Drug-Drug Interactions in Older Cancer Patients Examples of existing resources to learn about DDI Friday, November 13, 2015 Prague Dr. Vincent Launay-Vacher, PharmD Service ICAR Pitié-Salpêtrière University Hospital Paris - France

Disclosure last 3 years Direct Amgen Bayer Boehringer-Ingelheim (honoraria, consulting, …) Amgen Bayer Boehringer-Ingelheim Hospira Leo Pharma Roche Teva Indirect (research grants, grants to Service ICAR, …) Daiichi-Sankyo Gilead Ipsen Leo Pharma Roche Teva

DDI in clinical practice Frequent Potentially harmful for the patient: Increased toxicity Decreased efficacy Even more frequent in the elderly: IPOP Study1 Community setting: non cancer patients, age ≥ 65 50 pharmacies / preliminary results on 488 patients A mean of 7 different drugs (INN) 1Service ICAR – IPOP Study – Preliminary results, unpublished

IPOP Study 1Service ICAR – IPOP Study – Preliminary results, unpublished

Where to get information on DDI ? Regulatory information: Summary of Product Characteristics (SmPC) Vidal Dictionnary (France) British National Formulary (UK) Physician’s Desk Reference (USA) EMA website: Example for Erlotinib (Tarceva®)

SmPC Tarceva®: EMA website

Where to get information on DDI ? Regulatory information: Summary of Product Characteristics Useful background information Not very practical Scientific Society: European Society of Medical Oncology (ESMO) Has developed an online resource on DDI with Kinase Inhibitors Released at the last European Cancer Congress in Vienna (September 2015) Available on the ESMO Educational Portal: oncologypro.esmo.org

ESMO Educational Portal: oncologypro.esmo.org In the Guidelines & Practice section Focused on Kinase inhibitors DDI with other medicinal products http://oncologypro.esmo.org/Guidelines-Practice/Drug-Drug-Interactions-with-Kinase-Inhibitors

ESMO Educational Portal: oncologypro.esmo.org http://oncologypro.esmo.org/Guidelines-Practice/Drug-Drug-Interactions-with-Kinase-Inhibitors

ESMO Educational Portal: oncologypro.esmo.org http://oncologypro.esmo.org/Guidelines-Practice/Drug-Drug-Interactions-with-Kinase-Inhibitors

ESMO Educational Portal: oncologypro.esmo.org Individual drug quick summaries: Erlotinib Imatinib Pazopanib Regorafenib Sorafenib Sunitinib Vandetanib Vemurafenib http://oncologypro.esmo.org/Guidelines-Practice/Drug-Drug-Interactions-with-Kinase-Inhibitors

ESMO Educational Portal: oncologypro.esmo.org Files that can be downloaded for patients http://oncologypro.esmo.org/Guidelines-Practice/Drug-Drug-Interactions-with-Kinase-Inhibitors

ESMO Educational Portal: oncologypro.esmo.org

Where to get information on DDI ? Regulatory information: Summary of Product Characteristics Useful background information Not very practical Scientific Society: European Society of Medical Oncology (ESMO) More practical General although focused on Kinase inhibitors Tools for patients and patient-HCP communication Other website: SiteGPR®

SiteGPR®: www.sitegpr.com In the Interaction tab iMED Specific booklets One by drug Kinase inhibitors http://www.sitegpr.com/page.php?pg=iMED

iMED on SiteGPR®: www.sitegpr.com Sunitinib: iMED gives advices on DDI with 302 other drugs http://www.sitegpr.com/page.php?pg=iMED

All types of interaction Pharmacodynamic Metabolic Transport http://www.sitegpr.com/page.php?pg=iMED

Where to get information on DDI ? Regulatory information: Summary of Product Characteristics Useful background information Not very practical Scientific Society: European Society of Medical Oncology (ESMO) More practical General although focused on Kinase inhibitors Tools for patients and patient-HCP communication Other website: SiteGPR® Individual guides for each drug: iMED Comprehensive resource (>300 DDIs analyzed) More general tool: Drugs.com

Drug Interactions Checker: www.drugs.com For HCP and patients Allows multiple analyses and direct whole prescription analysis at once http://www.drugs.com/drug_interactions.php

Drug Interactions Checker: www.drugs.com Two types of information: for professionals for patients However, both are freely accessible http://www.drugs.com/drug_interactions.php

Drug Interactions Checker: www.drugs.com Data on drug-food interaction are provided only the pharmacodynamic DDI is presented http://www.drugs.com/drug_interactions.php

Where to get information on DDI ? Regulatory information: Summary of Product Characteristics Useful background information Not very practical Scientific Society: European Society of Medical Oncology (ESMO) More practical General although focused on Kinase inhibitors Tools for patients and patient-HCP communication Other website: SiteGPR® Individual guides for each drug: iMED Comprehensive resource (>300 DDIs analyzed) More general tool: Drugs.com Allows a whole prescription analysis at once Probably not exhaustive in terms of DDI analyzed and presented Provides data on drug-food interactions

Drug Interactions Checker Summary SmPC DDI with KI iMED® Drug Interactions Checker Regulatory Not practical More practical Kinase inhibitors Information for patients and communication tools Practical: 1 guide per drug (iMED) Comprehensive analyses Practical: whole prescription analyzed Not exhaustive Provides data on drug-food interaction Public HCPs & Patients HCPs only ESMO members Free registration Source Tool Characteristics Access

Thank you… …for your attention ! vincent.launay-vacher@aphp.fr www.sitegpr.com www.c-kin.org