Expert Discusses New Specialty Drugs That are in the Pipeline

In an interview with Pharmacy Times® at the American Society of Health-System Pharmacists Summer Meetings and Exhibition, Aimee Banks, PharmD, BCPS, MSCS, clinical pharmacist in the Multiple Sclerosis Clinic at Vanderbilt University Medical Center, discusses new hematology, oncology, and autoimmune therapies in the pipeline that pharmacists should be aware of.

Q: Are there any new hematology and oncology drugs in the pipeline that pharmacists should have their eye on?

Aimee Banks: There are yes, actually, Sandra Cuellar, PharmD, presented earlier today the hematology and oncology pipeline, and there are several very interesting agents that have a first-in-class designation as far as new mechanisms of action. Just a couple that she highlighted on one and the melanoma space is Opdualag. That's a very interesting agent that actually just had a recent approval, but pretty breakthrough in that disease state. Opdualag for melanoma is one to make note of.

In the non–small cell lung cancer space, it seems that therapies are really being targeted towards this specific gene expression. There are a lot of different gene mutations and just keeping an eye on the various agents in the pipeline as their mechanisms are tailored very specifically to those gene mutations and expressions. That was really what she highlighted as far as non–small cell lung cancer

As far as breast cancer treatments, Dr. Khullar really did a great job of discussing the oral SERDs, which are very specific to hormone positive breast cancer treatments. Those specific cancers are usually very resistant to the current agent. The agents in that class of SERDs for breast cancer treatment are really important to monitor for.

In the space of multiple myeloma, she was very excited and passionate to present on tocilizumab, which is a bio specific antibody that has very robust and specific outcomes in that patient population, especially for those patients who have had treatment failures to the current agents on the market. A lot of growth in the oncology space and a lot of really important agents to keep watch on for pharmacists.

Q: What are some new autoimmune therapies in the pipeline that pharmacists should be aware of?

Aimee Banks: In the auto immune space, Caitlyn Young, PharmD, presented several different kind of subcategories, but kind of my takeaway from her presentation today was that there's a lot of label extensions. Therapies that have been on the market and approved for other diagnoses and indications, their labels are being updated to include new indications.

That was kind of a takeaway for me from her program.

Then she also talked about biosimilars as well, not only the newer treatments, but some older agents, even have been available for several years now. We're really about to hit kind of a boom as far as a significant number of biosimilar agents in the autoimmune disease states that will be on the market, which will be, I think, positive for patient care because there'll be hopefully more affordable options. It is going to be really challenging for specialty pharmacist and clinical pharmacist, I think, to help with transitions of care as patients switch back and forth in between those agents. Those were 2 kind of takeaways from Dr. Young's presentation.

Then in the neurology area, which is what I'm most specifically involved in from day-to-day patient care in MS space, I think one key agent to focus on is the next agent that we will have approved as ublituximab for the treatment of MS. That is not a new mechanism, but it may have some benefits over the currently available treatments. So that's one to watch.

Then the Bruton tyrosine kinase inhibitors, or the BTKIs, that class of medication is still an earlier phase development and research. However, there's some really promising data, not only for relapsing patients, but also patients with progressive disease. So those won't be approved in the next year, but in the next 1 to 2 years really want to keep an eye on the outcomes from the phase three data, or the data from the phase three clinical trials rather, for those BTK inhibitors, hoping that they're really going to have those positive outcomes for patients with progressive MS.

Then in other areas of neurology, specifically, ramucirumab was just approved for generalized myasthenia gravis. It's currently being investigated in neuromyelitis optica spectrum disorder. So that is going to be hopefully another treatment that's approved there.

Then in the Alzheimer's space, several agents that are in earlier development, but just definitely want to keep an eye on those. They're shifting from phase 2 into phase 3 studies and actually under FDA review already, even before the completion of the phase 3 trials, the FDA at least could review those before the completion of those phase 3 trials was which is a little bit unique in that space, so those are the ones that I would say keep the closest eye on.