Intervention by Pharmacist in Outpatient Service for Lenvatinib Therapy for Hepatocellular Carcinoma at Our Hospital and Its Usefulness

Abstract

In cancer chemotherapy, oral anticancer drugs are used as monotherapy or combination therapy of multiple regimens for various cancer types. In recent years, apart from the conventional cytotoxic anticancer drugs, the number of molecular targeted drugs that target specific factors related to cancer growth and proliferation has been increasing. Despite their benefits, these drugs have characteristic adverse effects, and management becomes more complicated over the long term. On the other hand, the involvement of pharmacists in cancer chemotherapy is also expanding. Some facilities have an adverse effect countermeasure team for each drug. In our hospital, a pharmacist outpatient service for lenvatinib (LEN Outpatient) is being implemented. In this study, we investigated the status of LEN Outpatient and the usefulness of this service. Thirteen patients who utilized LEN Outpatient (intervention group), and 9 patients who did not utilize LEN Outpatient (non-intervention group) were studied. A significantly larger number of patients in the intervention group started first stage dose reduction. The incidence of adverse effects tended to be higher in the intervention group; especially, the incidence of hypertension was significantly higher. The duration of LEN administration tended to be longer in the intervention group. The entry of information about adverse effects in medical records was better in the intervention group. The adoption rate of prescription proposed by pharmacists was 77.5％, with the highest rate for supportive care proposals. These results suggest that pharmacist intervention might have led to earlier detection of adverse effects and earlier implementation of countermeasures.