Session descriptions and speaker information for sessions on Wednesday.
Practice Management Boot Camp (001) (extra-fee event) 0.4 CEUs
A Primer on Precertification, Formulary Management, and Inventory Control
Lindsey Amerine, PharmD MS BCPS
This session will describe the fundamentals of precertification, formulary management, and inventory control of oncology agents. Each has an impact on oncology budgets and daily operations, which are key areas of focus for oncology managers. Formulary and inventory management can work in concert to streamline operational practices.
From the Bedside to the Board Room: Tools for Making the Transition from Clinician to Director
Victoria Brown, PharmD BCOP
This presentation will cover key leadership and management principles for clinicians who are transitioning from direct patient care provider to a formal leadership and management role. Topics will include communication with internal and external stakeholders (e.g., advocating on oncology pharmacy issues to corporate-level executives), basic tools for people management, and the transition from peer to manager. The potential leadership gap in pharmacy means that there is a significant need for more practice-based leadership. This session will help identify the tools needed to help those who are considering a career transition or who have recently made a transition to a formal leadership role.
The Oncology Pharmacy Navigator: A New Best-Practice Model for Managing Medications in Cancer Programs
Kelly Scott-Rice, PharmD
The Oncology Pharmacy Navigator (OPN) is a new best-practice model and an integral part of the multidisciplinary program at Legacy Cancer Institute (LCI) in Portland, OR. During the American College of Surgeons Commission on Cancer’s accreditation visit, surveyors specifically cited the oncology pharmacy navigator as a “best practice.” The OPN is dedicated to improving adherence to medications, maintaining accurate medicine lists, addressing medication-related symptoms quickly, and improving overall compliance with treatment plans. The OPN is a specially trained pharmacist who provides patient-specific medication therapy management, ensures that patients understand their medicines, reduces the risk of drug errors and duplications, provides patient and family education, and solves drug-related problems. Over the course of the first year, the OPN tracked quality outcomes, interventions, and cost savings. In the first year, the OPN was directly responsible for more than $237,000 of cost savings. Referrals to the OPN increased by more than 50% in the second year of the LCI program. Medication lists are often inaccurate, and medication reconciliation is a top priority for many healthcare facilities. On average, cancer outpatients in the LCI program are on 13 medicines (range 3–69). The OPN performs medication reconciliation on at least half of all referrals and has developed additional quality targets. The OPN is an innovative role that has helped distinguish LCI, assists in accreditation, and, most important, truly benefits the cancer patients served.
REIMBURSEMENT: Oncology Updates
Tim Tyler, PharmD FCSHP FHOPA
This presentation will review reimbursement changes and challenges in the oncology marketplace for hospital and community providers. Topics will include the current status of federal government–enacted changes in reimbursement for cancer care that affect institutional and community-based practices, differences in reimbursement for various products, and differences between reimbursement for intravenous products versus oral products.
Biomarkers for Immunotherapy (101) 0.125 CEUs
R. Donald Harvey, PharmD BCOP FCCP FHOPA; Jacob K. Kettle, PharmD BCOP; Josiah Land, PharmD BCOP
Since the advent of novel immunotherapy agents, ushered in by ipilimumab, patient selection using assays to predict response has evolved. Some, but not all, checkpoint inhibitors are accompanied by a requirement to test tumor biopsy material for expression of a relevant marker (programmed death-ligand 1 [PD-L1]) prior to initiation; however, even agents in the same class have differing requirements based on tumor type. Additional biomarkers beyond PD-L1, including genomic measures and other immune-based targets, may also help to stratify populations for improved response. However, some have argued that testing is globally unnecessary because of responses in patients shown to be negative for the biomarker of interest. This session will explore how different biomarkers that predict activity in a given patient or population are used, including their benefits and limitations. Characteristics of assay performance will be discussed, as well as how laboratory, tissue collection, and clinical and treatment variables may influence results. Finally, discussion of debates about the clinical use of microsatellite instability in broad populations and PD-L1 interpretation across non-small-cell lung cancer patients will highlight clinical challenges in checkpoint inhibitor use.
Prophylaxis and Treatment of Invasive Mold Infections (102) 0.125 CEUs
Jim Lewis, PharmD FIDSA; Bernard Marini PharmD BCOP; Anthony Perissinotti, PharmD BCOP
This session will involve a spirited debate about newer data in the field of prophylaxis and management of invasive mold infections. Emphasis will be placed on antifungal therapies in the hematologic malignancy population.
