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Pharmacy Careers
LeAnn Norris Wins New Practitioner Award By Karen Rosenberg
T
he Hematology/Oncology Phar macy Association (HOPA) New Practitioner Award recognizes a HOPA member early in his or her career who has made a significant contribution to developing or supporting clinical hematology/oncology pharmacy services. This year’s recipient, LeAnn Norris, PharmD, BCPS, BCOP, is assistant professor of clinical pharmacy and outcomes sciences at the South Carolina College of Pharmacy in Columbia and a member of The Oncology Pharmacist editorial board.
completed my PGY2 oncology residency in 2006 and debated staying on in Greensboro or taking a faculty position in South Carolina. I knew that I enjoyed working with students and thought that I would enjoy a career in academia, so I decided to move back to South Carolina and take the position in Columbia in 2006.
I currently cover two services at the hospital here, the outpatient chemotherapy clinic and the hospice and palliative care unit. I’m on service 12 months a year, 20 hours a week per month so I have to try to squeeze in everything in 1 day. Every day is different and every day has a new challenge, and I love that.
Why did you choose to specialize in oncology? I have always had an interest in oncology but I also considered specializing in infectious diseases. Once Please tell us about the I met Lew Iacovelli and career that has led up to your saw the role he has with his winning the Outstanding New patients at the cancer cenPractitioner Award. ter, the positive influence I graduated from the College he has in his patients’ of Pharmacy at the University of lives, and his relationship LeAnn Norris, South Carolina in Columbia, with some of the physiPharmD, BCPS, which is now known as the cians he works with, I BCOP South Carolina College of knew immediately that Pharmacy, in 2004 and completed my that was what I wanted to do. He’s PGY1 pharmacy residency at the Moses been an excellent role model and menCone Health Center in Greensboro, tor for me. North Carolina. Then I stayed on for my PGY2 at the regional cancer center In addition to your teaching duties, within the Moses Cone Health System, do you have any direct contact with where I trained under Lew Iacovelli. I patients?
Do you encourage your students to go on for specialty training? I definitely advise all of my students that if they’re even thinking about residency, they need to pursue it. My opinion about specialty residencies is that if you have a very strong interest in an area, I highly encourage you to go on to a second year of residency, with the understanding that your job possibilities may sometimes be more limited. It’s a very rewarding experience, and generally there are no regrets in spending that extra year to pursue additional training. A lot of students on my rotation will go on to work in a community pharmacy or a chain drugstore. Even if they have no interest in pursuing a career in oncology, I encourage them to make the most out of their rotation when they’re on service with me because everyone is
affected by cancer in some way. I always try to make sure that my students can have an educational conversation with patients and that patients can see them as a good resource, even if it’s just a matter of answering questions for a cancer patient who’s coming in to pick up a prescription for nausea medication. You learn how to counsel patients in pharmacy school, but sometimes when patients are very sick there’s a different way of communicating with them. I personally had to learn how to counsel patients all over again when I started in oncology. Another piece of advice that I would give to students who are perhaps in a PGY1 residency and are interested in pursuing a career in oncology is that networking is key to advancing in this field because just by meeting people, you open doors up to potential jobs or potential collaborations in research. I’ve been a member of HOPA since my first year of residency. It offers a great resource not just for specialists or people who have done oncology training, but also for people who have started in a new oncology pharmacy position, whether they have been practicing in another area for some time or are just starting out in their career. ●
GASTROINTESTINAL CANCERS
Nab-paclitaxel Plus Gemcitabine May Help Patients with Advanced Pancreatic Cancer By Jill Stein
WASHINGTON, DC—Nanoparticle albumin-bound paclitaxel, often referred to as nab-paclitaxel, combined with gemcitabine boosts survival when given as first-line treatment in patients with advanced pancreatic cancer, according to results released at the 101st annual meeting of the American Association for Cancer Research. “Our study found that the combination of nab-paclitaxel at the maximum tolerated dose plus gemcitabine more than doubled the length of survival that has been reported with solo gemcitabine, which is the treatment standard in this population,” said Daniel Von Hoff, MD, FACP, physician-inchief and senior investigator at the Translational Genomics Research Institute in Phoenix, Arizona. Von Hoff presented findings in 67 patients treated with the combination of nanoparticle albumin-bound paclitaxel and gemcitabine as part of a phase
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1/2 open-label study. Nanoparticle albumin-bound paclitaxel is a novel formulation of paclitaxel that allows for the preferential delivery of active drug to the site of the tumor. “Pancreatic cancer has the worst survivorship of any cancer in the world, with a 1-year survival rate in metastatic disease of about 15% and a 2-year survival rate of less than 5%,” Von Hoff said. Presently, the disease affects approximately 259,000 people worldwide and more than 42,000 people in the United States. In the phase 1 dose-escalation portion of the study, nanoparticle albuminbound paclitaxel (100 mg/m2, 125 mg/m2, 150 mg/m2) in combination with gemcitabine 1000 mg/m2 was administered weekly for 3 weeks with 1 week of rest. The 125-mg/m2 dose was identified as the maximum tolerated dose. Of 44 patients who were treated with
nanoparticle albumin-bound paclitaxel at the maximum tolerated dose with gemcitabine 1000 mg/m2, the median overall length of survival was 12.2 months. “To date, the longest survival that has been reported with gemcit abine alone has been 5.65 months,” Von Hoff said. Of patients treated with the combination therapy, the overall response rate was 50% and the disease control rate was 68%. A disease control rate was defined as a complete response, partial response, or stable disease for 16 weeks or longer according to response evaluation criteria in solid tumor criteria. Overall, three patients in the study population of 67 had a complete response. Also, all patients who had nanoparticle albumin-bound paclitaxel at the recommended dose who were screened for the tumor marker carbohydrate antigen (CA) 19-9 had a decrease in tumor
marker level of a magnitude that has been shown to correlate with improved overall survival. CA 19-9 has been shown to be highly specific and sensitive for pancreatic cancer. Notably, about two thirds of patients had CA 19-9 decreases of greater than 70%, which correlated with a median overall survival of 15.6%. “This is very dramatic,” Von Hoff noted. “In fact, our study team involving doctors, research nurses, data managers, and so on come from very well-respected cancer centers and have ‘deep’ clinical experience, and we have never seen this level of activity before.” The nanoparticle albumin-bound paclitaxel–gemcitabine combination is now being tested in patients with advanced pancreatic cancer in a phase 3 trial. “Although there have been a lot of false starts in the past and we’re acutely aware of that possibility, we’re definitely encouraged by our findings,” he said. ●
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