"I genuinely think nurses and pharmacists need to know why these medicines are called hedgehog inhibitors so that we can, in fact, effectively educate our patients. Just because to date, this class has the weirdest name I've encountered, and I almost expect at this point that my patients are going to ask me about it. I think that we need to be informed that, just on, where do these names come from, why is it called this, and does it matter to my patient?" Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about hedgehog pathway inhibitors.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by March 21, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to hedgehog pathway inhibitors used for cancer treatment.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ Pharmacology 101 series
• ONS Voice articles:
  • An Oncology Nurse's Guide to Targeted Therapy
  • FDA Approves Glasdegib for AML in Adults Aged 75 or Older or Who Have Comorbidities
  • Oncology Drug Reference Sheet: Glasdegib
  • Understanding Precision Medicine Therapeutics
• ONS courses:
  • Genomic Foundations for Precision Oncology
  • ONS Cancer Biology™
• ONS Guidelines™ and Symptom Interventions:
  • Diarrhea
  • Fatigue
• ONS Huddle Card: Targeted Therapy
• ONS Learning Libraries:
  • Oral Anticancer Medication
  • Pain Management
• Oral Chemotherapy Education Sheets
• American Association for Cancer Research article: Hedgehog Pathway Inhibitors: A New Therapeutic Class for the Treatment of Acute Myeloid Leukemia
• American Journal of Clinical Dermatology article: Evaluation of the Tolerability of Hedgehog Pathway Inhibitors in the Treatment of Advanced Basal Cell Carcinoma: A Narrative Review of Treatment Strategies
• Cureas article: Hedgehog Pathway Inhibitors: Clinical Implications and Resistance in the Treatment of Basal Cell Carcinoma
• International Journal of Molecular Sciences article: Hedgehog Pathway Inhibitors as Targeted Cancer Therapy and Strategies to Overcome Drug Resistance

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To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

"Many patients unfortunately will have side effects with this class. I mean—and I know that's not controversial—but you actually find callouts in some of the kind of the national consensus guidelines. These treatments might not be tolerable for a decent number of patients. Some of these side effects can certainly reduce quality of life. Again, nothing that controversial here when we say it out loud, but just the frequency with which it occurs can make it quite difficult for some patients." TS 9:13

"Certainly, based on what we said before, I think one of the easiest things to do for patients starting this class is to just make sure that they have really classical supportive medicines like antidiarrheals and antiemetics before they start treatment. Diarrhea, nausea occurred in about 20%–40% of patients across trials. So certainly patients should be aware of that risk. Again, not a controversial side effect, but it's just simple things we can do to make sure that our patients are quick to start treatment is to make sure that they have these medicines and they're educated on how to use them." TS 11:21

"I think patients need to be aware that side effects, as I had mentioned before, can be especially frequent with this class. So for a patient, they need to be aware that communicating your needs to your oncology team is really crucial to their own ability to use these treatments with minimal interruptions." TS 14:45

"I think that regardless of whoever is following up with our patients, though, as our arsenal of oral anticancer therapies does continue to expand, both nurses and pharmacists need to have specialized knowledge of these agents to be successful in their patient care roles." TS 18:28

"When there are clear recommendations for reproductive health, as I summarized before with these agents, I obviously think we need to be aware of them and not just defer to these generic recommendations. Because if you just defer to, 'Well, use barrier contraception and then for a week after your last dose,' you know, 'Okay, it's not true with these agents.'" TS 24:37