The variety of ongoing research in cancer has never been more dynamic. Increased understanding into the pathogenesis of cancers, intriguing research into the development of new treatments, the establishment of advanced methods of identifying actionable targets for treatment, and improved strategies for managing adverse events occurring with therapy are among the up-to-the-minute topics in the field.
This new feature in Value-Based Cancer Care is a compendium of pioneering work by established and up-and-coming hematology oncology pharmacists and other healthcare providers working in a variety of oncology settings who published abstracts in the March issue of the Journal of Hematology Oncology Pharmacy, the official publication of the Hematology/Oncology Pharmacy Association (HOPA). We aim to highlight this important research and follow up with our readers when it is published as full articles.
Presenting Authors: Mary C. Cash, PharmD, BCOP, and Erin M. Eberwein, PharmD, BCOP, Duke University Hospital, Durham, NC
Co-Authors: Elizabeth R. Eubanks, PharmD, MPH, BCPS, BCOP, and Daniel Schrum, PharmD, BCOP, Duke University Hospital, Durham, NC; Joshua Burrows, MS, and Hui-Jie Lee, PhD, Duke University School of Medicine, Department of Biostatistics and Bioinformatics, Durham, NC
BACKGROUND: The use of post-transplant cyclophosphamide, tacrolimus, and mycophenolate (PTCy-Tac-MMF) has gained popularity for the prevention of graft-versus-host disease (GVHD) following hematopoietic stem cell transplant (HSCT) with an HLA-matched related donor (MRD) or an HLA-matched unrelated donor (MUD) donor. Although the results of BMT-CTN 1703 solidified the role of PTCy-Tac-MMF as standard of care following reduced-intensity conditioning, limited data exist evaluating its use following myeloablative conditioning.
OBJECTIVE: The purpose of this study is to compare the efficacy and safety of PTCy-Tac-MMF and tacrolimus and methotrexate as GVHD prevention among patients who underwent HSCT from an MRD or MUD following myeloablative conditioning.
Presenting Authors: Emily Behren Ketchum, PharmD, BCOP, Wellstar-MCG Health Georgia Cancer Center, Augusta, GA; Amber B. Clemmons, PharmD, BCOP, FHOPA, University of Georgia College of Pharmacy, Augusta, GA
Co-Authors: Stephanie Daniels, PA-C, and Sarah Jimenez, DNP, APN-BC, AGACNP, AOCNP, Wellstar-MCG Health Georgia Cancer Center, Augusta, GA; Mohammad Mian, MD, PhD, MPH, and Locke J. Bryan, MD, Department of Medicine, Hematology and Oncology, Wellstar-MCG Health Georgia Cancer Center, Augusta, GA
BACKGROUND: Febrile neutropenia (FN) is a common and potentially life-threatening complication of high-dose cytarabine (HiDAC) consolidation for patients with acute myeloid leukemia. Early detection may limit negative sequelae. Although continuous temperature monitoring via commercially available remote temperature monitoring transdermal patch is reported to detect FN earlier than intermittent manual monitoring in hospitalized patients, evaluation in the outpatient oncology setting is lacking.
OBJECTIVE: To examine the feasibility and effectiveness of a remote continuous temperature monitoring device for early detection of FN after HiDAC.
Presenting Author: Eugene R. Przespolewski, PharmD, BCOP, DPLA, Roswell Park Comprehensive Cancer Center, Buffalo, NY
Co-Authors: Alharith Abdel-Arazzaq, University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY; Sarah Mullin Falls, MS, PhD, and Grazyna Riebandt, PharmD, BCOP, DPLA, Roswell Park Comprehensive Cancer Center, Buffalo, NY
BACKGROUND: Many hematology-oncology pharmacists have reported high burnout levels for reasons including increased hours worked and administrative requirements in a recently completed survey. This has resulted in challenges in recruiting and retaining hematology-oncology pharmacists in addition to already demanding clinical responsibilities. Oncology PGY-2 residency program directors (OPGY-2 RPDs) are particularly vulnerable with voluminous regulations and administrative requirements to conduct a residency program in addition to clinical responsibilities. Neither the well-being of OPGY-2 RPDs nor the implementation and impact of additional resources have been described.
OBJECTIVES: The goals are to describe the status, structure, support for RPDs, and time requirements of OPGY-2 across the country, and to provide a well-being assessment of these RPDs to capture the level of burnout.