Clinical Challenges in Advanced Melanoma: Immunotherapy or BRAF-Targeted Therapy? (103) 0.1CEUs
Jaime Anderson, PharmD BCOP
The treatment of unresectable and metastatic melanoma has been constantly evolving over the last several years, largely because of the clinical benefit and success of immune checkpoint inhibitors and targeted therapies for BRAF-mutant melanoma. More recently, this evolution has also moved into the adjuvant setting for those with resected malignant melanoma. In this session we will navigate through recent clinical trial data and discuss how to apply this information, given the heterogeneity of the melanoma patient population. As a way to guide optimal treatment decisions, we will also address the ongoing controversy about when to initiate therapy with immune checkpoint inhibitors versus oral combination targeted therapy. Finally, we will identify key clinical trials currently being conducted to help resolve clinical challenges in treating malignant melanoma.
BCOP Session 1 (BC1) 0.1 CEUs
New Oncology Clinical Trial Designs: What Works?
Janelle Perkins, PharmD BCOP
This session will provide an overview of the limitations of traditional clinical trial designs used in oncology for the evaluation of personalized medicine and targeted therapies. Newer trial designs for these strategies will be presented, including umbrella and basket trials, along with a discussion of clinical outcome assessment, model-based phase 1 trials, and biomarker-based designs. Advantages and disadvantages of these designs will be assessed, and other trial designs may be included if time permits. The intended audience is clinical oncology pharmacists and academicians whose role includes the design or interpretation of clinical trials to improve the therapeutic outcomes of their patients.
Targeting FLT3: An Update in the Management of FLT3-Mutated Acute Myeloid Leukemia (104) 0.1CEUs
Amanda Seddon, PharmD BCOP BCPS
In April 2017, the U.S. Food and Drug Administration approved the first tyrosine kinase inhibitor for the treatment of patients diagnosed with AML. The approval of midostaurin marks the beginning of targeted therapy development for this difficult-to-treat disease. Three other FLT3 inhibitors are currently in phase 2 trials for AML and show promising efficacy, which may dramatically change the treatment paradigm for this disease. This session will provide an overview of FLT3-mutated AML, including currently available treatment, first- and second-generation inhibitors, mechanisms of resistance, and future directions. The session is directed to the advanced practitioner.
Research (105) 0.1CEUs
The RX for Successfully Integrating Research into Your Daily Pharmacy Practice
Judith A. Smith, PharmD BCOP CPHQ FCCP FISOPP
This session will provide an overview of incorporating research into clinical practice going from bench to bedside and back. We will briefly review the foundational resources needed and the challenges of balancing research and clinical practice. Another goal will be to demonstrate the spectrum of valuable research contributions pharmacists are making to advance patient care. Finally, we will discuss recommendations for getting started building research into practice.
Pharmacy and Research in 2018: Let’s Get Started
Hai Tran, PharmD
This session will focus on taking the first steps into research. Some individuals see the word research and shrug or turn the other way, perhaps seeing it as a task too daunting to take on alone. But by taking small steps and asking for help, they may find the task less daunting. At whatever level, everyone needs help, and research requires collaboration. Critical to the succesful completion of a research project are knowing the need for the research, having ample time, and involving the department’s and institution’s administrators, especially if research is not on the institution’s list of priorities.
BCOP Session 2 (BC2) 0.1 CEUs
Updates in the Management of Urothelial Carcinoma
Kirollos Hanna, PharmD BCOP BCPS
This session will cover treatment updates in the management of urothelial carcinoma and the role of immunotherapy. Treatment options for metastatic urothelial carcinoma (mUC) have been limited. In light of immunotherapies, options now include two programmed cell death-1 and three programmed death-ligand 1 (PDL-1) inhibitors in the locally advanced or metastatic setting—atezolizumab, nivolumab, durvalumab, avelumab, and pembrolizumab. This session will provide a detailed overview outlining the efficacy data of these agents and considerations for prioritizing therapy. In addition, we will discuss safety data, PDL-1 testing, management, and the role of the pharmacist in using checkpoint inhibitors to treat mUC. This session will also briefly outline ongoing clinical trials using immunotherapies for urothelial carcinoma.