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Corey J Medler, J Aubrey Waddell, Dominic A Solimando
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast...
November 2015: Hospital Pharmacy
Hung Q Doan, Sirunya Silapunt, Michael R Migden
Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer. If left untreated, BCCs can become locally aggressive or even metastasize. Currently available treatments include local destruction, surgery, and radiation. Systemic options for advanced disease are limited. The Hedgehog (Hh) pathway is aberrantly activated in a majority of BCCs and in other cancers. Hh pathway inhibitors are targeted agents that inhibit the aberrant activation of the Hh pathway, with smoothened being a targeted component...
2016: OncoTargets and Therapy
Michelle Quinlan, Jocelyn Zhou, Eunju Hurh, Dalila Sellami
PURPOSE: Sonidegib prevents activation of the Hedgehog signal transduction pathway. This PK-QT analysis has been performed to test for potential prolongation of the QT/QTc interval during extended use, and to understand the exposure-QT relationship for sonidegib in patients and in healthy volunteers (HV). METHODS: A pooled analysis of the change in QT interval corrected for heart rate according to Fridericia's formula was conducted across four patient studies from a total of 341 patients (n = 211, 102, 21, and 7 from the phase II pivotal study A2201, study X2101, study X1101, and study B2209, respectively), and across four healthy volunteer studies from a total of 204 healthy volunteers (n = 146, 36, 16, and 6 from study A2114, study A1102, study A2108, and study A2110, respectively)...
September 23, 2016: European Journal of Clinical Pharmacology
Nicholas J Collier, Faisal R Ali, John T Lear
INTRODUCTION: Basal cell carcinomas (BCCs) are the commonest malignancy in the Western world. Locally advanced BCCs (laBCCs) represent tumours that have developed in difficult-to-treat facial sites, aggressively recurrent tumours, large neglected tumours and those in which current treatment options are excluded by clinical or patient-driven criteria. It is estimated laBCCs represent 1% of BCCs. AREAS COVERED: Sonidegib is an oral hedgehog pathway inhibitor with a novel structure...
October 2016: Expert Review of Anticancer Therapy
M Catherine Pietanza, Anya M Litvak, Anna M Varghese, Lee M Krug, Martin Fleisher, Jerrold B Teitcher, Andrei I Holodny, Cami S Sima, Kaitlin M Woo, Kenneth K Ng, Helen H Won, Michael F Berger, Mark G Kris, Charles M Rudin
OBJECTIVES: The Hedgehog pathway has been implicated in small cell lung cancer (SCLC) tumor initiation and progression. Pharmacologic blockade of the key Hedgehog regulator, Smoothened, may inhibit these processes. We performed a phase I study to determine the maximum tolerated dose (MTD) of sonidegib (LDE225), a selective, oral Smoothened antagonist, in combination with etoposide/cisplatin in newly diagnosed patients with extensive stage SCLC. MATERIALS AND METHODS: Patients received 4-6 21-day cycles of etoposide/cisplatin with daily sonidegib...
September 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Egle Ramelyte, Valerie C Amann, Reinhard Dummer
INTRODUCTION: Advanced and metastatic basal cell carcinomas (BCCs) are rare but still present a severe medical problem. These tumors are often disfiguring and impact the quality of life by pain or bleeding. Based on discovery of the hedgehog (Hh) signaling pathway and its role in the pathogenesis of BCCs, smoothened (SMO) inhibitors have been developed with Sonidegib being the 2nd in class. It is the only Hh pathway inhibitor investigated in a randomized trial accompanied by pharmacodynamic investigations...
October 2016: Expert Opinion on Pharmacotherapy
Mario E Lacouture, Brigitte Dréno, Paolo Antonio Ascierto, Reinhard Dummer, Nicole Basset-Seguin, Kate Fife, Scott Ernst, Lisa Licitra, Rogerio I Neves, Ketty Peris, Susana Puig, Jonas Sokolof, Aleksandar Sekulic, Axel Hauschild, Rainer Kunstfeld
: : Abnormal activation of hedgehog pathway signaling is a key driver in the pathogenesis of basal cell carcinoma (BCC). Vismodegib, a first-in-class small-molecule inhibitor of hedgehog pathway signaling, is approved by regulatory authorities for the treatment of adults who have metastatic BCC or locally advanced BCC that has recurred after surgery, or who are not candidates for surgery and who are not candidates for radiation. A second inhibitor, sonidegib, was also recently approved for the same patient group with locally advanced BCC...
