Pharmacists Gather to Debate Oncology Trends and Practice

Chris Fausel, PharmD, clinical manager, Oncology Pharmacy, Indiana University Health, Val R Adams, PharmD, associate professor, University of Kentucky, Kirollos Hanna, PharmD, oncology pharmacy manager, M Health Fairview—Maple Grove, and assistant professor of Pharmacy, Mayo Clinic College of Medicine, and Lisa Holle, PharmD, clinical professor, UConn School of Pharmacy, UConn Health Carole and Ray Neag Comprehensive Cancer Center, return to discuss Great Debates & Updates Oncology Pharmacy, a CPE event aimed at educating pharmacists interested in oncology developments. In this podcast, the cochairs review last year's program and share what attendees can expect to learn at the meeting in 2022.

Learn more about the meeting and how to register for the event.

Read the full transcript:

Welcome to Clinical Pathways Learning Network, the digital home for The Journal of Clinical Pathways, Clinical Pathways University, The Oncology Clinical Pathways Congress, and Great Debates & Updates Oncology Pharmacy.

In this podcast episode, the cochairs of Great Debates & Updates Oncology Pharmacy provide an overview of what attendees can expect to learn this year.

Dr Fausel: Welcome everyone. My name is Chris Fausel. I am an oncology pharmacist in precision medicine at Simon Cancer Center in Indianapolis, Indiana, for Indiana University. It’s my pleasure to welcome you all back in 2022 for Great Debates & Updates Oncology Pharmacy. We kicked it off in 2021 with our first meeting ever, and we're back again in 2022.

First off, I'd like to introduce all my cochairs for the program. Ladies get to go first. Dr Lisa Holle is a clinical professor at UConn School of Pharmacy, and she practices at the UConn Carole and Ray Neag Comprehensive Cancer Center in Connecticut. Dr Holle, welcome.

Dr Holle: Thank you. Glad to be here again.

Dr Fausel: Next up is Dr Val Adams from the great state of Kentucky. He's an associate professor at the University of Kentucky and a longstanding faculty member for Pharmacy Learning Network. Welcome, Dr Adams.

Dr Adams: Thanks Dr Fausel. It's a pleasure to be back with this esteemed group.

Dr Fausel: And last but not least, our young stud Dr Kirollos Hanna. He's the oncology pharmacy manager for the M Health Fairview and Maple Grove sites. He's also an assistant professor of pharmacy at the Mayo Clinic College of Medicine. Dr Hanna, welcome.

Dr Hanna: Thank you so much, Dr Fausel. Really excited to be working with this group again for this year.

Dr Fausel: We had an opportunity, in the middle of the pandemic last year, to put together an educational program. With the uncertainty with the pandemic, we felt that there was a huge void in pharmacy education, specifically oncology pharmacy education. So, we had a couple of overarching goals when we set this up.

Number one, of course, it had to be virtual because no one was allowed to get together in 2021, for the most part. The second thing is we wanted to make this a unique and useful exercise for people that are going to invest their time in it. So we decided to try and tackle topics that don't get talked about all that much in pharmacy CE programs.

We also wanted to make it more engaging. Instead of having someone talk for 60 minutes at a pop about an individual topic, we would often have cofaculty members who would share the material when presenting. At the end, they would have a back and forth. It worked really, really well. We enjoyed it.

I think, looking back at 2021, we were pleasantly surprised about how well the meeting worked in a virtual setting. I'll open it up to thoughts from my colleagues here.

Dr Holle, what did you think about how things went back in 2021 for the first program?

Dr Holle: I think it went well. It was an interesting format, as you mentioned, the back and forth between presenters. We have such great colleagues that have expertise. To be able to hear the differences in how people are approaching different tumor types, especially the ones that we don't talk about at most of our conferences, was valuable. And it seems like the audience was engaged because the question-answer session did have a lot of feedback.

Dr Fausel: Indeed it did. Dr Adams, what did you think about last year?

Dr Adams: I think overall it was great. I completely agree with Lisa. I see it a bit different. One of the things that I enjoyed the most about our meeting last year was we got to talk more about the gray. We get so many new drugs, and it's not always clear how you handle specific drugs or situations. So the back and forth and different perspectives were something I really enjoyed, and I think we're going to continue that.

