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All Journal Indonesian Journal of Cancer Chemoprevention Indonesian Journal of Global Health research Indonesian Journal of Cancer
Santosa, Damai
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Nursing Public Health

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The Efficacy and Safety of Ixazomib for Newly Diagnosed Multiple Myeloma (NDMM) and Refractory or Relapsed Multiple Myeloma (RRMM): An Updated Systematic Review Lubis, Ainun Basyiroh; Santosa, Damai; Rizky, Daniel; Tandarto, Kevin; Kartiyani, Ika; Yunarvika, Vina; Ardini, Desta Nur Ewika; Setiawan, Budi; Pangarsa, Eko Adhi; Suharti, Catharina
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1241

Abstract

Background: Newly diagnosed multiple myeloma (NDMM) is a significant healthcare concern, comprising 1.8% of newly diagnosed cancers in the United States. Recent advancements in NDMM and refractory/relapsed multiple myeloma (RRMM) treatment, including novel agents like ixazomib, have improved patient outcomes. Ixazomib, an oral proteasome inhibitor, has shown promise in clinical trials, particularly in combination with lenalidomide and dexamethasone (IRd). This study aims to find the efficacy and safety profiles of ixazomib for NRMM and RRMM.Methods: We conducted a systematic literature review using Scopus, PubMed, Google Scholar, and ProQuest databases, focusing on randomized controlled trials (RCTs) evaluating ixazomib’s efficacy and safety in NDMM and RRMM treatment. Eligibility criteria included studies published within the last 3 years reporting data on ixazomib in NDMM and RRMM patients. Quality assessment utilized the Cochrane Risk of Bias tool for RCTs.Results: The review identified three studies from 2021–2023 demonstrating ixazomib’s efficacy and safety in MM treatment across various patient groups. Benefits included improved progression-free survival (PFS) in non-transplant NDMM, significant PFS advantage in relapsed/ refractory MM, and efficacy in transplant-ineligible NDMM induction regimens.Conclusion: Ixazomib emerges as a well-tolerated maintenance therapy offering significant PFS advantages in NDMM and RRMM, irrespective of age or frailty status. Future research, including multicenter studies, is warranted to further elucidate ixazomib’s role in MM management.
Healthcare Financing for Bone Marrow Transplants: A Scoping Review Santosa, Damai; Suryawati, Chriswardani; Sriatmi, Ayun
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.7125

Abstract

Bone marrow transplantation (BMT) is a life-saving procedure for haematological malignancies and other severe blood disorders. It is need resource-intensive treatment with significant financial implications. The cost of BMT varies across different countries and healthcare systems, influenced by factors such as treatment protocols, hospital infrastructure, medication expenses, and post-transplant care. Understanding the financial aspects of BMT is crucial for improving accessibility and ensuring sustainable healthcare service. Objective to analyse the cost of BMT across different regions, identify sources of financing, and explore financial challenges and potential solutions for patients undergoing BMT. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases from 2001 - 2025. MeSH Terms using ((haematology malignancy OR leukaemia OR acute leukaemia OR acute myeloid leukaemia OR acute lymphoblastic leukaemia OR myeloma OR lymphoma OR thalassemia) AND (bone marrow transplantation OR stem cell transplantation OR haematopoetic stem cell transplantation OR hematopoietic stem cell transplantation OR allogeneic transplantation ) AND (OR costing OR payer)). Data were extracted on total BMT costs, cost components, sources of financing, and financial challenges associated with the procedure. The analysis followed the Cochrane Handbook for Systematic Reviews of Interventions. Out of 528 initially screened studies, 19 articles met the inclusion criteria. The cost of BMT varied significantly by country, with developed nations reporting higher costs than developing countries. The primary cost components included hospital and treatment expenses, medications, and follow-up care. Financing sources varied across regions, including private health insurance, government-funded healthcare programs, non-profit organisations, fundraising efforts, and out-of-pocket payments. Many patients in low- and middle-income countries face financial barriers due to limited insurance coverage and high out-of-pocket expenses. BMT remains a costly procedure with significant financial challenges, particularly in regions with limited healthcare funding.
Adherence to Guidelines: Evaluation of Opioid Usage According to the Who Step Ladder Guideline in Inpatient Cancer Patients Pangarsa, Eko Adhi; Setiawan, Budi; Santosa, Damai; Rizky, Daniel; Yunarvika, Vina; Suharti, Catharina
Indonesian Journal of Global Health Research Vol 7 No 4 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i4.6343

