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Guidelines

Further Defining the Scope of Hematology/Oncology Pharmacy Practice

In an effort to describe the evolution of oncology pharmacy and promote a better understanding of the profession, HOPA has updated its 2013 Scope of Hematology/Oncology Pharmacy Practice. Further Defining the Scope of Hematology/Oncology Pharmacy Practice (PDF) details the roles, responsibilities, tasks, and competencies of hematology/oncology pharmacists in various practice settings. Because advances in the field are occurring rapidly and because oncology pharmacists may enter the profession by a number of pathways, HOPA also explores the importance of board certification for oncology pharmacists serving in different roles and positions.

Oncology Pharmacy Technician Guidelines

In collaboration with ASHP, HOPA members have published ASHP-HOPA guidelines on the roles and responsibilities of the pharmacy technician in ambulatory oncology care (PDF). These guidelines address the rapid evolution of ambulatory oncology practice in the past decades.

Dose Rounding of Biologic and Cytotoxic Anticancer Agents

Drafted by the a group of HOPA members and experts put together by the HOPA Standards Committee, this position statement document (PDF) is intended to serve as a guideline for use during the developing of dose-rounding policy as well as to support and validate existing policies.

ESMO: Management of Toxicities from Immunotherapy

In 2017, the European Society for Medical Oncology published the Management of Toxicities from Immunotherapy in the Annals of Oncology. Immunotherapy is an essential component of cancer care and expands the treatment of possibilities for patients. These clinical practice guidelines offer an overview of the main immune-related adverse events and include recommendations for their management.

Scope of Hematology/Oncology Pharmacy Practice

Created with the purpose to unify and establish a setting for demonstrating the value of a profession in improving patient outcomes, the Scope of Hematology/Oncology Pharmacy Practice (PDF) demonstrates the value of the hematology/oncology pharmacy practice as a diverse specialty within health care.

NCCN Mobile Apps for Smartphones and Tablets

The National Comprehensive Cancer Network® has created a series of Mobile Apps to help healthcare professionals and patients alike. The Virtual Library of NCCN Guidelines® App assists healthcare professionals in the implementation of the guidelines. NCCN Guidelines for Patients® was created to help patients with cancer talk to their physicians about treatment. The NCCN Reimbursement Resource App gives users the ability to search for available resources and payment assistance programs.

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines

The HOPA Board and Standards Committee in collaboration with clinical experts have reviewed the following Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines and have endorsed their use. Pharmacogenomics enable individualization of therapy to patients. These guidelines offer assistance with interpretation of pharmacogenomic testing, when it is available, to optimize therapy.  

CPIC Guideline for Allopurinol and HLA-B
CPIC Guideline for Opioids and CYP2D6, OPRM1, and COMT
CPIC Guideline for Ondansetron and Tropisetron based on CYP2d6 genotype
CPIC Guideline for Rasburicase G6PD
CPIC Guideline for Tacrolimus and CYP3A5
CPIC Guideline for Tamoxifen based CYP2D6 genotype
CPIC Guideline for Thiopurines and TPMT and NUDT15
CPIC Guideline for Voriconazole and CYP2C19

Standards

Best Practices for the Management of Oral Oncolytic Therapy: Pharmacy Practice Standard

The HOPA Standards Committee organized a work group of oncology pharmacist specialists to create a pharmacy practice standard for the management of oral oncolytic therapy that describes the pharmacist’s role on the cancer care team, provides examples of practice tools and resources, summarizes current data related to outcomes, and discusses opportunities to enhance the care of patients with cancer who receive oral oncolytic therapy. The standard was published in ASCO’s Journal of Oncology Practice and is available online here.

HOPA Investigational Drug Service Best Practice Standards

The HOPA Investigational Drug Service Best Practice Standards (PDF) is the first of its kind to provide best practice standards and guidance for pharmacists and institutions to conduct clinical trials. This document emphasizes the critical role of the pharmacy in the investigational drug service, from protocol concept to close-out. This document provides a foundation for pharmacy to be involved very early in the protocol development and review, to ensure the trial meets institutional medication guidelines, is executed efficiently, and adheres to all regulations and standards.

Summaries

Oral Chemotherapy Resources

The growing number of oral medications for the treatment of cancer over the past decade has revolutionized oncology care, providing many new options for cancer treatment. HOPA recognizes these new options also create common practice challenges. Oral Chemotherapy Resources (PDF) provides a summary of practice tools, standards, and guidelines that HOPA recommends for use in the management of oral chemotherapy.

