Browsing by Author "Haro-Varas, JC"

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    Ifosfamide-induced nephrotoxicity in oncological patients
    (Taylor and Francis Ltd., 2024) Quiroz-Aldave, JE; Durand-Vásquez, MDC; Chávez-Vásquez, FS; Rodríguez-Angulo, AN; Gonzáles-Saldaña, SE; Alcalde-Loyola, CC; Coronado-Arroyo, JC; Zavaleta-Gutiérrez, FE; Concepción-Urteaga, LA; Haro-Varas, JC; Concepción-Zavaleta, MJ
    Introduction: Ifosfamide is an alkylating chemotherapeutic agent used in the treatment of various neoplasms. Its main adverse effects include renal damage. Areas covered: A comprehensive review was conducted, including 100 articles from the Scielo, Scopus, and EMBASE databases. Ifosfamide-induced nephrotoxicity is attributed to its toxic metabolites, such as acrolein and chloroacetaldehyde, which cause mitochondrial damage and oxidative stress in renal tubular cells. Literature review found a 29-year average age with no gender predominance and a mortality of 13%. Currently, no fully effective strategy exists for preventing ifosfamide-induced nephrotoxicity; however, hydration, forced diuresis, and other interventions are employed to limit renal damage. Long-term renal function monitoring is essential for patients treated with ifosfamide. Expert opinion: Ifosfamide remains essential in neoplasm treatment, but nephrotoxicity, often compounded by coadministered drugs, poses diagnostic challenges. Preventive strategies are lacking, necessitating further research. Identifying timely risk factors can mitigate renal damage, and a multidisciplinary approach manages established nephrotoxicity. Emerging therapies may reduce ifosfamide induced nephrotoxicity.
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    Sarcoma European and Latin American Network (SELNET) Recommendations on Prioritization in Sarcoma Care During the COVID-19 Pandemic
    (Oxford University Press, 2020) Martin-Broto, J; Hindi, N; Aguiar S, Jr; Badilla-González, R; Castro-Oliden, V; Chacón, M; Correa-Generoso, R; de Álava, E; Donati, DM; Eriksson, M; Falla-Jimenez, M; German, G; Gobo Silva, ML; Gouin, F; Gronchi, A; Haro-Varas, JC; Jiménez-Brenes, N; Kasper, B; Lopes de Mello, CA; Maki, R; Martínez-Delgado, P; Martínez-Said, H; Martinez-Tlahuel, JL; Morales-Pérez, JM; Muñoz-Casares, FC; Nakagawa, SA; Ortiz-Cruz, EJ; Palmerini, E; Patel, S; Moura, DS; Stacchiotti, S; Sunyach, MP; Valverde, CM; Waisberg, F; Blay, JY
    Background: The COVID‐19 outbreak has resulted in collision between patients infected with SARS‐CoV‐2 and those with cancer on different fronts. Patients with cancer have been impacted by deferral, modification, and even cessation of therapy. Adaptive measures to minimize hospital exposure, following the precautionary principle, have been proposed for cancer care during COVID‐19 era. We present here a consensus on prioritizing recommendations across the continuum of sarcoma patient care. Material and Methods: A total of 125 recommendations were proposed in soft‐tissue, bone, and visceral sarcoma care. Recommendations were assigned as higher or lower priority if they cannot or can be postponed at least 2–3 months, respectively. The consensus level for each recommendation was classified as “strongly recommended” (SR) if more than 90% of experts agreed, “recommended” (R) if 75%–90% of experts agreed and “no consensus” (NC) if fewer than 75% agreed. Sarcoma experts from 11 countries within the Sarcoma European‐Latin American Network (SELNET) consortium participated, including countries in the Americas and Europe. The European Society for Medical Oncology‐Magnitude of clinical benefit scale was applied to systemic‐treatment recommendations to support prioritization. Results: There were 80 SRs, 35 Rs, and 10 NCs among the 125 recommendations issued and completed by 31 multidisciplinary sarcoma experts. The consensus was higher among the 75 higher‐priority recommendations (85%, 12%, and 3% for SR, R, and NC, respectively) than in the 50 lower‐priority recommendations (32%, 52%, and 16% for SR, R, and NC, respectively). Conclusion: The consensus on 115 of 125 recommendations indicates a high‐level of convergence among experts. The SELNET consensus provides a tool for sarcoma multidisciplinary treatment committees during the COVID‐19 outbreak.