UP FRONT
2015 Highlights of ASH® in Latin America
April 23 – 24, 2015
Cartagena, Colombia
2015 Highlights of ASH® in Asia
February 28 – March 1, 2015
Bangkok, Thailand
Hear internationally recognized experts analyze the
latest updates in hematology research from the
ASH Annual meeting.
2015 American Association for Cancer
Research Annual Meeting
April 18 – 22, 2015
Philadelphia, PA
The AACR Annual Meeting 2015 will highlight the latest
discoveries in every area of cancer research and will
provide a unique opportunity for investigators from
all over the world to meet, interact, and share their
insights. This year’s meeting theme is “Bringing Cancer
Discoveries to Patients.”
Extravasation Tissue Injury
Only administer through a secure and free-flowing venous access line. If extravasation is
suspected, discontinue infusion immediately and consider local treatment measures.
Neurologic Toxicity
Sensory and motor neuropathies are common and are cumulative. Monitor patients for
symptoms of neuropathy, such as hypoesthesia, hyperesthesia, paresthesia, hyporeflexia,
areflexia, neuralgia, jaw pain, decreased vibratory sense, cranial neuropathy, ileus, burning
sensation, arthralgia, myalgia, muscle spasm, or weakness, both before and during
treatment. Orthostatic hypotension may occur. The risk of neurologic toxicity is greater
if Marqibo is administered to patients with preexisting neuromuscular disorders or when
other drugs with risk of neurologic toxicity are being given. In the studies of relapsed and/
or refractory adult ALL patients, Grade ≥3 neuropathy events occurred in 32.5% of patients.
Worsening neuropathy requires dose delay, reduction, or discontinuation of Marqibo [see
Dosage and Administration].
Myelosuppression
Monitor complete blood counts prior to each dose of Marqibo. If Grade 3 or 4 neutropenia,
thrombocytopenia, or anemia develops, consider Marqibo dose modification or reduction as
well as supportive care measures.
Tumor Lysis Syndrome
Tumor lysis syndrome (TLS) may occur in patients with ALL receiving Marqibo.
Anticipate, monitor for, and manage.
Constipation and Bowel Obstruction
Ileus, bowel obstruction, and colonic pseudo-obstruction have occurred. Marqibo can
cause constipation [see Adverse Reactions]. Institute a prophylactic bowel regimen to
mitigate potential constipation, bowel obstruction, and/or paralytic ileus, considering
adequate dietary fiber intake, hydration, and routine use of stool softeners, such as
docusate. Additional treatments, such as senna, bisacodyl, milk of magnesia, magnesium
citrate, and lactulose may be considered.
Fatigue
Marqibo can cause severe fatigue. Marqibo dose delay, reduction, or discontinuation may
be necessary.
Hepatic Toxicity
Fatal liver toxicity and elevated levels of aspartate aminotransferase have occurred.
Elevated levels of aspartate aminotransferase of Grade ≥3 occurred in 6-11% of patients
in clinical trials. Monitor hepatic function tests. Reduce or interrupt Marqibo for hepatic
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toxicity.
Embryofetal Toxicity
Marqibo can cause fetal harm when administered to a pregnant woman. Vincristine sulfate
liposome injection was teratogenic or caused embryo-fetal death in animals.
Women of childbearing potential should avoid becoming pregnant while being treated with
Marqibo. There are no adequate and well-controlled studies of Marqibo in pregnan