 

Oral Chemo Recipe

Drug (Generic)FormulationLinkReference
Abemaciclib (Verzenio) Solution   Obtain information directly from Eli Lilly
Alectinib (Alecensa) Solution Suspension Case Report For Oil-Based Suspension Bejarano Varas MT, Gould S, Charlot M, et al. J Oncol Pharm Pract 2019; 25: 1722-1725. Information directly from Genentech
Alpelisib (Piqray) Suspension   Obtain information directly from Novartis
Apalutamide (Erleada)     Obtain information directly from Janssen
Axitinib (Inlyta) Suspension https://academic.oup.com/ajhp/article/71/13/1092/5111292?login=true Borst DL, Arruda LS, Maclean E, Ptihavala YK, Morgado JE. Common questions regarding clinical use of axitinib in advanced renal cell carcinoma. American Journal of Health-System Pharmacy, Volume 71, Issue 13, 1 July 2014, Pages 1092–1096
Bexarotene (Targretin) Suspension https://pubmed.ncbi.nlm.nih.gov/21275495/ Pharmacotherapy https://pubmed.ncbi.nlm.nih.gov/21275495/
Busfulfan Suspension https://pubmed.ncbi.nlm.nih.gov/21275495/ Pharmacotherapy https://pubmed.ncbi.nlm.nih.gov/21275495/
Capecitabine (Xeloda) Solution https://pubmed.ncbi.nlm.nih.gov/21275495/ Pharmacotherapy https://pubmed.ncbi.nlm.nih.gov/21275495/
Capmatinib (Tabrecta)      
Ceritinib (Zykadia) Solution Enteral tube administration of oral chemotherapy drugs - PubMed (nih.gov) J Oncol Pharm Pract 2020 Apr;26(3):703-717
Chlorambucil (Leukeran) Suspension https://pubmed.ncbi.nlm.nih.gov/21275495/ Pharmacotherapy https://pubmed.ncbi.nlm.nih.gov/21275495/
Cyclophosphamide (Cytoxan)   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835970/ Kennedy R, Groepper D, Tagen M, Christensen R, Navid F, Gajjar A, Stewart CF. Stability of cyclophosphamide in extemporaneous oral suspensions. Ann Pharmacother. 2010 Feb;44(2):295-301. doi: 10.1345/aph.1M578. Epub 2010 Jan 26. PMID: 20103616; PMCID: PMC2835970.
Erlotinib (Tarceva) Suspension https://doi.org/10.2146/ajhp150581 Li Q, et al. Stability of extemporaneous erlotinib, lapatinib, and imatinib oral suspensions. American Journal of Health-System Pharmacy, Volume 73, Issue 17, 1 September 2016, Pages 1331–1337
Imatinib (Gleevec) Suspension Novartis Package Insert [40 mg/mL] Li Q, Liu Z, Kolli S, et al. Stability of extemporaneous erlotinib, lapatinib, and imatinib oral suspension. Am J Health Syst Pharm 2016;73(17):1331-1337. [30 mg/mL] Hinterlang M, Gendron A, Fleury T, et al. Design and stability of pediatric oral formulation of imatinib. J Oncol Pharm Pract 2021; 1078155221991200.
Lapatinib (Tykerb) Suspension https://doi.org/10.2146/ajhp150581 Li Q, et al. Stability of extemporaneous erlotinib, lapatinib, and imatinib oral suspensions. American Journal of Health-System Pharmacy, Volume 73, Issue 17, 1 September 2016, Pages 1331–1337
Lenalidomide (Revlimid)   https://pubmed.ncbi.nlm.nih.gov/26152703/ Morita TO, Yamaguchi A, Kimura S, Fujii H, Endo K, Izumi K, Saito S, Minami H. Stability of lenalidomide suspension after preparation by a simple suspension method for enteral tube administration. J Oncol Pharm Pract. 2016 Aug;22(4):579-83. doi: 10.1177/1078155215593623. Epub 2015 Jul 6. PMID: 26152703.
  Suspension   Compounding Today Formula #503; commerical product available
Mercaptopurine (6-MP) Suspension   Alliabadi HM, et al. AJHP. 2008;65:441-447; commercial product available
Pazopanib (Votrient) crushed tablet or oral suspension https://link-springer-com.usd.idm.oclc.org/article/10.1007/s10637-011-9725-2 Heath EI, et al. A phase I pharmacokinetic and safety evaluation of oral pazopanib dosing administered as crushed tablet or oral suspension in patients with advanced solid tumors. Investigational New Drugs volume 30, pages1566–1574(2012)
Pomalidomide (Pomalyst)   https://pubmed.ncbi.nlm.nih.gov/31822201/ Park JJ, Huang E, Monteleone CA, Kane MP, Cooper DL. Pomalidomide desensitization for hypersensitivity: A case report. J Oncol Pharm Pract. 2020 Jul;26(5):1244-1247. doi: 10.1177/1078155219889676. Epub 2019 Dec 10. PMID: 31822201.
Procarbazine (Matulane) Suspension Lexicomp [10 mg/mL] Matulane® data on file, Sigma Tau Pharmaceuticals, Inc. [10 mg/mL] Bravo P, Bertin L, Pinon A, et al. Development and stability of an oral suspension of procarbazine in pediatrics. J Drug Deliver Sci Technol
Thalidomide (Thalomid)   https://pubmed.ncbi.nlm.nih.gov/22180553/ Kraft S, Johnson CE, Tyler RP. Stability of an extemporaneously prepared thalidomide suspension. Am J Health Syst Pharm. 2012 Jan 1;69(1):56-8. doi: 10.2146/ajhp110105. PMID: 22180553.
Thioguanine (Tabloid) Suspension   Pediatric Dosage handbook 16th ed 2009-2010

Disclaimer: This chart was last updated in April of 2021, if you have information for a compounded recipe to be added, please submit here. Please include the supporting reference for review and approval by HOPA. Please follow institutional guidance for handling process of hazardous drugs.

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