An In-depth Analysis of Intravenous Oncology Drug Compounding in Pharmacies: Ensuring Safety, Enhancing Efficiency, Driving Innovations, and Maintaining Stability
Authors: Zhou Jiangping , Wang Yan , Wang Junping , Sheng Mengyuan 
Published: December 2024

Introduction: Intravenous (IV) oncology drug administration plays a pivotal role in cancer therapy, enabling swift and precise delivery of therapeutic agents. The preparation process for these drugs is highly complex, necessitating rigorous adherence to safety standards, efficient operational workflows, and adoption of advanced technologies to ensure both patient safety and treatment effectiveness. This review delves into the practices and innovations within pharmacy settings that underpin the preparation of IV oncology drugs, with an emphasis on safety, operational efficiency, technological advancements, and drug stability. Safety: Ensuring safety in the preparation of IV oncology medications is crucial due to the hazardous properties of chemotherapeutic agents. Compliance with standards such as USP <797> and USP <800> is vital to mitigate contamination risks and minimize exposure. Safety measures include the use of personal protective equipment (PPE), engineering controls such as biological safety cabinets (BSCs) and compounding aseptic containment isolators (CACIs), along with comprehensive staff training programs. Past incidents, such as contamination at the New England Compounding Center, illustrate the necessity for robust safety protocols to safeguard both patients and healthcare professionals. Efficiency: Optimizing efficiency in the preparation process is essential to address high demand while maintaining stringent safety and quality standards. Key steps include prescription validation, drug compounding, quality assurance, and dispensing. The adoption of technologies like automated compounding devices (ACDs) and pharmacy management systems has streamlined these processes, significantly reducing errors and preparation times. However, achieving a balance between operational efficiency and uncompromised safety remains a persistent challenge, requiring ongoing staff education, resource optimization, and strict compliance with regulatory guidelines. Innovative Technologies: The integration of cutting-edge technologies, including robotics, automation, and artificial intelligence (AI), has transformed IV drug preparation. Robotic systems offer enhanced precision and minimize human error, while AI and advanced aseptic techniques optimize workflows and dosing accuracy. Future advancements may include the application of 3D printing, nanotechnology, and blockchain to further elevate the safety, efficiency, and traceability of preparation processes. Stability: Preserving the stability of compounded oncology drugs is fundamental to their therapeutic effectiveness and safety. Stability is influenced by variables such as storage conditions, handling methods, and the compatibility of diluents and containers. Adhering to guidelines like USP <797> is crucial for maintaining stability. Innovations in stabilizing agents, packaging, and real-time monitoring systems are advancing the field, helping to overcome stability-related challenges and improving treatment outcomes. Conclusion: This review underscores the paramount importance of safety, efficiency, innovation, and stability in the preparation of IV oncology drugs. Strict adherence to safety standards, streamlined workflows, the adoption of advanced technologies, and meticulous stability management are critical to enhancing pharmacy practices and patient care. Future efforts should prioritize the integration of emerging technologies, standardization of procedures, continuous education for staff, and implementation of real-time monitoring to further progress in this domain. Addressing these challenges with innovative solutions will drive improvements in both patient safety and therapeutic outcomes.