作风险.方法 运用危害分析和关键控制点(HACCP)法对急诊药房工作进行风险管理.具体步骤包括成立工作组,建立工作流程图,分析危害和评估风险,确定关键控制点(CCP),制订和实施HACCP计划.结果 确定了4个CCP,包括药品定位错误、未按效期或保存条件放置,未严格审核处方,调配发药错误,未进行用药指导或指导错误;针对问题,建立关键限值(CL)和监测体系,通过落实纠偏措施,确认程序并建立质量记录档案,改善监测指标,连续2年未出现调剂差错或患者投诉.结论 HACCP用于急诊药房的管理,可降低单人值班的医疗风险,提升药学服务质量,保障患者用药安全.

目的：探讨药师在静脉药物配制中心开展临床药学工作的模式。方法总结药师在静脉药物配制中心开展的各项药学服务工作。结果静脉药物配制中心的建立，不仅降低了有毒药物对医务人员的损害，使输液配制更加科学、安全，而且由于药师的参与，使临床用药更加合理、规范。结论临床药学工作在静脉药物配制中心的开展，有利于进一步提高药学服务水平，促进药学服务广泛深入地发展。

Objective: To provide the pharmaceutical information and pharmacy service for clinically safe use of the cancer therapeutic agent carboplatin.Methods: Three cases of adverse reactions caused by carboplatin were reported.Two patients developed chest distress,breath holding,and hypotension;and one patient developed severe anaphylactic shock.The relevance to carboplatin hypersensitivity was reviewed.Results: From the cases and literature review,we summarized the incidence,clinical features,management,risk factors,predicting method,outcome and following treatments of carboplatin-related hypersensitivity reaction.We also obtained relevant pharmaceutical information.Conclusion: Pharmacists' knowledge of carboplatin-related hypersensitivity reaction and management options is useful to make a better medicinal decision.

OBJECTIVE:To investigate the status of perioperative prophylactic use of antibiotics in tumor patients with different surgical incisions. METHODS:A total of 60 (15 seasonly) case histories of discharged patients who underwent tumorectomy between Jul.2007 and Jun. 2008 were randomly sampled for statistical analysis in respect of the perioprative prophylactic use of antibiotics. RESULTS:The incisional wound infection rate was 0%; the ratio of patients using antibiotics was 100%. An average of 1.5 kinds of antibiotics were used and the course of treatment was 4.8 days for type I incision versus 1.9 kinds and 7.7 days for type II incision. Of the antibiotics used,Cephalosporins represented 68.3% (41/60) and Quinolones 41.7% (25/60). CONCLUSION:The incisional wound infection rate is under good control in our hospital; however,whether perioperative prophylactic use of antibiotics should be applied in all tumor patients and the choice of drug kinds remain to be studied further based on the drug susceptibility. The timing and duration of medication as well as drug combination remain to be improved.

Objective:To analyze the current situation of adverse drug reactions (ADRs) monitoring in the tumor patients, and provide evidences for ADR monitoring in the future. Methods: 73 ADR reports collected in 2008 in our hospital were analyzed ret-rospectively in order to find the characteristics and regularity of ADRs in the tumor patients. Results: Among the 73 ADR cases, 63 cases (accounting for 86.3%) were induced by intravenous injection. 31 Categories of drugs were involved in the ADRs, among which the anticancer drugs ranked the first (45.2%). The main clinical manifestations of ADRs were systemic damages (27.4%) and respiratory system disorders (21.9%), and then followed by the lesions of skin and mucous membrane. Conclusion: ADR monitoring in the tumor patients should be strengthened in order to ensure the safety of drug use.

OBJECTIVE:To study the clinical efficacy and economic effectiveness of three different chemotherapy regimens in the treatment of advanced gastric cancer.METHODS:A total of 58 patients with gastric cancer were divided into three groups according to the different chemotherapy regimens applied and retrospectively assessed by using cost-effectiveness analysis in pharmacoeconomics.Group A:Oxaliplatin [85 mg·(m~2)~-1,iv,d_1] plus Calcium Leucovorin [200 mg·(m~2)~-1,iv,d_1～2] plus 5-Fu [400 mg·(m~2)~-1,iv,d_1～2 and 600 mg·(m~2)~-1·d~-1,iv,22 h,d_1～2];Group B:Docetaxel [75 mg·(m~2)~-1,iv,d_1] plus DDP [30 mg·(m~2)~-1,iv,d_1～3] and 5-Fu [500 mg·(m~2)~-1,iv,d_1 and d_8];Group C:Capecitabine [2 000 mg·m~-2·d~-1,po,d_1～14] plus L-OHP [130 mg·m~-2,iv,d_1].One cycle of treatment lasted 21 days for all the three groups.RESULTS:The effective rates of the three groups were 33.3%,38.9% and 43.8%,respectively.The hospitalization costs for each course of chemotherapy treatment in the three groups were 5 063.7,6 940.0 and 6 951.9 Yuan,respectively.The costs for each unit of effectiveness in Group A,B and C were 152.1,178.4 and 158.7 Yuan respectively.On the basis of Group A,the supplemental cost for each unit increment of effectiveness was 335.1 Yuan in Group B and 179.8 Yuan in Group C.CONCLUSION:The results show that Group C is the preferable chemotherapy regimen for advanced gastric cancer.