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Author Notes:

Valerie Relias, Tufts Medical Center, 800 Washington Street #245, Boston, MA 02111, USA. Email: vrelias1@tuftsmedicalcenter.org

Medical writing support was provided by Geraldine Thompson of Engage Scientific Solutions, and was funded by Pfizer.

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Relias serves on Speakers Bureau for AbbVie and Genentech. Dr McBride is a consultant for Sandoz, Sanofi Genzyme, and Teva. Dr Newman has no potential disclosures to report. Dr Paul has no potential disclosures to report. Dr Saneeymehri has no potential disclosures to report. Ms Stanislaus discloses potential conflicts of interest with Celgene, Jazz, Novartis, and Takeda. Dr Tobin is a consultant for KaryoPharm. Drs Hoang and Ryan are employees of Pfizer. Ms Galinsky is a consultant/advisory board member for AbbVie, Merus Pharmaceuticals, and Pfizer.

Subjects:

Research Funding:

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The BRIGHT AML 1003 trial reviewed in this article is a clinical study sponsored by Pfizer. Pfizer funded a meeting for discussion of glasdegib, and provided a formal review of the publication, including for medical accuracy, but the authors had final authority, including choice of journal. The authors were compensated for expenses for their attendance at the meeting, but were not compensated for manuscript preparation.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • Pharmacology & Pharmacy
  • acute myeloid leukemia
  • elderly
  • glasdegib
  • hedgehog pathway inhibitor
  • low-dose cytarabine

Glasdegib plus low-dose cytarabine for acute myeloid leukemia: Practical considerations from advanced practitioners and pharmacists

Tools:

Journal Title:

JOURNAL OF ONCOLOGY PHARMACY PRACTICE

Volume:

Volume 27, Number 3

Publisher:

, Pages 658-672

Type of Work:

Article | Final Publisher PDF

Abstract:

Objective: Acute myeloid leukemia (AML) is primarily a disease of older adults. These patients may not be candidates for intensive treatment, and there has been an ongoing need for treatment options for this group. We review the use of glasdegib, a hedgehog-pathway inhibitor available for use in combination with low-dose cytarabine (LDAC). Data Sources: PubMed and relevant congress abstracts were searched using the term “glasdegib”. In addition, based on our experience with glasdegib, we considered treatment aspects of particular relevance to pharmacists and advanced practitioners. Data Summary: In a randomized phase II study, the combination of glasdegib plus LDAC demonstrated superior overall survival versus LDAC alone (hazard ratio 0.51, 80% confidence interval 0.39–0.67, p = 0.0004). The trial reported adverse events (AEs) of special relevance for older patients, such as hematologic events, gastrointestinal toxicity, and fatigue, as well as AEs associated with Hh-pathway inhibitors (alopecia, muscle spasms, dysgeusia). Educating patients about typical AEs can facilitate adherence as well as early AE identification and proactive management. For LDAC, which is a long-established therapy in AML, various stages of delivery need consideration, with attention to individual circumstances. Practical measures such as dispensing a longer supply can reduce the number of return clinic visits, providing a meaningful difference for many patients. Conclusions: Pharmacists and advanced practitioners play important roles in treatment with glasdegib plus LDAC. Ultimately, framing plans for treatment delivery within the individual circumstances of each patient may enable them to stay on therapy longer, giving them the greatest potential to achieve benefit.

Copyright information:

© The Author(s) 2020

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/rdf).
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