When To Consider SANCUSO

When to Consider SANCUSO

    • When to consider Sancuso

      • Sancuso® (granisetron transdermal system) is indicated for the prevention of nausea and vomiting in adults receiving moderately and/or highly emetogenic chemotherapy regimens of up to 5 consecutive days.1

      • Due to its route of administration, SANCUSO may be an alternative for patients on chemotherapy who are unable to take or retain oral antiemetics, including patients who have symptoms or side effects such as oral mucositis or dysphagia, those with gut motility issues, and those receiving concomitant radiation plus chemotherapy treatment1-4,a,b

      • As SANCUSO can be worn for up to 7 consecutive days depending on the duration of the chemotherapy regimen, it may be an alternative for patients who have experienced breakthrough symptoms in the past as well as forgetful patients who may not remember to take oral antiemetics1,5,6

    • Are your patients on chemotherapy experiencing diseases or treatment-related complications that make it difficult to take or retain oral antiemetics?

      • Cancer Types

        • Head and Neck Cancers7

          • Chemoradiationb

          • Chemotherapy

            • Platinum based (cisplatin)

            • Microtubular inhibitor (paclitaxel)

            • Antimetabolite (5-FU)

        • Breast Cancer8

          • Chemotherapy

            • Platinum based (cisplatin)

            • Microtubular inhibitor (paclitaxel)

            • Antimetabolite (5-FU)

          • Lung Cancer9

            • Chemoradiationb

              • Chemotherapy

                • Platinum based (cisplatin, carboplatin)

          • Gastrointestinal Cancer10

            • Chemoradiationb

            • Chemotherapy

              • Platinum based (cisplatin)

              • Microtubular inhibitor (paclitaxel)

              • Antimetabolite (5-FU)

          • Gynecological Cancer11,12

            • Chemoradiationb

            • Chemotherapy

              • Platiunum based (cisplatin, carboplatin)

  • Testicular Cancer13

    • Chemoradiationb

    • Chemotherapy

      • Platinum based (cisplatin, carboplatin)

  • Colorectal Cancer Cancer14,15

    • Chemoradiationb

    • Chemotherapy

      • Platinum based (cisplatin)

      • Antimetabolite (5-FU)

  • Possible Chemotherapy Complications

    • Difficulty Swollowing2

    • Limited Gut Mobility/absorption3

  • About Sancuso References

    • aPatients with cancer who are mechanically compromised include those with oral and/or gastrointestinal impairment associated with chemotherapy, with or without radiation, or tumor burden, who may be unable to take or retain oral antiemetics.2

    • bSANCUSO is not indicated for radiation-induced nausea and vomiting.1

    • Verify all references: SANCUSO [package insert]. Bridgewater, NJ: Cumberland Pharmaceuticals, Inc.; 2023. Lalla RV, Bowen J, Barasch A, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014;120(10):1453-1461. doi:10.1002/cncr.28592. Keller J, Layer P. Intestinal and anorectal motility and functional disorders. Best Pract Res Clin Gastroenterol. 2009;23(3):407-423. doi:10.1016/j.bpg.2009.02.012. Schulmeister L. Granisetron transdermal system: a new option to help prevent chemotherapy-induced nausea and vomiting. Clin J Oncol Nurs. 2009;13(6):711-714. doi:10.1188/09.CJON.711-714. NCCN Clinical

Practice Guidelines in Oncology (NCCN Guidelines®): Antiemesis. National Comprehensive Cancer Network. https://www.nccn.org/ professionals/physician_gls/pdf/antiemesis.pdf. Updated July 20, 2011. Accessed December 18, 2019. Chemo brain. American Cancer Society website. http://www.cancer.org/treatment/treatments-and-side-effects/ physical-side-effects/changes-in-mood-or-thinking/chemo-brain.html.

Updated June 9, 2016. Accessed December 18, 2019. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Head and neck cancers. National Comprehensive Cancer Network. https://www.nccn.org/ professionals/physician_gls/pdf/head-and-neck.pdf. Updated May 30, 2014. Accessed December 18, 2019.

 

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Breast cancer. National Comprehensive Cancer Network. https:// www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Updated April 1, 2014. Accessed December 18, 2019. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Small cell lung cancer. National Comprehensive Cancer Network. https://www.nccn.org/professionals/ physician_gls/pdf/sclc.pdf.

