Hi ,

Welcome back to the Oncology Insights Newsletter which fosters your continuous growth in oncology pharmacy practice

Last time you learned about metastatic breast cancer treatment strategy, alpelisib toxicities, and poked a little fun at NCCN

This week you'll learn about "sib" pathways, abemaciclib and elevated SCr, and learning in public

Have a great week!

Kelley

PS

I’m looking for 5 pharmacists to work with in August who want to finally understand the new myeloma drugs and how they should be used in practice

The August Case Study of the ELO Collaborative will help you wrap your head around CAR-T vs CD3 engagers vs bispecifics vs all the other myeloma drugs!

We’ll also be covering chronic leukemias and indolent lymphomas this month so you’ll kick start your oncology learning with blood cancers.

If you’re working in oncology in the US and want your knowledge of oncology to finally be an asset to you, hit reply and tell me a bit about your role to see if this case study is right for you

This next group gets started on Monday 8/12 so the deadline to join is tomorrow, 8/7

🧠 IPS (Insight, Pearl, Sundry)

Insight

As you are building your oncology knowledge, you’ll start recognizing commonalities across different diseases

One that you might be noticing are similarly named drugs

For example, alpelisib, a kinase inhibitor used in breast cancer, ends in “sib”

And so do copanlisib, duvelisib, and idelalisib

But these 3 aren’t approved in breast cancer… 🤔

It has to do with which pathways they inhibit

Idelalisib blocks the PI3K delta pathway

Alpelisib primarily blocks the PI3K alpha pathway

Copanlisib blocks the PI3K delta and alpha pathways

Duvelisib blocks the PI3K delta and gamma pathways

Now copanlisib also has some alpha inhibition like alpelisib does and there have been small studies that show activity in breast cancer, however, it hasn’t been robust enough to make it over the finish line yet

Pearl

A great question popped up last week from a member in the ELO Collaborative for our breast cancer expert

Abemaciclib, a CDK 4/6 inhibitor used in breast cancer, has been shown to increase serum creatinine (SCr)

As pharmacists, we see a lot of drugs that impact SCr, but they aren’t all the same

With abemaciclib, the elevation is uusally due to inhibition of renal tubular secretion transporters and is NOT a reflection on glomerular function so it doesn’t warrant a change based on that lab alone

But since it can also cause diarrhea, we want to make sure the SCr is not a marker of dehydration and actual impaired filtration

If you are not sure, there are other tests which are not based on creatinine, such as cystatin C, that can help you make a determination

Sundry

Learning in public is a powerful motivator

This is when you share with others that you are working towards something - and expect accountability

You are much more likely to achieve something when other people know you’re working on it and will ask you how it’s going

Get some accountability by commenting on this LinkedIn post

💡 Have a topic you want to see discussed in the newsletter? Hit reply and share it! 💡

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The ELO Collaborative is my signature oncology pharmacy membership community that was created for pharmacists working in oncology and trying to learn on the job. It combines a curated curriculum with access to expert oncology pharmacists to walk through case studies and answer questions.

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