Development of a Quality Measures Tool for the Utilization of Tyrosine Kinase Inhibitors in Non-small Cell Lung Cancer: An Integrated Specialty Pharmacy Initiative

2019 ◽  
Vol 15 (6) ◽  
pp. e27
Author(s):  
Garrett Crothers ◽  
Nisha B. Shah ◽  
Moonjung Kim ◽  
Autumn Zuckerman
2020 ◽  
Vol 26 (6) ◽  
pp. 1441-1451
Author(s):  
Garrett Crothers ◽  
Nisha B Shah ◽  
Moonjung Kim ◽  
Autumn D Zuckerman

Background Tyrosine kinase inhibitors, commonly prescribed for non-small cell lung cancer, are efficacious but pose safety risks that can diminish quality of life. Quality measures to ensure appropriate utilization and monitoring of tyrosine kinase inhibitors are needed to reduce unnecessary healthcare costs and maximize therapeutic benefit. With integrated clinical and pharmaceutical care services, a health-system specialty pharmacy is the ideal setting for quality measures development. Purpose The purpose of this initiative was to develop a tool to assess quality in the utilization of tyrosine kinase inhibitors in non-small cell lung cancer by engaging multiple key stakeholder perspectives to identify the fundamental elements of high-quality clinical and specialty pharmacy care. Summary Quality measures for the utilization of tyrosine kinase inhibitors in non-small cell lung cancer were developed by conducting package insert, guideline, and literature review followed by integrating feedback from key stakeholder groups through individual conversations and a structured assessment. The finalized guide assesses safety, efficacy, persistence, and patient-reported outcomes using defined clinical and specialty pharmacy measures. Most stakeholders agreed that the proposed measures were relevant as well as accurate and expressed support for implementation. Conclusions The proposed tool provides a framework for specialty pharmacies to deliver quality care in the use of tyrosine kinase inhibitors for the treatment of non-small cell lung cancer. Further work is needed to implement and validate this tool.


2019 ◽  
Vol 32 (3) ◽  
pp. 236 ◽  
Author(s):  
Andreia Tereso ◽  
Luís Carreto ◽  
Manuela Baptista ◽  
Maria Amélia Almeida

The treatment of advanced non-small-cell lung cancer shifted with the development of molecular-targeted therapies, like the tyrosine kinase inhibitors. One example of tyrosine kinase inhibitors is crizotinib, an anaplastic lymphoma tyrosine kinase inhibitor, which targets an echinoderm microtubule-associated protein-like-4-anaplastic lymphoma kinase gene fusion. This mutation is found in only 2% to 7% of non-small-cell lung cancer cases. Although these new therapies have shown promising results, the occurrence of interstitial lung disease as a side effect could be problematic. As the diagnosis of drug-related-interstitial lung disease is difficult to make, computed tomography is an important diagnostic tool. The recognition of computed tomography manifestations of tyrosine kinase inhibitors -induced interstitial lung disease is the key for an early recognition and management of this pulmonary toxicity. We aim to raise awareness of tyrosine kinase inhibitors-induced interstitial lung disease, by reporting the first case of a Portuguese patient treated with crizotinib for non-small-cell lung cancer who developed drug-induced interstitial lung disease.


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