Dr Fausel: Thank you. Dr Hanna, what are your thoughts about how things went last year?

Dr Hanna: Dr Fausel, I couldn’t agree more with what Dr Adams said. Oncology has really transitioned into gray. Thinking back, some of the topics that we had last year around certain lymphomas, around CLL, and having those debates, was really exciting.

We had such a large audience from 2021 that provided a lot of feedback on sessions that they're looking for. We also received tons of positive feedback about that debate-style approach, rather than just a lecture that we generally see. So it was a really exciting year. We had incredible turnout and I am even more excited about 2022.

Dr Fausel: Thank you for that wonderful segue Dr Hanna. Towards the end of 2021, we got together with the organizers of this program. They said, you know what? We want to do this again. We had two different sessions that we did in 2021. We're going to do three sessions in 2022.

The content will largely be the same, but there may be some individual tweaks between these sessions. Another important piece is the live sessions are all completely free. Anyone can join and watch these sessions. There is a charge if you want to have continued access for 30 days, or 90 days. But that's pretty remarkable, that all this content is going to be provided for free in real time for anybody that wants to join and watch.

For 2022, let's talk about what topics we're going to be focusing on. When we first got together at the beginning of this year to talk about the 2022 program, we didn't want to repeat exactly what we did in 2021. We wanted to have some new topics. We really think we were able to come up with a nice balance of topics that need to be addressed almost every year, as well as fresh, new information that hasn't been presented yet.

Who wants to give me their perspectives on day one, and what's involved in the content for day one?

Dr Holle: I'd be happy to do that, Chris. We're going to start off this year's session with a provocative topic: should multiple myeloma patients be transplanted? And it's going to be a debate format, so I think that'll be really exciting. In addition to that, something new that we're doing this year is challenging cases, where we talk about actual patient cases and how individual practitioners would approach them differently. Because as we just talked about, oncology is a very gray area, and there isn't always a right answer to follow a particular patient case.

The first one we'll talk about is breast cancer. Another topic that I think intrigues us and is difficult in our patient population is using opioids in patients who have an opioid use disorder. Trying to get some clarity on what people are doing with that in their own practice settings could be helpful. And then we'll round out the day by talking about cancer care disparities, and how all of us are trying to handle and tackle that within our own practices.

I think it's going to be an exciting first day.

Dr Fausel: Thank you, Dr Holle. That was excellent. Dr Hanna, what are your impressions about the agenda for day number two?

Dr Hanna: Thanks, Dr Fausel. I'm personally really excited for day number two, because we start off the day with talking about COVID 19. And who doesn't want to talk about the pandemic?

We're going to be talking about whether cancer patients should be getting vaccinated. We have two incredible faculty members, Dr Lewis and Dr Frame, who will be walking us through what type of immunity patients with cancer may mount after the vaccine, the debates and challenges there, as well as some of the therapeutic options that we now have for our immunocompromised patients.

Moving along into that day, we're going to stem off some of the conversations we had on day one, like the multiple myeloma talk. Dr Karen Fancher is going to walk us through some challenging cases around patients with multiple myeloma, as well as lymphoma. Obviously, the lymphoma patient population has a lot of significant advancements there. We’re going to be trying to home in on patients with various cytogenetic aberrations, double hit lymphomas, CNS involvement, etc. We’re excited to hear what those cases are and why you would select certain therapies.

We're then going to move into one of our very own, Dr Lisa Holle, and myself. We will be discussing advances in bladder cancer. And bladder cancer has just exploded over the past couple of years with immunotherapy, targeted therapy, antibody drug conjugates—this whole sequencing of therapies, and when you should use what, and when, and how. I’m really looking forward to presenting that with Dr Holle. Again, after all these sessions, there will always be opportunities for Q&A.

We're going to wrap up our day two with one of my mentors and colleagues, Dr Robert Mancini, who was my residency program director. He's going to talk to us about a very unique topic: the burden of care. What it means to have cancer or to be a caretaker for patients with cancer, how to handle death in these patients, and having difficult conversations with patients.

I’m excited about that unique topic, and again, just very excited about day two and this whole conference.

Dr Fausel: Thank you very much, Dr Hanna. Dr Adams, take us home. What are we going to talk about on day three?

