Oncology Drug Reference Sheet: Entrectinib
Entrectinib was approved by the U.S. Food and Drug Administration in August 2019 as the third tumor-agnostic cancer drug, meaning it targets a specific mutation of the cancer, not the organ of origin. The other two currently approved tumor-agnostic drugs are larotrectinib and pembrolizumab.
FDA Vaping Regulations; CMS Scope of Practice; APPs Improve Health Care
Congress returned from the winter holiday season to an administrative announcement partially curtailing flavored e-cigarettes and vaping mechanisms. Additionally, the U.S. Food and Drug Administration (FDA) began the year with the announcement of a new policy prioritizing enforcement against certain unauthorized flavored e-cigarette products to help curb the youth smoking epidemic. However, to the chagrin of the smoking cessation community, FDA is still allowing menthol and traditional tobacco flavors to be sold as usual, and reports have indicated that teens and other underage users will still opt for traditional products if they’re available.
FDA Approves Avapritinib for Gastrointestinal Stromal Tumors With a Rare Mutation
On January 9, 2020, the U.S. Food and Drug Administration (FDA) approved avapritinib (AyvakitTM) for adults with unresectable or metastatic gastrointestinal stromal tumor harboring a platelet-derived growth factor receptor alpha exon 18 mutation, including D842V mutations.
FDA Approves Pembrolizumab for BCG-Unresponsive, High-Risk Non-Muscle Invasive Bladder Cancer
On January 8, 2020, the U.S. Food and Drug Administration (FDA) approved pembrolizumab for the treatment of patients with Bacillus Calmette-Guerin unresponsive, high-risk, non-muscle invasive bladder cancer with carcinoma in situ with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.
FDA Finalizes Enforcement Policy on Unauthorized Flavored Cartridge-Based E-Cigarettes
Amid the epidemic levels of youth use of e-cigarettes and the popularity of certain products among children, the U.S. Food and Drug Administration today issued a policy prioritizing enforcement against certain unauthorized flavored e-cigarette products that appeal to kids, including fruit and mint flavors. Under this policy, companies that do not cease manufacture, distribution and sale of unauthorized flavored cartridge-based e-cigarettes (other than tobacco or menthol) within 30 days risk FDA enforcement actions.
FDA Approves Fam-Trastuzumab Deruxtecan-Nxki for Unresectable or Metastatic HER2-Positive Breast Cancer
On December 20, 2019, the Food and Drug Administration granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu®) for patients with unresectable or metastatic HER2-positive breast cancer who have received two or more prior anti-HER2-based regimens in the metastatic setting.
FDA Grants Accelerated Approval to Enfortumab Vedotin-ejfv for Metastatic Urothelial Cancer
On December 18, 2019, the U.S. Food and Drug Administration granted accelerated approval to enfortumab vedotin-ejfv (PadcevTM) for adult patients with locally advanced or metastatic urothelial cancer who have previously received a programmed death receptor-1 (PD-1) or programmed death-ligand 1 inhibitor, and a platinum-containing chemotherapy in the neoadjuvant/adjuvant, locally advanced or metastatic setting.
FDA Approves Enzalutamide for Metastatic Castration-Sensitive Prostate Cancer
On December 16, 2019, the U.S. Food and Drug Administration (FDA) approved enzalutamide (Xtandi®) for patients with metastatic castration-sensitive prostate cancer.
Drug Importation Resistance; Flavored Vaping Ban; 2020 Candidates' Health Policy
Addressing the rising costs of prescription medications is a key priority for the Trump administration. As patients struggle with the financial burden of high drug prices, the U.S. Food and Drug Administration is reviewing options to import medications from Canada at a lower cost to consumers. However, the plan has major hurdles that FDA must address before it can become a reality.
FDA Approves Atezolizumab With Paclitaxel Protein-Bound and Carboplatin for Metastatic NSCLC Without EGFR/ALK Aberrations
On December 3, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq®) in combination with paclitaxel protein-bound and carboplatin for the first-line treatment of adult patients with metastatic non-squamous non-small cell lung cancer (NSCLC) with no EGFR or ALK genomic tumor aberrations.
NINR Acting Director; Vaping Flavor Ban; Drug Pricing 2020
In 2018, long-time National Institute of Nursing Research (NINR) Director Patricia Grady, PhD, RN, FAAN, retired. A national search yielded no new directors, and the National Institutes of Health appointed Principal Deputy Director Lawrence Tabak, DDS, PhD, to serve as acting NINR director. However, when the director of the National Institute of Dental and Craniofacial Research announced she would retire at the end of 2019, Tabak, who previously served as the dental agency’s director, was appointed as the obvious replacement.