October 2016: Oncologist
Hironobu Minami, Yuichi Ando, Brigette Buig Yue Ma, Jih-Hsiabg Lee, Hiroyuki Momota, Yutaka Fujiwara, Leung Li, Koichi Fukino, Koji Ito, Takeshi Tajima, Asuka Mori, Chia-Chi Lin
Sonidegib is a selective inhibitor of smoothened receptor, which is a key regulator of hedgehog signaling pathway. The purpose of this study is to determine the maximum tolerated dose based on dose-limiting toxicity (DLT) and the recommended dose (RD) of sonidegib in Asian patients with advanced solid tumors. This was an open-label, single-arm, multicenter, 2-group, parallel, dose-escalation, phase 1 study conducted in Asian patients (patient group in Japan [group 1] and patient group in Hong Kong and Taiwan [group 2])...
July 28, 2016: Cancer Science
R Tibes
Basal cell carcinoma (BCC), although mostly locally confined, is the most common cancer. Most BCCs harbor inactivating mutations in the membrane receptor/gene Ptch, thereby activating the Hedgehog signaling pathway (Hh) via the essential signaling molecule Smoothened (SMO). Novel small-molecule inhibitors or antagonists of SMO have shown excellent response rates in patients with locally advanced, unresectable and metastatic BCC in roughly 35-60% of patients, with disease control rates and clinical benefit being even higher...
May 2016: Drugs of Today
Jocelyn Zhou, Michelle Quinlan, Kelli Glenn, Hildegard Boss, Franck Picard, Henry Castro, Dalila Sellami
AIMS: This study aimed to evaluate the impact of esomeprazole on the pharmacokinetics of sonidegib. METHODS: This Phase I study evaluated the impact of the proton pump inhibitor (PPI) esomeprazole on the oral absorption and pharmacokinetics (PKs) of a single dose of sonidegib under fasted conditions. A total of 42 healthy subjects were enrolled to receive either sonidegib alone (200 mg single dose) or sonidegib in combination with esomeprazole (40 mg pre-treatment 5 days and combination were given on day 6)...
October 2016: British Journal of Clinical Pharmacology
Leon Chen, Sirunya Silapunt, Michael R Migden
The Hedgehog inhibitors are promising alternative for patients with advanced basal cell carcinoma that are not amenable to radiotherapy or surgery. Sonidegib, also known as LDE225, is an orally available SMO antagonist that was recently approved by the US FDA for the treatment of patients with locally advanced basal cell carcinoma. This article will provide an overview of the pharmacology and pharmacokinetics of sonidegib and in-depth analysis of the BOLT trial with additional data from the 12-month update...
September 2016: Future Oncology
Troy Kish, Lauren Corry
No abstract text is available yet for this article.
May 2016: P & T: a Peer-reviewed Journal for Formulary Management
David A Irvine, Bin Zhang, Ross Kinstrie, Anuradha Tarafdar, Heather Morrison, Victoria L Campbell, Hothri A Moka, Yinwei Ho, Colin Nixon, Paul W Manley, Helen Wheadon, John R Goodlad, Tessa L Holyoake, Ravi Bhatia, Mhairi Copland
Targeting the Hedgehog (Hh) pathway represents a potential leukaemia stem cell (LSC)-directed therapy which may compliment tyrosine kinase inhibitors (TKIs) to eradicate LSC in chronic phase (CP) chronic myeloid leukaemia (CML). We set out to elucidate the role of Hh signaling in CP-CML and determine if inhibition of Hh signaling, through inhibition of smoothened (SMO), was an effective strategy to target CP-CML LSC. Assessment of Hh pathway gene and protein expression demonstrated that the Hh pathway is activated in CD34(+) CP-CML stem/progenitor cells...