Dr Adams: Day three is loaded. There are a lot of ways to slice and dice it. We're going to start with glioblastoma (GBM), but when's the last time you heard a CE talk on GBM? So part of that is going to be a back and forth about some of the failures. We're starting to see precision medicine, and there's a little glimmer of hope, but we're certainly going to incorporate the failures.

Then we're going to move to an area of success. We're going to talk about renal cell, where we've got so many new immunotherapy combinations and other things that it's not clear what to do.

Then we're going to move to thyroid cancer. Guess what? Dr Fausel and I get to debate how we would handle some of these difficult questions that come up. When you look at the protocols and the publications, it's easy, but most of our patients are non-protocolized. That means it's never clear what to do exactly—again, back in that gray zone.

One of the last things that's new this year: we've added a perspective piece, and it's drug access. Fortunately, we have somebody from the industry side that has a lot of control over drug access. Lance Piecoro's going to talk about that. And we've got a pharmacy director. How does each group approach drug access? How do we navigate those processes?

Really excited about day three. I think it's a good mix and going to be great.

Dr Fausel: Thank you very much, Dr Adams, and I can't wait for our little debate on day three. That is going to be a lot of fun.

In addition to days one, two, and three, there's also some content for eight different lectures that is going to be available for on-demand viewing. There's a number of different topics, including some common topics like breast cancer, melanoma, and chronic myeloid leukemia, but also some rare topics that almost never get discussed in a pharmacy audience.

We're going to talk a little bit about neuroendocrine tumors, which I think will be a wonderful opportunity to hear that lecture. We're also going to talk about some pediatric cancer topics. We're going to talk about stem cell transplant and cervical cancer. So there are some good topics that are going to be available for folks outside of just the live presentations. They can go back and take a look at them when they're standing in line at the store or something like that, and they need something to do.

One last thing I want to finish up with is, I want to get everyone's opinion on who could benefit from this meeting. Obviously, oncology pharmacists are in the wheelhouse for all this information. Whether you work in acute care medicine on the inpatient side, stem cell transplant, outpatient oncology clinics, or specialty pharmacy, all of this is bread and butter for your daily work.

But what are some of the other professions, and some of our other colleagues, that could potentially benefit from this? Dr Holle?

Dr Holle: I think everybody can benefit from it, but particularly the advanced practice practitioners. I think all of us probably get asked by those providers what is the best thing to do certain situations. As we talked about, the gray areas of oncology are difficult to navigate. So I think they could really benefit from this particular program. There are options to attend in different times of the year.

Dr Fausel: Great. Thank you. Dr Adams, what do you think?

Dr Adams: I agree with Dr Holle on the advanced practitioners. I think this really benefits new practitioners, even the medical fellows, because when things are gray and you're not sure, you only know what you've trained with. If you're new, somebody might be ordering something different. When you move organizations, they may do things differently, and you probably don't appreciate why they do what they do. That's the beauty of this meeting: you get different perspectives. And I think that really benefits the newbies, to be honest.

Dr Fausel: That's a great insight, Dr Adams. Thank you. Dr Hanna, what do you think?

Dr Hanna: I agree with both Dr Adams and Dr Holle. The only other group of people I would say is the community oncologists. I think this would be extremely beneficial for the community oncologist who sees everything under the sun walking in their doors.

When you're seeing everybody, you can't really keep up with everything, whereas on the academic side, you may see a lot of oncologists focused in certain disease states. Oftentimes they're pretty well versed in terms of treatment updates and these controversial topics. It's extremely difficult to keep up with oncology, and better understanding these gray areas will enable the community oncologist to better specialize themselves or gain a better familiarity.

Dr Fausel: Great. Thank you, Dr. Hanna.

I would like to thank all my cochairs for joining me today and discussing this information. I can't say enough how much great work they have all done to make this program a success. We'd also like to thank the folks that have also helped us get this program off the ground. To everybody working in the background, thank you very much for all your efforts.

We're very excited about Great Debates & Updates Oncology Pharmacy. We're going to be doing it three times this year, the first time at the end of April. We're looking forward to seeing everybody then. Thanks, and everybody please stay safe. Take care.

Thank you for listening. For more updates on topics related to the development, implementation, and evaluation of clinical pathways, visit our website at journalofclinicalpathways.com.