While our survey showed that PwCF felt that the COVID-19 pandemic had impacted their mental health more than ETI therapy, around 9% of survey responders felt that ETI did cause an increase in either anxiety or depression. This finding was similar to the numbers Spoletini and colleagues found in their adult clinic. They also found that a dose reduction of ETI improved or resolved mental health adverse events for most patients. [2] A recently published study by Guimbellot and colleagues studied ivacaftor levels in PwCF who were on ivacaftor monotherapy and showed many patients had levels higher than the published minimum effective concentrations.[6] Thus, there may be a correlation between ETI levels and mental health adverse events that should be further explored in a prospective manner.

Etoposide is an antineoplastic agent widely used for treatment of many pediatric cancers and associated with infusion related adverse drug reactions (ADRs). In this brief report we describe etoposide infusion related ADRs that occurred over a 10-year period at two freestanding pediatric hospitals. Infusion reactions occurred in 1% of patients. Of the 32 patients that experienced adverse reactions, 41% were rechallenged after the reaction and all were able to tolerate at least one future dose with either pre-treatment or extending infusion duration.