U.S. Pharmacist Journal of Specialty Pharmacy Update
December 2018

CAR-T Cells: Driving a New Era of Oncology Immunotherapy
Chimeric antigen receptor T (CAR-T) cells represent a novel and personalized therapeutic approach to cancer immunotherapy. Genetically engineered, CAR-T cell therapy offers high response rates in patients with relapsed or refractory B-cell malignancies whose treatment options are limited. Recognizing distinct, potentially life-threatening toxicities, however, is essential to sustaining the unique benefits of CAR-T cell therapy. Here are more details.

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Management of Bleeding in Patients Treated With Direct
Oral Anticoagulants

The use of direct oral anticoagulants (DOACs) in the treatment and prevention of thromboembolic disorders has become increasingly prevalent. With no need for frequent blood monitoring and fewer drug and dietary interactions, DOACs present advantages over vitamin K antagonists. However, the risk of bleeding remains without adequate reversal options. Treatment options for managing bleeding associated with DOACs include nonspecific agents as well as specific agents, such as idarucizumab, andexanet alfa, and ciraparantag. Read more.

Why We Need Standardized Performance Measures in Specialty Practice
The Triple Aim Initiative from the Institute for Healthcare Improvement provides a framework for optimizing health-system performance: improved patient experience of care, improved health of populations, and reduced per-capita cost of healthcare. Established quality metrics also allow consistent comparisons between specialty pharmacies, and the The National Quality Forum can provide endorsement of quality measures that meet these requirements. Specialty pharmacies should look to these endorsed measures. Read more.

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