FDA Grants Authorization to Eight Smokeless Tobacco Products
Tobacco products are under more scrutiny than ever before. With the rise in youth vaping, the advent of flavored e-cigarettes, and the production of other nicotine delivery systems, the U.S. Food and Drug Administration (FDA) has tightened its review process for new products. The agency is looking to the smoking cessation community, taking insight from the Trump administration, and weighing feedback from other elected officials in the Senate and House of Representatives for ways to protect public health. That said, companies are using technology to create new tobacco-based products, and FDA must find ways to assess harm while balancing free market interests.
FDA Grants Accelerated Approval to Zanubrutinib for Mantle Cell Lymphoma
On November 14, 2019, the U.S. Food and Drug Administration (FDA) granted accelerated approval to zanubrutinib (Brukinsa™) for adult patients with mantle cell lymphoma who have received at least one prior therapy.
Sharpless Returns to NCI; Vape Shop Exemption; Single-Payer State Health Care
Ned Sharpless, MD, an oncologist by training, has had a year of transitions. He began his Washington career as the National Cancer Institute director in 2017, but after two years at the helm, he was tapped to be acting U.S. Food and Drug Administration (FDA) commissioner when Scott Gottlieb stepped down in March 2019. However, after heated discussions with the Senate over the perceived lack of action from FDA regarding restrictions to vaping and tobacco products, the Trump administration likely reconsidered his role at FDA and sought to find a more permanent appointee.
FDA Approves Niraparib for HRD-Positive Advanced Ovarian Cancer
On October 23, 2019, the U.S. Food and Drug Administration (FDA) approved niraparib (Zejula®) for patients with advanced ovarian, fallopian tube, or primary peritoneal cancer treated with three or more prior chemotherapy regimens and whose cancer is associated with homologous recombination deficiency (HRD)-positive status. HRD is defined by either a deleterious or suspected deleterious BRCA mutation, or genomic instability in patients with disease progression greater than six months after response to the last platinum-based chemotherapy.
Plan Ahead to Ensure Consistency in Patient Care and Communication During Drug Shortages
A manufacturing delay leading to a shipping delay caused the October 2019 vincristine shortage, according to a letter Pfizer sent to its customers on October 18; the U.S. Food and Drug Administration first reported the shortage on October 16. It affects both the 1 mg/ml and 2 mg/2 ml single-dose ONCO-TAIN™ glass fliptop vials.
Oncology Drug Reference Sheet: Darolutamide (Nubeqa®)
Based on the results of the phase III ARAMIS trial that demonstrated significant improvement in metastasis-free survival, the U.S. Food and Drug Administration approved darolutamide under priority review on July 30, 2019. Darolutamide is approved for nonmetastatic, castration-resistant prostate cancer in men receiving concurrent gonadotropin-releasing hormone therapy or who have had bilateral orchiectomy.
Shalala's Vaping Fight; Pre-Existing Conditions; Trump Nominates Hahn
Vaping has been associated with significant public health effects during the past several months, according to the Centers for Disease Control and Prevention. Congress is making e-cigarette regulation a top priority—especially in the wake of the youth smoking epidemic. Now, several members of Congress have developed their own legislative efforts to address the national issue.
FDA Approves Daratumumab for Transplant-Eligible Multiple Myeloma
On September 26, 2019, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex®) for adult patients with multiple myeloma in combination with bortezomib, thalidomide, and dexamethasone in newly diagnosed patients who are eligible for autologous stem cell transplant.
FDA Rolls Out More New Indications for Existing Agents
Pembrolizumab, lenalidomide, and avelumab all received new treatment indications in spring 2019. Here’s what you need to know about dosing, adverse events, and other nursing considerations for these and other drugs that the U.S. Food and Drug Administration (FDA) approved from April–June 2019.
FDA Approves Apalutamide for Metastatic Castration-Sensitive Prostate Cancer
On September 17, 2019, the U.S. Food and Drug Administration (FDA) approved apalutamide (ErleadaTM) for patients with metastatic castration-sensitive prostate cancer. Apalutamide was initially approved in 2018 for patients with non-metastatic castration-resistant prostate cancer.
FDA Approves Combination Pembrolizumab Plus Lenvatinib
On September 17, 2019, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the combination of pembrolizumab (Keytruda®) plus lenvatinib (Lenvima®) for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability high (MSI-H) or mismatch repair deficient (dMMR) and who have disease progression following prior systemic therapy but are not candidates for curative surgery or radiation.
FDA Calls Out Juul; Opioid Crackdown; States Tackle Drug Pricing
With more deaths reported from vaping and a forceful U.S. Senate declaration to the U.S. Food and Drug Administration (FDA) acting commissioner to either enact stronger federal provisions restricting e-cigarettes, flavored tobacco, and inhalants or resign, the Trump administration moved quickly to demonstrate a recognition that cessation is a national, bipartisan concern. FDA sent a warning letter to Juul about its marketing and labeling, and the president, Health and Human Services secretary, and FDA commissioner issued very public statements on the matter, making it clear that federal oversight will be enforced on youth tobacco issues.
