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Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new therapeutic approach for patients with peritoneal cancer. So far, most published studies investigated the administration of established cytostatic agents through PIPAC. This study aimed to evaluate the effect of PIPAC on two breakthrough anti-cancer agents, specifically anti-PD1 pembrolizumab, and anti-HER2 antibody-drug conjugate (ADC) - trastuzumab-deruxtecan. We conducted systematic analyses on samples of pembrolizumab and trastuzumab-deruxtecan at clinically relevant concentrations before and after PIPAC administration using an experimental setup of a hermetic container system, mimicking the abdominal cavity and using identical features as in clinical use. We utilized a range of chromatographic and spectroscopic techniques to explore potential alterations in the primary, secondary, and tertiary structures of the drugs, focusing on post-translational modifications resulting from the aerosolization. Our findings indicate that PIPAC did not compromise the integrity of tested biopharmaceuticals. The size variants of both drugs, assessed by size exclusion chromatography (SEC), remained unchanged. Reversed-phase liquid chromatography (RPLC) and hydrophobic interaction chromatography (HIC) revealed no significant differences in hydrophobicity variants, the average drug-to-antibody ratio (DAR), or DAR distribution before and after PIPAC treatment. Circular dichroism (CD) spectroscopy confirmed that the secondary and tertiary structures were preserved. While pembrolizumab showed no change in charge variants post-PIPAC, trastuzumab-deruxtecan exhibited a non-negligible change in the quantity of charge variants on the monoclonal antibody itself, while the payload remained unchanged. This shift could possibly be related to the metallic composition of the CapnoPen® device (made of nickel and chromium) used in PIPAC and for these experiments. Together, our results suggest that PIPAC does not alter the structure of pembrolizumab and trastuzumab-deruxtecan, paving the way for future clinical trials., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. The authors declare the following competing financial interests: Mateusz Imiołek is an employee of Waters (Milford, MA, USA), a manufacturer of chromatography systems and consumables. ACQUITY, UPLC, Empower and BioResolve are trademarks of Waters Technologies Corporation. Capnopen® is a trademark of Capno pharm GmbH. Milli-Q is a trademark of Merck KGaA. Keytruda is a trademark of Merck Sharp & Dohme, LLC. Enhertu is a trademark of Daiichi Sankyo Company Limited. Accutron is a trademark of Medtron AG. AdvanceBio is a trademark of Agilent Technologies Inc. MAbPac is a trademark of Thermo Fisher Scientific AG. Excel is a trademark of Microsoft Corporation. All other trademarks are the property of their respective owners., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Coping with relational dilemmas constitutes one of the core competencies of the therapeutic professions. Although students and novice therapists who are transitioning to becoming therapists often experience relational dilemmas as a threat to their professional identity, there is scant literature on strategies to help them develop their professional identity. This inductive study is based on data collected from group supervision courses for undergraduate students in Occupational Therapy in 12 groups over six years. The findings emerged from the analysis of 196 dilemma cases presented by the students in class, combined with the 196 personal reflections that the that students wrote at the end of the course about their personal development as occupational therapists. This study presents the five strategies that appeared most critical for coping with these dilemmas and by extension, for identify formation: (1) looking for the overarching goal, (2) differentiating facts from interpretations, (3) understanding what the 'other' is trying to say, (4) discovering the dialogue between the inner voices, and (5) the notions of Having, Doing, and Being. The strategies are based on cognitive models and behavioral repertoires in the literature, and can provide guidelines for student therapists to use to transition from class to workplace. They can also be implemented by clinical instructors and academic educators., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature.)

Health educators nurture future generations of professionals by helping them to navigate the complex transition from students to therapists. The purpose of this study was to illustrate how a pedagogical method of collaborative reflection (involving reflective writing, sharing, and discussion) on relational dilemmas with role partners can develop occupational therapists' professional identity. The course, in which this method was applied, implemented the supervision and peer learning frameworks as related to student's fieldwork experiences, and is based on the perception of growing from conflicts and exploration. The study is based on analyzing qualitative data of 392 dilemma cases and 196 texts of personal reflection on classroom work of undergraduate students in occupational therapy. A thematic analysis of the case studies revealed six overarching relational dilemmas that novice therapists are often called upon to deal with when working with patients, patients' families and colleagues from other health professions. Analyzing the personal texts of reflection highlighted the effectiveness of collaborative reflection in bridging the gap between theory and practice, and in helping students develop their professional identity. The method can be adapted to curricula for students and therapists in other health professions, in undergraduate courses, and in group supervision programs.

