Session descriptions and speaker information for Thursday, April 4, at HOPA's Annual Conference.
Breakout Session Ambulatory Practice (201) 0.1 CEUs
Adjuvant Colon Cancer: Deciphering the Data on 3 Months Versus 6 Months of Oxaliplatin-Based Therapy
Recent literature evaluates two oxaliplatin-based (CAPOX and FOLFOX) regimens for durations of 3 months versus 6 months in the adjuvant setting for Stage 3 colon cancer. This presentation will focus on available literature on the duration of therapy and choice of an oxaliplatin-based regimen for adjuvant colon cancer. The presenter will discuss the SCOT, TOSCA, IDEA France, HORG, and ACHIEVE trials, as well as the IDEA pooled analysis. Attendees will gain an in-depth understanding of current literature on this topic that can be applied to clinical practice.
Kelly Gaertner, PharmD BCOP BCPS
Advanced Hepatocellular Carcinoma: Should Patients VEG Out or CHECK Themselves in the Second-Line Setting?
The majority of patients diagnosed with hepatocellular carcinoma (HCC) are diagnosed with advanced disease. The emergence of sorafenib in the front-line setting following the SHARP trial has led to a transformative practice change in HCC. However, many clinicians continue to debate the best second-line option. Regorafenib (a VEGF inhibitor) and nivolumab (an immune checkpoint inhibitor) emerged as viable second-line options following the RESOURCE (Lancet 2017) and CheckMate 040 (Lancet 2017) trials. More recently, the National Comprehensive Cancer Network guidelines were updated to include cabozantinib and lenvatinib as well. These four options have different administration, monitoring, and adverse-event profiles. The presenter will discuss the treatment considerations with regorafenib, nivolumab, cabozantinib, and lenvatinib therapy in advanced second-line HCC.
Julianne Orr, PharmD BCOP
Breakout Session: Special Populations (202) (0.1 CEU)
Current and Emerging Treatment Standards for Patients with Chronic Lymphocytic Leukemia
The focus of this session is an exploration of both current (chemoimmunotherapy and novel oral therapies) and emerging options for patients with chronic lymphocytic leukemia (CLL). The presenter will discuss ways to incorporate treatment options into the current paradigm of care (including managing complications related to toxicity, relapse, and resistance) and will describe methods to improve communication, patient engagement, education, and decision making between patients and healthcare providers.
Alison Duffy, PharmD BCOP
Are "Silver Survivors" Too Old for Treatment? An Update on How Chronologic and Functional Age Can Influence Treatment-Related Effects
Unique challenges exist in the management of older adults with cancer. Associations between cancer and age-related physiologic changes have a direct impact on the pharmacokinetics and pharmacodynamics of cancer therapies and can affect drug dosing, dose intensity, efficacy, safety, and quality of life. However, the breadth and depth of these issues have not been fully evaluated because the majority of clinical trials focus on younger and healthier populations. Consequently, little information is available to support clinicians in making evidence-based decisions regarding treatment with cancer therapies in older adults, especially those over age 75. Prior clinical pharmacology studies summarized the literature on how age-related physiologic changes can influence and affect anti-cancer therapies; this presentation goes further by integrating how functional age, determined by the geriatric assessment, can also influence treatment-related effects and health outcomes. Broadening cancer therapy trials to capture not only chronologic age but also functional age would allow clinicians to better identify subsets of older adults who could benefit from treatment versus those most vulnerable to morbidity and mortality.
Ginah Nightingale, PharmD BCOP
Breakout Session: Hematopoietic Cell Transplant (203) (0.1 CEU)
Remission Possible: The Evolving Role of Maintenance Therapy Following Autologous Transplantation
The use of maintenance therapy following hematopoietic cell transplantation (HCT) is an area of active research and interest in the hematology community. Literature and guidelines lack strong recommendations for most diseases, and the list of potential agents available to use for maintenance therapy is growing. Selection of appropriate agents and appropriate patients is a complex process that requires critical evaluation by a pharmacist.
Katie Gatwood, PharmD BCOP
Chronic GVHD: Individualized Treatment or a Systematic Approach?
Chronic graft-versus-host disease (cGVHD), while related to and often correlated with acute GVHD, is a distinctly different pathologic process. It is significantly more difficult to manage than acute GVHD and creates long-term complications and comorbidities in patients after bone marrow transplant. The course of the condition requires continuous calibration of medication therapies in this setting. Many cGVHD patients, especially those who do not get a complete response to therapy within 1 year, require long-term immunosuppressant or treatment therapies. Much new research into the biology and pathophysiology of cGVHD suggests that the approach to the treatment of cGVHD may depend on patient-specific factors, including the tissue involved. Many new therapeutic approaches have been tried, including use of low-dose IL-2, ruxolitinib, ibrutinib, bortezomib, rituximab, tocilizumab, vorinostat, maraviroc, and brentuximab. Other procedural therapies, including adoptive T-cell transfer and extracorporeal photopheresis, have also been tested and streamlined in therapy. In addition, advances in targeted therapies have shown promise in early clinical trials for the management of cGHVD. There is more interest and funding for research on cGVHD and a host of potential targets in the pathogenesis pathways.