2016: Scientific Reports
Audrey A Jacobsen, Adam S Aldahan, Olivia B Hughes, Vidhi V Shah, John Strasswimmer
IMPORTANCE: Hedgehog pathway inhibitors (HPIs) were made available by US Food and Drug Administration approval in 2012 for vismodegib and 2015 for sonidegib. Both target the Smoothened molecule and are indicated for locally advanced basal cell carcinoma (laBCC) and metastatic basal cell carcinoma (mBCC). OBJECTIVE: To evaluate clinical experience with HPIs, including efficacy and adverse effects. DATA SOURCES: We conducted a systematic review in concordance with the PRISMA guidelines of PubMed, the Cochrane Central Register of Controlled Trials, ClinicalTrials...
July 1, 2016: JAMA Dermatology
Jocelyn Zhou, Michelle Quinlan, Eunju Hurh, Dalila Sellami
Sonidegib selectively inhibits smoothened protein, suppresses the growth of Hedgehog pathway-dependent tumors, and has recently been approved in the indication of locally advanced basal cell carcinoma. A comprehensive exposure-response analysis was conducted to further characterize the relationship of sonidegib exposure to efficacy and safety. Minimum observed plasma concentration at pre-dose (Cmin), peak concentration (Cmax), and area under the curve were used as exposure endpoints. Exposure-efficacy analyses included data from 190 patients who received sonidegib 200 mg or 800 mg once daily in the primary efficacy study...
April 20, 2016: Journal of Clinical Pharmacology
Emilie Lauressergues, Peter Heusler, Fabrice Lestienne, David Troulier, Isabelle Rauly-Lestienne, Amélie Tourette, Marie-Christine Ailhaud, Claudie Cathala, Stéphanie Tardif, Delphine Denais-Laliève, Marie-Thérèse Calmettes, Anne-Dominique Degryse, Antoine Dumoulin, Luc De Vries, Didier Cussac
The Hedgehog (HH) pathway has been linked to the formation of basal cell carcinoma (BCC), medulloblastoma, and other cancers. The recently approved orally active drugs vismodegib (GDC-0449) and sonidegib (LDE-225) were not only efficacious for the treatment of advanced or metastatic BCC by antagonizing the smoothened (SMO) receptor, but also produced important side effects, limiting their use for less invasive BCC. Herein, we compared a large series of SMO antagonists, including GDC-0449 and LDE-225, the clinically tested BMS-833923, CUR-61414, cyclopamine, IPI-926 (saridegib), itraconazole, LEQ-506, LY-2940680 (taladegib), PF-04449913 (glasdegib), and TAK-441 as well as preclinical candidates (PF-5274857, MRT-83) in two SMO-dependent cellular assays and for G-protein activation...
April 2016: Pharmacology Research & Perspectives
Reinhard Dummer, Alexander Guminski, Ralf Gutzmer, Luc Dirix, Karl D Lewis, Patrick Combemale, Robert M Herd, Martin Kaatz, Carmen Loquai, Alexander J Stratigos, Hans-Joachim Schulze, Ruth Plummer, Sven Gogov, Celine Pallaud, Tingting Yi, Manisha Mone, Anne Lynn S Chang, Frank Cornélis, Ragini Kudchadkar, Uwe Trefzer, John T Lear, Dalila Sellami, Michael R Migden
BACKGROUND: The hedgehog pathway inhibitor sonidegib demonstrated meaningful tumor shrinkage in more than 90% of patients with locally advanced basal cell carcinoma (BCC) or metastatic BCC in the BCC Outcomes with LDE225 Treatment study. OBJECTIVE: This report provides long-term follow-up data collected up to 12 months after the last patient was randomized. METHODS: In this multicenter, randomized, double-blind phase II study, patients were randomized 1:2 to sonidegib 200 or 800 mg...
July 2016: Journal of the American Academy of Dermatology
(no author information available yet)
No abstract text is available yet for this article.
February 29, 2016: Medical Letter on Drugs and Therapeutics
Aleksandar Sekulic, Daniel Von Hoff
The hedgehog (Hh) signaling pathway is aberrantly activated in a majority of basal cell carcinomas (BCC). Vismodegib and sonidegib are targeted inhibitors of Smoothened (SMO). Both drugs are approved for use in locally advanced BCC (laBCC), with vismodegib also approved for metastatic BCC (mBCC).
February 25, 2016: Cell
Dennis J Cada, Ross Bindler, Danial E Baker
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line...
October 2015: Hospital Pharmacy
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