The anadian ssociation of armacy in

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The Canadian Association of Pharmacy in Oncology
NEWSLETTER SUMMER 2009
Association Canadienne de Pharmacie en Oncologie
President’s Message
As we all enter into our
summers, I’d like to
acknowledge all the great
work you all do for cancer
patients across this great
country. I had the opportunity
to attend the 7th National
Summit on Community
Cancer Care which was held
here in Prince George, BC.
We hosted approximately 400
attendees and discussed
innovative strategies for
delivery of care. Focuses
included utilization of
telehealth, human resource
challenges, prevention and
building healthier
communities. As I attended
the sessions, I was reminded
of the many ways
pharmacists and technicians
have been instrumental in
improving access to services
and care.
One stream of the conference
focused on education needs
and programs. Very soon,
you will receive a survey from
CAPhO which will attempt to
capture the education needs
of the pharmacists across the
country. Participation from
members as well as non-
members will be crucial in
giving us the information we
need to move forward with
education initiatives. Please
complete the survey and
please forward the survey to
anyone you think should
complete it. As an incentive,
we are offering a random
draw for prizes. Most of all, I
hope the incentive will be that
CAPhO will be able to create
education programs that meet
the needs of our members.
I’d like to recognize the hard
work of members, Kimberly
Stefaniuk, Larry Broadfield
and Jeff Barnett for their work
in laying the groundwork for
the survey. I’d also like to
thank Rhonda Kalyn, our
education chair, for her work
on this project.
I’d like to recognize the hard
work of our membership
committee. They have been
working to develop an
information pamphlet to be
used for recruitment. We are
also working towards
development of display
materials that could be used
for conferences and other
events to advertise our
association.
Thank you to all who
submitted requests and ideas
for locations for NOPS 2011.
We are still discussing
possible sites, so additional
suggestions are welcome;
just send me an email:
[email protected]
.
I wish everyone a very warm
and relaxing summer.
Remember to mark your
calendars for NOPS 2009 in
Ottawa: October 23-25, 2009!
Warm regards,
Dana Cole
CAPhO President
Oncology Pharmacy
Education Needs Survey
Update
Rhonda Kalyn
Education Chair
After a short delay, the
Oncology Pharmacy
Educational Needs Survey is
complete. It is currently being
tested on Survey Monkey,
and will be ready for
dissemination at the
beginning of July. To allow for
summer vacations, the survey
will be available until the end
of August.
To thank you for your
patience and the time you
spend doing the survey, we
are now offering two prizes in
the prize raffle:
• One iPod

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• One complimentary
registration for the National
Oncology Pharmacy
Symposium (NOPS), which
is being held in Ottawa,
October 23-25, 2009.
CAPhO values your input. We
will use it to determine if a
Cancer Oncology Pharmacy
Education (COPE) program is
needed in Canada, and what
format it should take.
NOPS 2009
October 23-25, 2009
Fairmount Château Laurier
Ottawa, Ontario
Hélène Bourget-Letarte
NOPS 2009 Co-Chair
Although summer has just
officially started and all of us
are busy with planning
vacation time, the National
Oncology Pharmacy
Symposium (NOPS) is just
around the corner! NOPS
2009 will be held in Ottawa
October 23-25 at the
Fairmount Château Laurier. If
you are interested in learning,
discussing, sharing and
networking with other
pharmacy colleagues
practicing in oncology, NOPS
offers it all.
The planning committee is
busy with finalizing the
program and planning the
social event on Saturday
evening. Safety in oncology,
both from patient and health
care provider perspective, is
the driving theme of this
year’s conference. Medication
reconciliation, drug
interactions in oncology
pharmacy and repetitive
strain injuries are some of the
topics that will be covered
during the symposium.
Breakout sessions divided
into clinical, technical and
administrative themes were
much appreciated last year
and will have them once
again this year. The full
program will be posted on the
CAPhO website very shortly.
The poster display was a
huge success at NOPS 2009
and CAPhO invites you to
begin preparing your posters
now for submission starting at
the beginning of July.