Abstract

WHO analgesic step-ladder is still the mainstay guideline in managing pain. However, pain in cancer patients developed from a more complex pathomechanism, hence requiring special consideration. This study aimed to compare the visual analog scale (VAS) of opioid and non-opioid analgesia in treating cancer patients and evaluate its rationality with World health organization (WHO) analgesic step-ladder.Method: A single-center, cross-sectional and analytic-descriptive study conducted in our centre. The population of this study comprised all cancer patients receiving analgesic therapy. The sampling technique used was consecutive, involving patients who met the inclusion and exclusion criteria. A total of 62 patients were included in the study as the research sample. Pain level was measured before and between 12 – 24 hours after analgesia, using VAS and divided into mild, moderate, or severe. Analgesic regimens were documented, and the daily opioid dose was presented on milligram morphine equivalent. Statistical analysis was performed to compare the variables before and after analgesia using the Wilcoxon signed-rank test, with a p-value <0.05 considered statistically significant.Result: From 62 patients, 46 subjects were included. Median milligram morphine equivalent was 20 mg (0-60). While the majority of patients experienced mild pain, 13 patients (27.7%) had moderate to severe pain. The most commonly used opioid was intravenous fentanyl, administered to 13 patients (27.7%), with a median morphine equivalent dose of 20 mg/day. Only 1 patient received opioid rationally according to WHO. Both non-opioid and opioid group had significant VAS differences before and after therapy (p = 0.014 and p <0.001). In both non-opioid and opioid groups, there were differences of VAS scores in the post-administration of analgesic, but these differences were not statistically significant (p= 0.885). Conclusion: The study concludes that, although most analgesics were not administered in accordance with the WHO step-ladder guideline, both opioid and non-opioid analgesics were effective in reducing pain in palliative cancer patients.
Effect of Astaxanthin Supplementation in Preventing Anemia in Head and Neck Cancer Patients Receiving Cisplatin Chemotherapy Aminullah, Yusuf; Subagio, Hertanto Wahyu; Santosa, Damai; Naftali, Zulfikar
Indonesian Journal of Cancer Chemoprevention Vol 14, No 2 (2023)
Publisher : Indonesian Society for Cancer Chemoprevention

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14499/indonesianjcanchemoprev14iss2pp72-82

Abstract

The incidence of anemia due to reactive oxygen species (ROS) in patients with head and neck cancer (HNC) can be caused by a side effect of cisplatin chemotherapy, namely myelosuppression. In the presence of ROS, external antioxidants are needed, including astaxanthin as an antioxidant to neutralize and fight ROS in preventing anemia. This study aims to prove and analyze the antioxidant effect of astaxanthin in preventing anemia in HNC patients due to cisplatin chemotherapy for 3 weeks. The study design was a randomized controlled trial pre-post test design, involving 42 research subjects who were randomly divided into two groups, then 3 cc of blood was taken I to check the hemoglobin level and the number of erythrocytes. The treatment group was given astaxanthin 2x4 mg and the control group was given a combination of vitamin C 1x500 mg and vitamin E 1x250 IU for 3 weeks then 3 cc of blood was taken II to check hemoglobin levels and erythrocyte counts. The independent variable is intake of astaxanthin, the dependent variable is hemoglobin level and the number of erythrocytes and the confounding variables are age, sex, type of HNC, stage of HNC, ECOG and BMI. Data analysis was performed by the Descriptive test, Levene test, Shapiro Wilks, Wilcoxon test, and Mann-Whitney test. The significance of the hypothesis test was obtained with p<0.05. The 42 research subjects met the inclusion criteria, most aged between 41-50 years, male and female ratio 2:1, The most HNC were Nasopharyngeal Cancer, the most HNC stage was stage IV, the most HNC performance status was ECOG I and the most HNC patients had normal BMI. There was a significant difference in hemoglobin levels p=0.012 (p<0.05) and the number of erythrocytes, p=0.04 (p<0.05) between the treatment and control groups. There was a significant difference in hemoglobin levels after therapy in the treatment and control groups p=0.012 (p<0.05) and the number of erythrocytes p=0.04 (p<0.05) between the treatment and control groups. Astaxanthin can prevent anemia in the form of decreased hemoglobin levels and the number of erythrocytes in HNC patients who receive cisplatin chemotherapy.Keywords: astaxanthin, anemia, HNC, cisplatin, ROS.
Co-Authors Aminullah, Yusuf Ardini, Desta Nur Ewika Ayun Sriatmi Budi Setiawan Catharina Suharti Hertanto Wahyu Subagio Kartiyani, Ika Lubis, Ainun Basyiroh Pangarsa, Eko Adhi Rizky, Daniel Tandarto, Kevin Yunarvika, Vina Zulfikar Naftali, Zulfikar