FDA Warns of Rare Lung Inflammation With Certain CDK 4/6 Inhibitors
Palbociclib (Ibrance), ribociclib (Kisqali), and abemaciclib (Verzenio) used to treat some patients with advanced breast cancers may cause rare but severe inflammation of the lungs, the U.S. Food and Drug Administration (FDA) announced on September 13, 2019. It approved new warnings about the risk on the prescribing information and package insert for the entire class of cyclin-dependent kinase 4/6 (CDK 4/6) inhibitor medicines. However, “the overall benefit of CDK 4/6 inhibitors is still greater than the risks when used as prescribed,” the agency noted.
Health Care in Campaigns; Respiratory Illness From Vaping; Drug Importation Politics
Chicago ONS Chapter member Janice Phillips, RN, CENP, PhD, FAAN, said it all in her op-ed published on Morning Consult. The entire Democratic field of presidential candidates has declared some form of healthcare overhaul, albeit to varying degrees of change. With expanded access and reduced costs for patients and families as a priority, the centerpiece to most presidential hopefuls’ domestic policy program is redesigning a struggling system.
Oncology Formulations Not Affected by Bevacizumab Recall
On September 3, 2019, AmEx Pharmacy issued a voluntary recall of two dosages of injectable bevacizumab. Although injectable bevacizumab is used in cancer treatment, the formulations affected by the recall are for much smaller dosages that are used to treat eye diseases (i.e., macular degeneration and diabetic retinopathy).
FDA Takes Stronger Oversight Role of Tobacco Products
As the youth smoking epidemic persists and illnesses related to vaping make the headlines, the U.S. Food and Drug Administration (FDA) is searching for solutions to combat the growing impact of new tobacco and nicotine products. After weeks of public outcry, FDA has doubled down on its regulatory stance, issuing several statements—including new warning letters to large tobacco companies—to reinforce its commitment to aggressive oversight and regulation of new tobacco products.
Oncology Drug Reference Sheet: Venetoclax
Venetoclax (Venclexta®) was approved by the U.S. Food and Drug Administration on May 15, 2019, for the treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) as a single agent or in combination therapy. Previously, it had been approved in late 2018 for use in combination therapy for acute myeloid leukemia (AML) in older adults or those with significant comorbidities.
FDA Approves Fedratinib for Myelofibrosis
On August 16, 2019, the U.S. Food and Drug Administration (FDA) approved fedratinib (Inrebic®) for adults with intermediate-2 or high-risk primary or secondary (post-polycythemia vera or post-essential thrombocythemia) myelofibrosis.
FDA Approves Entrectinib for NTRK Solid Tumors and ROS-1 NSCLC
On August 15, 2019, the U.S. Food and Drug Administration (FDA) granted accelerated approval to entrectinib (RozlytrekTM) for adults and pediatric patients 12 years of age and older with solid tumors that have a neurotrophic tyrosine receptor kinase (NTRK) gene fusion without a known acquired resistance mutation, are metastatic or where surgical resection is likely to result in severe morbidity, and have progressed following treatment or have no satisfactory standard therapy.
FDA Approves Pembrolizumab for Advanced Esophageal Squamous Cell Cancer
On July 30, 2019, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda®) for patients with recurrent, locally advanced or metastatic, squamous cell carcinoma of the esophagus (ESCC) whose tumors express PD-L1 (combined positive score [CPS] ≥10), as determined by an FDA-approved test, with disease progression after one or more prior lines of systemic therapy.
FDA Takes More Steps Toward Regulating E-Cigarettes
After the U.S. surgeon general’s announcement that youth smoking epidemic was in part a result of vaping and tobacco companies’ marketing and advertising of flavored products, federal agencies began looking for ways to address the growing problem. The ease at which elementary and high school students can access vaping mechanisms was a battle cry for former U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, who was an outspoken advocate for regulating and penalizing companies that targeted marketing efforts at young Americans.
No Health Cost Vote; FDA Youth Tobacco Campaign; Senate Committee Drug Bill
From soaring prescription medication costs to surprise medical bills, the issue of high healthcare costs has dominated headlines for months. Both sides of the aisle have been outspoken about the issue in a rare showing of bipartisanship. But despite the attention paid to the issue, little has been done legislatively to corral rising healthcare costs for patients and consumers. The recent announcement that the Senate wouldn’t vote on its healthcare cost bill prior to the August recess has left many wondering if the issue would be addressed at all.