Presenting Authors: Sandra Savignac, PharmD, MSc, CIUSSS de l’Est-de-l’Île-de-Montréal, Quebec, Canada; Marianne Boyer, BPharm, MSc, BCOP, Centre hospitalier de l’Université de Montréal, Quebec, Canada
Co-Authors: Christine Messier, BPharm, MSc, BCOP, and Marie-Lawrence Monfette, PharmD, MSc, BCOP, Centre hospitalier de l’Université de Montréal, Quebec, Canada; Nathalie Letarte, PharmD, MSc, BCOP, Faculté de pharmacie, Université de Montréal, Centre hospitalier de l’Université de Montréal, Quebec, Canada
BACKGROUND: The Canadian palbociclib monograph recommends a starting dose of 125 mg/day and subsequent dose reductions during treatment if adverse events occur. However, in practice, clinicians sometimes choose to initiate palbociclib at a lower dose to prevent the occurrence of adverse events in patients who are considered more likely to have them.
OBJECTIVES: This study aimed to identify baseline patient characteristics that may predict the need for palbociclib dose reduction during treatment. The secondary objectives were to describe treatment patterns and clinical outcomes, including progression-free survival, in patients treated with palbociclib at the Centre hospitalier de l’Université de Montréal. The study also aimed to identify the frequency and type of interventions carried out by oncology pharmacists for these patients.
Presenting Author: Kirollos Hanna, PharmD, BCPS, BCOP, FACCC, Minnesota Oncology, St. Paul, MN
Co-Authors: Marjan Massoudi, PharmD, BeiGene USA, San Diego, CA; Mei Xue, BeiGene USA, Cambridge, MA; Mark Balk, PharmD, BCPS, BeiGene USA, Salt Lake City, UT; Hossein ZivariPiran, Evidera, Toronto, ON, Canada
BACKGROUND: Chronic lymphocytic leukemia (CLL) is the most common leukemia type, with an annual incidence of 4.9 per 100,000 people in the United States. In 2020, an estimated 207,463 people were living with CLL. Zanubrutinib is a Bruton tyrosine kinase inhibitor that is FDA approved for CLL. In the phase 3 ALPINE trial (NCT03734016), zanubrutinib elicited a significantly higher overall response rate and significantly longer progression-free survival than ibrutinib.
OBJECTIVE: This study aimed to compare zanubrutinib versus ibrutinib in relapsed/refractory CLL by calculating the number needed to treat to avoid 1 event of disease progression or death and the associated incremental costs.
Presenting Authors: Brooke Looney, PharmD, CSP, and Stephanie White, PharmD, CSP, Vanderbilt University Medical Center, Nashville, TN
Co-Authors: Kristen Whelchel, PharmD, CSP, Autumn Zuckerman, PharmD, CSP, Ryan Moore, MS, and Leena Choi, PhD, Vanderbilt University Medical Center, Nashville, TN; Paul Hueseman, PharmD, MS, AstraZeneca, St. Louis, MO
BACKGROUND: Patients taking poly (ADP-ribose) polymerase inhibitors (PARPi) often encounter adverse events soon after initiation that may lead to treatment interruptions, dose reductions, and discontinuations. Research is needed to understand if increased treatment monitoring early in therapy impacts outcomes.
OBJECTIVE: This study assessed the impact of pharmacist-led tailored monitoring on medication interruptions, dose reductions, discontinuations, and emergency department visits/hospitalizations over the first 90 days of treatment in patients initiating PARPi therapy.
Presenting Authors: Hoim Kim, PharmD, BCOP, BCPS, City of Hope National Medical Center, Duarte, CA; Shelley Chang, MD, PhD, University of Southern California School of Medicine, Los Angeles, CA
Co-Authors: Shan Yuan, MD, and Shirong Wang, MD, City of Hope National Medical Center, Duarte, CA
BACKGROUND: Plerixafor is an adjunct agent for peripheral blood stem cell mobilization with well-demonstrated safety and efficacy since its FDA approval in 2009. Until recently, plerixafor was solely available in the United States under the brand name of Mozobil (Sanofi-Aventis; France), and its widespread use has been limited by cost. Our institution recently switched from using Mozobil to generic plerixafor (Meitheal Pharmaceuticals; Chicago, IL) with a much lower cost.
OBJECTIVE: This retrospective, observational study was conducted to compare the mobilization efficacy of generic and brand-name plerixafor in patients with multiple myeloma.
Presenting Author: Shanada Monestime, PharmD, BCOP, GO2 for Lung Cancer, Washington, DC
BACKGROUND: Pharmacists play a crucial role in various aspects of healthcare, yet their potential impact in promoting lung cancer screening remains largely untapped within the United States. Lung cancer screening promotion is a critical need, because less than 10% of high-risk populations undergo lung cancer screening, whereas rates exceed 60% for breast, prostate, and colorectal cancer screenings. Addressing this disparity is imperative, because early detection can increase overall survival.
OBJECTIVES: This study aims to identify counties with significant disparities in lung cancer incidence based on race and sex. The findings will identify high-priority areas where partnerships with pharmacists can be established to develop effective strategies for increasing lung cancer screening rates.