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Antidotes to vesicant chemotherapy extravasations.

R T Dorr1

  • 1Arizona Cancer Center, Tucson 85724.

Blood Reviews
|March 1, 1990
PubMed
Summary

Few chemotherapy extravasation antidotes are experimentally validated. Validated options include sodium thiosulfate for mechlorethamine, hyaluronidase for vinca alkaloids, and cooling with DMSO/hydrocortisone for anthracyclines.

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Area of Science:

  • Oncology
  • Pharmacology
  • Drug Safety

Background:

  • Chemotherapy extravasation is a serious complication of cancer treatment.
  • Many proposed antidotes lack experimental validation.
  • Identifying effective interventions is crucial for patient care and oncology practice.

Purpose of the Study:

  • To review and identify experimentally validated pharmacologic antidotes for vesicant anticancer agent extravasations.
  • To distill evidence-based recommendations for managing chemotherapy extravasations.

Main Methods:

  • Review of experimental studies and clinical anecdotes on extravasation antidotes.
  • Distillation of validated antidotes based on experimental and clinical evidence.
  • Comparison with FDA-approved package insert recommendations.

Main Results:

  • Validated antidotes include: isotonic sodium thiosulfate for mechlorethamine, hyaluronidase for vinca alkaloids, and topical DMSO with hydrocortisone for anthracyclines.
  • Topical DMSO shows experimental promise for mitomycin C extravasation.
  • Most validated antidotes are listed in FDA-approved drug inserts.

Conclusions:

  • Several pharmacologic antidotes are supported by evidence for specific chemotherapy extravasations.
  • Further research is needed for topical DMSO with anthracyclines and mitomycin C.
  • Development of novel agents like radical dimers is warranted to address chemotherapy extravasations.

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