FDA Recalls Textured Breast Implants Because of Lymphoma Risk
On July 24, 2019, the U.S Food and Drug Administration (FDA) requested that Allergan recall its BIOCELL textured breast implants and tissue expanders because of the associated increased risk of breast implant-associated anaplastic large cell lymphoma; Allergan agreed and is removing the products from the global market.
Oncology Drug Reference Sheet: Atezolizumab’s Indications for Breast and Lung Cancer
The U.S. Food and Drug Administration (FDA) first approved atezolizumab (Tecentriq®) in 2016, but it received additional approvals when used in combination treatments for locally advanced or metastatic triple negative breast cancer (TNBC) and small cell lung cancer (SCLC) in March 2019.
Fresenius Kabi Issues Voluntary Nationwide Recall of Two Lots of Fluorouracil Injection Because of the Potential for Glass Particulate
Fresenius Kabi USA, LLC, is voluntarily recalling two lots of fluorouracil injection, USP 5 g/100 mL (50 mg/mL), 100 mL fill in 100 mL vials, to the user level because of the potential for glass particulate. The affected lots, distributed between December 6, 2018, and February 20, 2019, are listed below:
FDA Grants Accelerated Approval to Selinexor for Multiple Myeloma
On July 3, 2019, the U.S. Food and Drug Administration (FDA) granted accelerated approval to selinexor (XpvioTM) in combination with dexamethasone for adult patients with relapsed or refractory multiple myeloma (RRMM) who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti-CD38 monoclonal antibody.
FDA Approves Daratumumab for Multiple Myeloma Ineligible for Autologous Stem Cell Transplant
On June 27, 2019, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex®) in combination with lenalidomide and dexamethasone for patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant.
FDA’s Latest Approved Drugs and Indications Include Two Oral Agents
Because two oral therapies received new indications in the U.S. Food and Drug Administration’s (FDA’s) most recent round of approvals, oncology nurses will want to focus on ways to manage patients in the home. Assessing oral adherence, encouraging patients to report adverse events, and ensuring their understanding of complex dosing regimens are critical components of nursing care. ONS offers an oral adherence toolkit and oral chemotherapy patient education sheets to help with patient management.
Oncology Drug Reference Sheet: Combination Trastuzumab and Hyaluronidase-Oysk
A new product that combines trastuzumab and hyaluronidase (Herceptin Hylecta™) received U.S. Food and Drug Administration approval in February 2019 for the treatment of HER2-overexpressing breast cancer. The approval was based on the results of two randomized trials: HannaH and SafeHER.
FDA Approves Pembrolizumab for Metastatic Small Cell Lung Cancer
On June 17, 2019, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda®) for patients with metastatic small cell lung cancer with disease progression on or after platinum-based chemotherapy and at least one other prior line of therapy.
FDA Links Breast Implants to Increased ALCL Risk
People with breast implants have a risk of developing breast implant-associated anaplastic large cell lymphoma (ALCL), the U.S. Food and Drug Administration (FDA) announced in April 2019. Typically the cancer is limited to the scar tissue and fluid near an implant, but some patients experience spread throughout the body. The risk increases with textured implants in particular.
FDA Approves Pembrolizumab for First-Line Treatment of HNSCC
On June 10, 2019, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda®) for the first-line treatment of patients with metastatic or unresectable recurrent head and neck squamous cell carcinoma (HNSCC).
FDA Approves Polatuzumab Vedotin-piiq for Diffuse Large B-Cell Lymphoma
On June 10, 2019, the U.S. Food and Drug Administration (FDA) granted accelerated approval to polatuzumab vedotin-piiq (PolivyTM), a CD79b-directed antibody-drug conjugate indicated in combination with bendamustine and a rituximab product for adult patients with relapsed or refractory diffuse large B-cell lymphoma, not otherwise specified, after at least two prior therapies.
Healthcare Financial Problems; ACA Reduced Disparities; FDA Project Facilitate
Health care is driving domestic policy agenda, and voters have shown it’s a crucial component in their decision making. The money associated with healthcare costs has been a driving factor in politics year after year. Public opinion polling found that health care is the most important factor when it comes to financial burden for Americans, reports from 2018 indicated that Americans spent more than $88 billion on health care alone.
Durbin Calls Out FDA; Medicare for All Support; Cancer Mortality Drops
In a letter to the U.S. Food and Drug Administration (FDA), Senator Dick Durbin (D-IL) shared harsh criticism for the agency’s lack of attention to the youth smoking epidemic. His letter from May 29, 2019, detailed efforts that the agency could be taking to curb the rise in youth tobacco use. The smoking cessation community, of which ONS is a palpable member, has sided with Durbin on the importance of continued FDA oversight on e-cigarettes and the vaping industry’s kid-friendly, fun-flavored tobacco products. Groups like the Campaign for Tobacco Free Kids have been forceful in comments to the agency about the need for stricter regulations on products.