The famous Canadian
Museum of Civilization is the
venue for the NOPS social on
Saturday night. Surround
yourself with the world’s
largest indoor collection of
totem poles, journey through
1,000 years of Canadian
history and culture, and have
good time with friends and
colleagues from across the
country. Stay tuned for
entertainment details!
Wishing all of you a
wonderful summer and
looking forward to see you at
NOPS 2009 in Ottawa.
NCIC Spring Meeting
Summaries of CAPhO
Grant Winners
Vicky Infantino
Clinical Trial Pharmacy
Technician
Juravinski Cancer Centre
Hamilton, Ontario
This year I was fortunate
enough to be one of the
successful grant applicants
supported by CAPhO to
attend my first NCIC Spring
2009 meeting.
As a Clinical Trial Pharmacy
Technician my goal was to
have the opportunity to
network with other colleagues
to share ideas about the
challenges we are
encountering with the more
complex Clinical Trials that
are up and coming. I also
wanted to gain a better
understanding of the roles
and responsibilities of a
Clinical Research Associate
(CRA).
On my first day I attended the
Clinical Research Associate
orientation and had the

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opportunity to be introduced
to the Trial team at NCIC
CTG. I was given an
overview of the internal
organization at the NCIC
CTG, trial team structures
and supports as well as the
trial team core activities. This
orientation also provided a
better understanding of the
funding process involved in
Clinical Trials.
That day I also attended a
CRA workshop on Electronic
Data Entry. We were
presented with the abilities of
EDC including the ability to
provide built-in audit trails
therefore reducing all printing,
mailing and faxing when
preparing for an audit.
The next day I attended a
Pharmacy Network meeting.
I found it very interesting to
listen in on the day to day
obstacles the Pharmacists
are challenged with in Clinical
Trials. There was a lengthy
discussion regarding the
relabelling of Lot numbers
and expiry dates on Clinical
trial drugs upon arrival to
each site as opposed to the
time of dispensing.
I then attended a GI disease
site meeting where seeds
were planted for new Clinical
Trials. I found it very
interesting to hear about a
Clinical Trial in its very early
planning stage.
I had the pleasure of
attending the Cosbie Lecture
in which Dr. Frances A.
Shepherd spoke about Lung
disease. I had the privilege to
witness this amazing lady be
recognized for her many
contributions to the field of
lung cancer research.
To summarize, these positive
experiences have helped me
become a more informed
team member of our Clinical
Trial team.
In closing I would like to thank
the members of CAPhO for
their generous contribution
that allowed me to attend the
NCIC Spring 2009 meeting.
Rongrong Karim
Clinical Trials Pharmacist
BCCA-Vancouver Centre
NCIC CTG Pharmacists
Network Open Session
• Drug Labeling: NCIC CTG
cannot assume the label
is compliant on site. Some
problems with Drug
Labelling:
o Supplementary labels
should NOT only be
affixed at the time of
dispensing. It should be
affixed at time of
receiving
o Supplementary labels
should be in both inner
and outside containers.
Questions arose
regarding container size
for supplementary label
and what to do with
blister pack. NCIC CTG
will double check and
get back to us
o Question regarding what
to do with sealed box,
i.e., potential for mistake
if open sealed box for
labeling purpose.
• Biologics lot release
program effective Jan 09.
Canada has more strict
guidelines regarding
regulating biologics
compare to U.S. More
tests have to be done to
get the biologics lot
approved in Canada.
PMB will not segregate lot
for a study. One lot might
be used for multiple
studies. When receiving
biologics for NCIC CTG
study, it is IMPORTANT
to check if the lot is
approved on NCIC CTG
website. If received a lot
that is not approved on
website, call NCIC CTG
Ethics and Regulatory
(Alina Sutton). It might be
one of the following two
situations:
o Paper work is in
progress or
o Process for paper work
has not started yet
o Bottom line: only use
lots that have been
approved on NCIC CTG
website
NCIC Clinical Trials Group
Disease Site Committee
Meeting
• Economics are affecting
trial opening. If a trial has
very slow accrual, NCIC
CTG is quick at cancel the
trial. The investigator is
asking the audience to
have more centres
activated for trials so the
accrual process can be
accelerated
Genito-Urinary Trials
• PRP.1: Soy protein, Vitamin
E, selenium vs. Placebo in
high grade prostatic
intraepithelial neoplasia.
