Farmacoepidemiologia na terapia molecular oncológica em clínicas privadas de oncologia da cidade de Fortaleza-Ceará

Abstract

Cancer incidence and mortality are growing rapidly worldwide, and it is considered a public health problem. In Brazil, estimates indicate the occurrence of 600 thousand new cases of cancer for the year 2019. These estimate s reflect the profile of a country that has prostate, lung, female breast and colorectal cancers among the most incident. A synergistic strategy for cancer therapy is evolving, where precision medicine acts as a diagnostic prerequisite for targeted therapy using prognostic biomarkers and tumor genotyping. Biomarkers are molecules useful in the clinical management of cancer patients, assisting in the diagnosis, assessment of therapeutic response, detection of recurrences and prognosis, in addition to assisti ng in the development of new treatment modalities. Molecular target therapies are revolutionary therapies that interfere with specific molecules to block cancer growth, progression and metastasis. Regarding the monitoring of cancer treatment, the pharmacis t's action is a fundamental part to guarantee the quality and safety of therapy in any stage of the disease. From this context, this descriptive, retrospective and quanliquantitative study was carried out, esigned to analyze pharmacoepidemiology in molecu lar therapy in patients diagnosed with breast, lung and colorectal cancer from January 2016 to December 2018, 75 records were selected. Among the medical records analyzed in the present study, 59% were breast cancer, 19% lung and 23% colorectal. The therap ies of choice to treat these cancers have been hormone therapy (HT), chemotherapy (CT) and molecular therapy (MT), being that for breast cancer 32% did only HT, 50% HT and CT, 7% HT, CT and MT anti HER 2 , 2% CT and MT anti HER 2 and 9% CT only; for lung ca ncer, 50% did only CT and the other 50% CT and MT anti VEGF or EGFR TKIs or anti PD 1 / PD L1; for colorectal cancer, 24% had only CT and 76% CT and MT anti VEGF or anti EGFR. It was observed that 25% of breast cancer patients who underwent molecular ther apy, presented infusion related reaction; 23% with colorectal cancer had adverse events (acneiform reaction and/or proteinuria) and 33% of these patients had therapy suspended; 83% with lung cancer had adverse events (rash, proteinúria and pneumonitis) whe re 60% of them had their therapies suspended. In view of the analysis of the results, a booklet was developed containing information about the main molecular biomarkers used for these three types of cancer, the molecular therapies of choice, the main adver se events, how to notify these events and the importance of pharmacotherapeutic follow importance of pharmacotherapeutic follow--up by the pharmacist.up by the pharmacist.