1. Aschenbrenner, Diane S. MS, APRN, BC


* Pazopanib (Votrient) is an oral medication for the treatment of advanced renal cell carcinoma.


* Ofatumumab (Arzerra) is a monoclonal antibody that serves as "target" therapy in the treatment of chronic lymphocytic leukemia in patients whose disease is no longer controlled by other forms of chemotherapy.



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Pazopanib (Votrient), the sixth drug for the treatment of kidney cancer to be introduced into the market since 2005, was recently approved by the Food and Drug Administration (FDA). An oral medication that inhibits angiogenesis (in which the development of new blood vessels provides nutrients to solid tumors for growth and survival), pazopanib is for patients with advanced renal cell carcinoma, in which the cancerous cells are found in the lining of the small tubules in the kidney. In a study involving 435 patients, pazopanib was associated with longer average duration of survival without disease progression compared with placebo (9.2 months vs. 4.2 months, respectively). Adverse effects of the drug include diarrhea, high blood pressure, changes in hair color, nausea, loss of appetite, vomiting, fatigue, weakness, abdominal pain, and headache. Two possible serious adverse effects of pazopanib include severe and fatal liver toxicity and the development of cardiac arrhythmia. Nurses should monitor liver function before and during drug treatment and should carefully assess for irregularities in heart rhythm. Periodic electrocardiograms should be taken in patients showing irregular heart rhythms. Electrolyte levels should also be monitored in these patients, as an imbalance can lead to cardiac arrhythmia.


The FDA has also approved ofatumumab (Arzerra) for the treatment of chronic lymphocytic leukemia, a slowly progressing cancer of the blood and bone marrow, as a second-line therapy in patients whose disease is no longer controlled by other forms of chemotherapy. Ofatumumab, a monoclonal antibody, is a "target" therapy, and binds to a specific protein found on the surface of both normal and malignant B cells, increasing their susceptibility to immune system attack. But ofatumumab also heightens the risk of infections, including progressive multifocal leukoencephalopathy, a generally fatal brain infection. More common adverse effects of the drug include a reduction in normal white blood cells, pneumonia, fever, cough, diarrhea, lower red blood cell counts, fatigue, shortness of breath, rash, nausea, bronchitis, and upper respiratory tract infections. Patients at high risk for hepatitis B should be screened before treatment with ofatumumab, and those with evidence of inactive hepatitis should be monitored for activation of the infection, both during and after treatment. Ofatumumab was approved under the FDA's accelerated process, which allows certain drugs to be brought to market for the treatment of refractory conditions before all normally required product testing has been completed. Ofatumumab's effectiveness in further slowing the progression of chronic lymphocytic leukemia when used along with standard chemotherapy will be evaluated in postmarketing clinical trials.