Soy supplement, Vitamin E
and selenium does not
delay the time to
progression.
• REC2 trial: Adjuvant
sorafenib or sunitinib for
unfavourable renal cancer.
Toxicity high in first cycle.
New major amendment

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coming to start at lower
dose (dose level -1)
• IND165: This is a phase 2
study. It showed more
fever, rigor and chills with
OGX-011. PSA progression
is significantly less in
combination arm (OGX-011
and docetaxel). A new
phase 3 trial is being
planned for overall survival.
• IND195: new trial coming
up. SB939 is an oral
histone deacetylase
(HDAC) inhibitor.
Circulating tumor cell (CTC)
will be done for this trial.
Breast Trials
• MA32. Use metformin 1700
mg po versus placebo as
adjunct for early adjuvant
Breast Cancer Patient
(within 4 years). It has been
show insulin might affect
cancer prognosis in the first
5 years. Therefore, the
study duration is for 5
years. Metformin can
reduce insulin usage by 25
to 33% within the first few
days. It has potential for
cancer treatment in two
ways; 1. thru liver to reduce
insulin; 2. act in tumor cells
via the mTOR pathway.
Sample size is 3582. It
might be OK to be on this
trial if patients are on other
clinical trials.
• MA27: exemestane versus
anastrozole to test two
issues. Potency with all the
aromatase inhibitors and if
there is a difference
between steroid AI and
non-steroid AI. Futility
analysis will be done for
this study. A futility analysis
is a calculation made
during the course of a trial
of the probability that the
trial will produce helpful
results. A trial is judged
futile if the probability is too
small.
• Correlative studies:
biomarker may help us
better understand how
individual cancer might
respond to treatment.
• Circulating tumour cells:
This is not a new concept.
It was discovered 100
years ago, but poorly
understood. There are
questions regarding if CTC
has metastatic potential,
i.e., breast cancer CTC can
circulate for years. There is
also evidence that CTC
might have prognostic
significance. Currently, only
one FDA approved system,
cell search system, to
measure CTC. Dr. Chi in
our center had purchased
one. However, the test is
not as sensitive as some of
the other tests.
Kathy Lebreux
Pharmacy Research
Technician
The Ottawa Hospital Cancer
Centre
My position at The Ottawa
Hospital Cancer
Centre(TOHCC), one of 3
Pharmacy Research
Technicians, is an important
part of the Clinical Trial team.
Attending the NCIC meeting
for the 1st time provided me
with a more complete picture
of the Clinical Trial process
and specifically how NCIC
trials operate.
I attended a variety of
disease site meetings and
lectures over the 3 days. I
found the CTG Pharmacists
Network meeting very
interesting and I was able to
take part in a conversation
regarding drug receipt and
Lot# procedures. I learned a
few helpful tools in the Stress
and Time Management
workshop which I brought
back to work with me and
shared with my colleagues. A
highlight of my weekend was
listening to Dr. Frances
Shepherd’s excellent Crosbie
Lecture on “Lung Cancer: A
Journey from Nihilism to
Hope Through Bench to
Bedside Research.”
Through networking at this
meeting and previous
Investigator meetings that I
have attended, I have come
to realize that the role of
Pharmacy Research
Technicians working in
Clinical Trials at TOHCC has
been expanded to a wide
scope of practice.
In the future I would be very
interested in becoming a
member of the Pharmacist
Network Group if there would
be an opening for a
Pharmacy Research
Technician within the group. I
would be happy to share any
information about the role of
Pharmacy Research
Technicians at our centre if
any other cancer centres are
considering expanding the
duties of their Pharmacy
Technicians.
I would like to thank the
CAPhO executives and
awards chair for selecting my
application for the sponsored
Travel Grant. I thoroughly
enjoyed the Spring NCIC
meeting and hope to be able
to attend future NCIC
meetings as well.