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TOP_August 2012_FINAL_v2_TOP 8/20/12 9:57 AM Page 1 CANCER CENTER PROFILE
University of Arizona Cancer T-DM1 in Metastatic Breast
The Expanding Role of the Oncology Pharmacist It's Just the Beginning for an Exciting New Class By Caroline Helwick The biggest newsmaker at the 2012 healthy tissue, T-DM1 not only has Annual Meeting of the American potent antitumor effects but is also very Society of Clinical Oncology well tolerated.
(ASCO) was a compound whose name Trastuzumab emtansine (T-DM1) is and actions sound practically missilelike: part of an emerging class of drugs called T-DM1. Because of its highly targeted antibody-drug conjugates (ADCs) that and potent effect that spares surrounding link a monoclonal antibody (in this case, Continued on page 4 RENAL CELL CARCINOMA
Quality of Life Drives Patient
Preference for Metastatic Renal
Daniel Butcher, Outpatient Oncology Pharmacy Supervisor, and Susan Vande Geest, Clinical StaffPharmacist, at the University of Arizona Cancer Center.
Cell Carcinoma Drug
Photo courtesy of the University of Arizona Cancer Center.
The University of Arizona Cancer Center (UACC) in Tucson is 1 of 41 National Cancer Institute (NCI)-designated comprehen- Society of Clinical Oncology, held in sive cancer centers in the United States. Called a "high-per- The surprising results of a random- ized trial on patient preference for Chicago, Illinois.
forming" center by US News & World Report, the center has 29 beds one cancer therapy over another In a double-blind, crossover trial, 169 on a dedicated oncology wing, plus beds in surgery, gynecology, show that patient-reported quality-of-life patients with metastatic renal cell carci- and pediatric units. The total number of beds in the facility is 487. (QOL) differences influence treatment noma (mRCC) were randomized 1:1 to UACC has 2 outpatient clinics: UACC North Campus is for preference far more than physicians had 10 weeks of 800 mg of pazopanib or 50 clinic/office visits, infusions, and Mohs surgery; and UACC Orange imagined, suggested researchers at the mg of sunitinib as first-line cancer treat- Continued on page 7 2012 Annual Meeting of the American ment; after a 2-week washout period, Continued on page 25 CONFERENCE NEWS: MASCC
Advances in Supportive
oral onColytiCS . . . . . . 24
Exploring the Drug Updates on Oral Chemotherapy Adherence—Where Are We Today? Quantifying the Drug ConferenCe newS: aSCo 2012
Shortage: One Center's Olanzapine Ef ective Antiemetic Management of Febrile
for Breakthrough CINV . . . . . 26 At the recent 2012 symposium of the Multinational As sociation of Supportive Care in Cancer Advances over the past few decades Duloxetine in Peripheral (MASCC), held in New York City, have led to reduced morbidity and mor- Considerations in Multiple experts discussed a wide range of topics tality from chemotherapy-induced fe - Myeloma—Ask the Experts: Ginseng Improves Cancer- related to management of treatment- brile neutropenia (FN). FN was once Maintenance Settings Related Fatigue . . . . . . . . .
induced side effects. Below are some considered fatal, but in the modern era, highlights from the MASCC annual mortality is about 5% and FN-related Continued on page 9 2012 Green Hill Healthcare Communications, LLC TOP_August 2012_FINAL_v2_TOP 8/20/12 9:58 AM Page 7 Cancer Center Profile University of Arizona Cancer Center Continued from cover Grove Campus offers clinic/office visits, infusions, and radiation oncology.
Surgery and radiation oncology services are also offered at the University Campus hospital center. In the fiscal year of 2011, 8560 patients were treated at UACC for solid tumor, soft tissue, and skin and blood cancers. UACC is best known for its specialties: lymphoma, skin can- cer and melanoma, gastrointestinal cancer, gynecologic cancer, and breast cancer. UACC encompasses 11 multi- disciplinary clinics for major disease sites, as well as a separate clinic for high-risk cancer genetics.
Research is a major focus at UACC.
Currently, more than 200 clinical trials are open for enrollment at UACC.
• Study to determine if ursodeoxy- cholic acid (a natural bile acid) can reverse the cellular damage of • Research to see if taking high-dose vitamin D (cholecalciferol) twice a week for 8 to 9 weeks prevents skin cancer in people with sun damage and low levels of vitamin D.
