Publications by authors named "B Nuijen"
[Redispensing of expensive oral anticancer medicines: a practical application].
Ned Tijdschr Geneeskd
November 2024
Article Synopsis
- The rising use of pricey oral anticancer medications (OAM) creates financial and environmental issues, especially due to wasted, unused drugs.
- Current efforts to minimize medication waste encounter challenges, including legal obstacles like the EU Falsified Medicines Directive.
- A proposed method for redispensing OAM shows promise, achieving 79% eligibility for returned drugs, saving over €483,000, and reducing hazardous waste, while encouraging changes to remove legal barriers for a broader implementation.
Article Synopsis
- The study aimed to evaluate the long-term stability of two expensive monoclonal antibodies, nivolumab and pembrolizumab, when stored in saline infusion bags and partially used vials, to reduce economic waste.
- The researchers found that both antibodies remained stable in terms of purity and concentration for up to six weeks under specific storage conditions (2-8°C in the dark, followed by ambient temperature and light exposure).
- The results support the clinical re-use of these medications and suggest it is feasible to compound fixed-dose infusions to further minimize costs.
Purpose: The development of resistance limits the clinical benefit of BRAF and MEK inhibitors (BRAFi/MEKi) in BRAFV600-mutated melanoma. It has been shown that short-term treatment (14 days) with vorinostat was able to initiate apoptosis of resistant tumor cells. We aimed to assess the antitumor activity of sequential treatment with vorinostat following BRAFi/MEKi in patients with BRAFV600-mutated melanoma who progressed after initial response to BRAFi/MEKi.
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- This study focused on assessing the safety and potential immune response of a naked DNA vaccine targeting the MART-1 antigen in patients with advanced melanoma through a phase I clinical trial.
- Nine patients were treated, and while there were no treatment-related deaths, common side effects included skin reactions and pain; one patient achieved stable disease for 353 days.
- The DNA vaccine was generally safe to use, highlighting the need for further research to enhance its effectiveness and understand the immune responses better.
Introduction: In a multicenter, open-label randomized phase 3 clinical trial conducted in the Netherlands and Denmark, treatment with ex vivo-expanded tumor-infiltrating lymphocytes (TIL-NKI/CCIT) from autologous melanoma tumor compared with ipilimumab improved progression-free survival in patients with unresectable stage IIIC-IV melanoma after failure of first-line or second-line treatment. Based on this trial, we conducted a cost-utility analysis.
Methods: A Markov decision model was constructed to estimate expected costs (expressed in 2021€) and outcomes (quality-adjusted life years (QALYs)) of TIL-NKI/CCIT versus ipilimumab in the Netherlands.