Updated June 18, 2014. Accessed December 18, 2019. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Gastric cancer. National Comprehensive Cancer Network.

https://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf. Updated May 30, 2014. Accessed December 18, 2019. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Ovarian cancer: including fallopian tube caner and primary peritoneal cancer.

National Comprehensive Cancer Network. https://www.nccn.org/professionals/ physician_gls/pdf/ovarian.pdf. Updated May 9, 2014. Accessed December 18, 2019. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Cervical cancer. National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/pdf/cervical.pdf.

Updated August 7, 2014. Accessed December 18, 2019. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Testicular cancer. National Comprehensive Cancer Network. https://www.nccn.org/ professionals/physician_gls/pdf/testicular.pdf. December 13, 2013.

Accessed December 18, 2019. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Colon cancer. National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/pdf/ colon.pdf. Updated August 20, 2014. Accessed December 18, 2019.

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Rectal cancer. National Comprehensive Cancer Network. https:// www.nccn.org/professionals/physician_gls/pdf/rectal.pdf. Updated August 20, 2014. Accessed December 18, 2019. Jensen SB, Pedersen AML, Vissink A, et al. A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer. 2010;18(8):1039-1060. doi:10.1007/s00520-010-0827-8. Stacey R, Green JT. Radiation-induced small bowel disease: latest developments and clinical guidance. Ther Adv Chronic Dis. 2014;5(1):15-29. doi:10.1177/2040622313510730. Ripamonti CI, Easson AM, Gerdes H. Management of malignant bowel obstruction.

Eur J Cancer. 2008;44(8):1105-1115. doi:10.1016/j.ejca.2008.02.028.

INDICATIONS AND USAGE

SANCUSO® (granisetron transdermal system) is indicated for the prevention of nausea and vomiting in adults receiving moderately and/or highly emetogenic chemotherapy regimens of up to 5 consecutive days.


CONTRADICTIONS

Sancuso is contraindicated in patients with known hypersensitivity to granisetron or to any of the components of the transdermal system.


WARNINGS AND PRECAUTIONS
  • Progressive Ileus and Gastric Distention: Sancuso may mask a progressive ileus and/or gastric distention. This should be particularly considered before use of Sancuso in patients who have had recent abdominal surgery. Monitor for decreased bowel activity, particularly in patients with risk factors for gastrointestinal obstruction.
  • Serotonin Syndrome: The development of serotonin syndrome has been reported with 5-HT3 receptor antagonists. Patients should be monitored for the emergence of serotonin syndrome, especially with concomitant use of Sancuso and other serotonergic drugs.
  • If symptoms of serotonin syndrome occur, discontinue Sancuso and initiate supportive treatment. Patients should be informed of the increased risk of serotonin syndrome, especially if Sancuso is used concomitantly with other serotonergic drugs. Skin Reactions: In clinical trials with Sancuso, application site reactions were reported that were generally mild in intensity and did not lead to discontinuation of use. The incidence of reactions was comparable with placebo. If severe reactions, or a generalized skin reaction occur (e.g., allergic rash, including erythematous, macular, papular rash or pruritus), remove the Sancuso transdermal system.
  • Increased Drug Exposure with Use of External Heat Sources: Prolonged exposure to heat results in increasing plasma concentrations of granisetron during the period of heat exposure. Do not apply a heat pad or heat lamp over or in the vicinity of the Sancuso transdermal system and avoid extended exposure to heat.
  • Phototoxicity with Ultraviolet Light Exposure: Granisetron may be affected by direct natural or artificial sunlight, including sunlamps. An in vitro study using Chinese hamster ovary cells suggests that granisetron has the potential for photogenotoxicity. To avoid a potential skin reaction, advise patients to cover the application site of the transdermal system with clothing if there is a risk of exposure to direct natural or artificial sunlight throughout the period of wear and for 10 days following its removal.

Adverse Reactions

The most common adverse reaction (≥ 3%) is constipation.

You are encouraged to report suspected adverse reactions to Cumberland Pharmaceuticals Inc. at 1-800-Sancuso or FDA at 1-800-FDA-1088 or www.fda.gov/ medwatch.

See full Prescribing Information for SANCUSO.