Nurses endure daily low-level exposure to cytotoxic drugs, which can lead to significant absorption with potential harmful consequences. New sterile medical devices called cytotoxic safe infusion systems (CSISs), intended by their manufacturers to improve safety and quality of cytotoxic drug infusions, have been made commercially available. CSISs from 3 manufacturers were tested in 2 cancer units and compared with standard infusion sets. The aim of this study is to evaluate the devices regarding occupational exposure, quality of the infusion, and economic aspects.

Chemotherapy products in hospitals include a reconstitution step of manufactured drugs providing an adapted dosage to each patient. The administration of highly iatrogenic drugs raises the question of patients' safety and treatment efficiency. In order to reduce administration errors due to faulty preparations, we introduced a new qualitative and quantitative routine control based on Fourier Transform Infrared (FTIR) and UV-Visible spectrophotometry. This automated method enabled fast and specific control for 14 anticancer drugs. A 1.2 mL sample was used to assay and identify each preparation in less than 90 sec. Over a two-year period, 9370 controlled infusion bags showed a 1.49% nonconformity rate, under 15% tolerance from the theoretical concentration and 96% minimum identification matching factor. This study evaluated the reliability of the control process, as well as its accordance to chemotherapy deliverance requirements. Thus, corrective measures were defined to improve the control process.

Nurses endure daily low-level exposure to cytotoxic drugs, which can lead to significant absorption with potential harmful consequences. New sterile medical devices called cytotoxic safe infusion systems (CSISs), intended by their manufacturers to improve safety and quality of cytotoxic drug infusions, have been made commercially available. CSISs from 3 manufacturers were tested in 2 cancer units and compared with standard infusion sets. The aim of this study is to evaluate the devices regarding occupational exposure, quality of the infusion, and economic aspects.

The interest of centralization of preparations of chemotherapy drugs is in addition to its economic aspect, to secure drugs circuit. The aims of this study are to determine needs in employees and equipments of 11 theoretical levels of production from 1,000 to 50,000 preparations per year and to determine the cost of chemotherapy's preparation for each theoretical unit. The operating cost was divided in four areas of expenditure: employees (66-78%), investment (5-15%), maintenance (3-15%) and consumables (4-16%). If we consider the 11 units, the theoretical cost varies between 27.4 € for a unit with 50,000 preparations per year and 114.1 € for a unit with 1,000 preparations per year. This study shows the importance of setting up an optimal unit of preparations according to its activity and highlights the high cost's variation in relation to the activity of the unit.

Although new chemotherapeutic drugs for metastatic breast cancer (MBC) have been approved over the past decade, it is unclear whether this has changed the overall outcome of patients. This study assessed the clinical and economic impacts of these drugs. We retrospectively studied MBC patients receiving chemotherapy in our institution over two time periods, 1994-1998 and 2003-2006. Patient characteristics and outcomes, and treatment characteristics and costs (€, 2008) were compared. Three hundred and one patients were identified, 149 patients in the first cohort and 152 in second one. The median number of lines of chemotherapy was similar in the two cohorts (three lines). The median costs of chemotherapy per patient nearly doubled over time, from 6,272 € in the 1994-1998 cohort to 13,035 € in the 2003-2006 cohort (P < 0.001). No survival difference was observed between the two groups, with a 3-year survival rate estimated to 41% in the 1994-1998 cohort and 44% in the 2003-2006 cohort (P = 0.52). In multivariate analysis, prognostic factors associated with longer overall survival were single metastatic site (HR 0.48; P < 10⁻³), bone metastases (HR = 0.67; P = 0.007) and positive hormone receptors (HR 0.56; P = 0.0002). New chemotherapeutic agents induced a significant cost increase over time. The limited size and heterogeneity of our cohort do not allow any conclusion concerning their impact on survival.