PMID- 33215562
OWN - NLM
STAT- MEDLINE
DCOM- 20210426
LR  - 20210426
IS  - 1477-092X (Electronic)
IS  - 1078-1552 (Print)
IS  - 1078-1552 (Linking)
VI  - 27
IP  - 3
DP  - 2021 Apr
TI  - Glasdegib plus low-dose cytarabine for acute myeloid leukemia: Practical 
      considerations from advanced practitioners and pharmacists.
PG  - 658-672
LID - 10.1177/1078155220973737 [doi]
AB  - 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.
FAU - Relias, Valerie
AU  - Relias V
AUID- ORCID: 0000-0002-1476-5747
AD  - Division of Hematology/Oncology, Tufts Medical Center, Boston, MA, USA.
FAU - McBride, Ali
AU  - McBride A
AD  - Department of Pharmacy, The University of Arizona Cancer Center, Tucson, AZ, USA.
FAU - Newman, Matthew J
AU  - Newman MJ
AUID- ORCID: 0000-0002-1402-5554
AD  - The Johns Hopkins Hospital Department of Pharmacy, Baltimore, MD, USA.
FAU - Paul, Shilpa
AU  - Paul S
AD  - Department of Pharmacy at the University of Texas MD Anderson Cancer Center, 
      Houston, TX, USA.
FAU - Saneeymehri, Seyyedeh
AU  - Saneeymehri S
AD  - Emory University Hospital/Winship Cancer Institute, Atlanta, GA, USA.
FAU - Stanislaus, Genique
AU  - Stanislaus G
AD  - John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, 
      USA.
FAU - Tobin, Jennifer
AU  - Tobin J
AD  - Blood Disorders Center, University of Colorado Hospital, Aurora, CO, USA.
FAU - Hoang, Caroline J
AU  - Hoang CJ
AD  - Pfizer Oncology, Pfizer Inc., New York, NY, USA.
FAU - Ryan, Joanne C
AU  - Ryan JC
AD  - Pfizer Oncology, Pfizer Inc., New York, NY, USA.
FAU - Galinsky, Ilene
AU  - Galinsky I
AD  - Department of Leukemia, Dana-Farber Cancer Institute, Boston, MA, USA.
LA  - eng
PT  - Clinical Trial, Phase II
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20201120
PL  - England
TA  - J Oncol Pharm Pract
JT  - Journal of oncology pharmacy practice : official publication of the International 
      Society of Oncology Pharmacy Practitioners
JID - 9511372
RN  - 0 (Antimetabolites, Antineoplastic)
RN  - 0 (Benzimidazoles)
RN  - 0 (Phenylurea Compounds)
RN  - 04079A1RDZ (Cytarabine)
RN  - K673DMO5H9 (glasdegib)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Antimetabolites, Antineoplastic/administration & dosage/adverse effects
MH  - Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/adverse 
      effects
MH  - Benzimidazoles/*administration & dosage/adverse effects
MH  - Cytarabine/*administration & dosage/adverse effects
MH  - Drug Interactions/physiology
MH  - Female
MH  - Gastrointestinal Diseases/chemically induced
MH  - Hematologic Diseases/chemically induced
MH  - Humans
MH  - Leukemia, Myeloid, Acute/diagnosis/*drug therapy
MH  - Male
MH  - Pharmacists/*standards
MH  - Phenylurea Compounds/*administration & dosage/adverse effects
MH  - Physicians/*standards
PMC - PMC8008421
OTO - NOTNLM
OT  - Acute myeloid leukemia
OT  - elderly
OT  - glasdegib
OT  - hedgehog pathway inhibitor
OT  - low-dose cytarabine
COIS- Declaration of Conflicting Interests: 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.
EDAT- 2020/11/21 06:00
MHDA- 2021/04/27 06:00
PMCR- 2021/03/30
CRDT- 2020/11/20 08:39
PHST- 2020/11/21 06:00 [pubmed]
PHST- 2021/04/27 06:00 [medline]
PHST- 2020/11/20 08:39 [entrez]
PHST- 2021/03/30 00:00 [pmc-release]
AID - 10.1177_1078155220973737 [pii]
AID - 10.1177/1078155220973737 [doi]
PST - ppublish
SO  - J Oncol Pharm Pract. 2021 Apr;27(3):658-672. doi: 10.1177/1078155220973737. Epub 
      2020 Nov 20.