Jerrelee Hollings, Pharmacist; Daniel Butcher, Outpatient Oncology Pharmacy Supervisor; and Amy Smith, Pharmacy Technician (left to right), at the University of Arizona Cancer Center.
• Study in breast cancer patients or Photo courtesy of the University of Arizona Cancer Center.
women at high risk who are taking tamoxifen to determine if a sup- DB: The multidisciplinary approach is
How has the role of the oncology
nings of cancer. My job as an oncology plement called diindolylmethane based on the recognition that a diagnosis pharmacist changed over the past
pharmacist is an extension of that. One (DIM) can reduce risk of cancer of cancer has physical and psychological in 4 deaths in the US are due to cancer.
re currence.
ramifications. With our pool of experts, DB: It is exciting to see that the oncol-
I felt I had the necessary qualifications to • I-SPY2 breast cancer trial, which is we are well equipped to address the ogy pharmacist is needed more now help cancer patients. a collaborative study to obtain entire disease spectrum and to help with than ever before. Our role has expand- genetic and biological markers from healing. We provide active supportive ed significantly from compounding and What advice would you give to
individual patients' tumors to screen care for treatment-related and disease- dispensing drugs to helping manage oncology pharmacists just
several promising treatments simul- related side effects as well as for healing, patients with complex diseases and entering the field?
with psychological and family support.
therapies. I firmly believe that oncology DB: Oncology can be overwhelming
UACC is affiliated with St. Joseph's and the work environment is complex.
Hospital and Medical Center in One piece of advice is not to be afraid Phoenix, and the Cancer Centers to ask questions. You are working with of Northern Arizona Healthcare in "Our role has expanded significantly from patients at the most stressful time in their Sedona. UACC's research facility has lives and the work can be emotionally compounding and dispensing drugs to helping manage 73 laboratories and about 300 re - taxing. Be sure to have a planned out- searchers drawn from the University of let to process your work experiences in patients with complex diseases and therapies." Arizona and other institutions.
a positive manner. You will see the full The Oncology Pharmacist interviewed —Daniel Butcher, PharmD range of emotions with your patients, Daniel Butcher, PharmD, Outpatient like an emotional roller coaster. You Oncology Pharmacy Supervisor, at the will need a good support system to pro- University of Arizona Cancer Center to What are you excited about in the
pharmacists can ease the burden on our vide balance. Learn from your patients.
get his perspective on the role of the field of oncology?
providers by implementing collaborative They are a valuable educational re - oncology pharmacist at his institution.
DB: Research. Since we are an NCI-des-
practice agreements that allow us to source on a daily basis. Your clinical ignated comprehensive cancer center, apply our specialized knowledge.
experience with patients is as impor- What approach does the University
a lot of studies are being conducted at This can have a financial impact. New tant as reading journals.
of Arizona Cancer Center take to
our site. Trying to keep up with current therapies are extremely expensive and I treat people with cancer?
studies can be daunting. It is rewarding believe we can guide appropriate use of If you were not an oncology pharma-
Daniel Butcher (DB): We are an NCI-
to watch agents that we have studied these therapies to improve outcomes for cist, what would you be doing?
designated comprehensive cancer cen- make it to the marketplace; for exam- DB: The quality that attracted me to
ter that employs experts in all related ple, nab-paclitaxel (Abraxane) and oncology is an interest in how things fields. We use a multidisciplinary ap - ipilimumab, an immunotherapy for What inspired you to become an
work. I think I would be a mechanical proach for each patient to identify the melanoma. We can have disappointing engineer or a nuclear physicist. When best treatment options.
results as well. Initially, we had the DB: When I was in pharmacy school, I
I was a kid, I would take apart appli- impression that CVAX would be an became interested in oncology drugs. I ances and other household items to see How does your approach translate
effective treatment for melanoma, but found the biology fascinating, including how they worked, and I always man- to better outcomes for your
then the trial was halted because the prepharmacy courses about DNA aged to put them back together in results were not promising.
and RNA and the biological underpin- AugusT 2012 I VOL 5, NO 5 7

Source: http://opa.ahsc.arizona.edu/sites/opa.ahsc.arizona.edu/files/uploads/TOP_Aug_CCProfile.pdf