Robert Mancini, PharmD BCOP
Breakout Session: Pediatrics (204) (0.1 CEU)
Included in Virtual Meeting
Updates in Classical Hodgkin Lymphoma Treatment
Classical Hodgkin lymphoma (cHL) is an uncommon malignancy; however, 10%–30% of patients experience relapse. The standard of care for relapsed or refractory (r/r) patients is high-dose chemotherapy followed by autologous stem cell transplant. If a patient is ineligible for transplant or relapses following transplant, treatment options are primarily palliative. Brentuximab vedotin (BV) is a CD30-directed antibody-drug conjugate and has demonstrated efficacy in patients with CD30-positive r/r cHL. Initial studies showed that BV induced a complete remission in 34% of patients, with a median duration of response of 20.5 months, and the 3-year follow-up data have confirmed positive results. Clinical studies confirmed that programmed death receptor-1 (PD-1) inhibitors have accomplished complete remission rates in 16% of r/r cHL patients. Pembrolizumab and nivolumab gained the FDA-approved indication for the treatment of r/r cHL in March 2018 and May 2018, respectively. BV and PD-1 inhibitors are recommended by the NCCN guideline as a second-line systemic therapy option as monotherapy or in combination. Updated NCCN recommendations with the use of BV and PD-1 inhibitors in the r/r cHL setting will be reviewed.
Brianne Dixon, PharmD
Keeping an Eye on Intra-Ocular Therapies for Retinoblastoma
The treatment of retinoblastoma has evolved substantially over the past 2 decades from external beam radiation or enucleation to incorporation of systemic chemotherapy for management of intraocular disease. Patients with advanced and extensive disease tend to have a poor response to systemic chemotherapy, which warrants a focus on investigating salvage therapies that prevent the need to enucleate. With this focus, therapy options for retinoblastoma have further advanced to include salvage regimens with various intra-ocular treatment modalities, such as intra-arterial and intravitreal chemotherapy. New literature supports the use of various intra-ocular therapies as viable options for the treatment of retinoblastoma. Delivering intra-arterial and intravitreal chemotherapy is a complex process, and the pharmacist involved in the care of the patient has much to consider. This session will provide an overview of retinoblastoma, with a focus on intra-ocular treatment options, the intricacies of the delivering these therapies, and the common side effects.
Kate Reichert, PharmD BCPPS
Breakout Session: Practice Leadership (205) (0.1 CEU)
Included in Virtual Meeting
Business 101: Applying Billing Models to Optimize Your Practice
This session will provide a basic overview of the finance principles associated with oncology pharmacy practice to help oncology pharmacists become more business savvy. Given the high cost of oncology drugs, it is important that the oncology pharmacist understand the relevant business models and how the business affects their practice. When oncology pharmacists apply business principles to everyday practice, the importance of their role as part of the healthcare team increases.
Andrea Ledford, PharmD BCOP
Authentic Leadership: Leading with Your True Self
Have you ever wished you had spoken up and said something that went against the status quo? Are you still searching for your inner voice, seeking to be true to yourself and your colleagues? Effective leaders lead with authenticity and humility. They know who they are. This session will examine the principles of authentic leadership, including the power of self-awareness, the need to practice values, and the power of credibility. Authentic leaders are grounded, knowing how to balance intrinsic and extrinsic motivations and achieve work-life stability. You will leave this session with the education and tools for remaining real to yourself and those you lead.
Amy Pick, PharmD BCOP
Annual Members' Meeting and Member Awards
John G. Kuhn Keynote Lecture (Non-CE)
Had I Known: My Breast Cancer Journey
Joan Lunden shares her personal experience of breast cancer and what she has learned through her journey about health; fitness; and the importance of family, friends, and community. She gives the patient’s perspective on treatment both from her own personal experience and from what she has heard from the thousands of women who write in to her website. Joan includes advice on how to be the CEO of your own health.
Joan Lunden, award-winning journalist, best-selling author, and health and wellness advocate
Research Session (0.1 CEU)
Real-World Data Use in Oncology (206)
Included in Virtual Meeting
Real-world data (RWD) and randomized clinical trial (RCT) data have different sources and are used in different ways; they are wisely used to complement each other. Both types have limitations, and each should be developed in a methodologically rigorous manner. Although RCT data allow the tightest understanding of causal relationships, such data may or may not mimic care and outcomes outside of stringently controlled clinical trials. Conversely, RWD is available in various forms and can be used to better understand generalizability and outcomes of pharmaceutical interventions when used in naturalistic settings. As the U.S. healthcare system moves from a fee-for-service model to a value-based model, the combined evaluation of RWD and RCT data helps predict not only therapy efficacy and effectiveness but also the economic implications of therapy for given populations of patients. Large-scale investments are being made throughout the oncology landscape to create large RWD sources for use in appropriate contexts. The presenter will review the principles, limitations, and advantages of RWD and RCT data; describe the evolving healthcare landscape; and demonstrate the need for clinical pharmacists to adapt, interpret, and be conversant with both types.
With the move to a value-based reimbursement model, the responsibilities of healthcare team members are changing to meet practice needs. How are these changes affecting oncology pharmacists and the roles they have within the team? The HOPA Practice Outcomes and Professional Benchmarking Committee surveyed pharmacists from 20 sites across the nation to help identify trends in the delivery of care to patients with cancer and understand the role that pharmacists play as healthcare team members.
Paul Cockrum, PharmD; Robert Ignoffo, PharmD FHOPA FASHP FCSHP
General Session (0.1 CEU)
Leadership: Shades Versus Reality (207)
Included in Virtual Meeting
The presenter will focus on the main characteristics of a leader, especially in the pharmacy field; discuss generational understandings of expectations and abilities as related to leadership; discuss the various roles that pharmacists must be able to assume; and explore the need for more women to get involved and take on leadership positions in the field.
Nelly Adel, PharmD BCOP BCPS
General Session (0.1 CEU)
Significant Papers: Oncology (208)
Included in Virtual Meeting
The session will provide high-level review and analysis of practice-changing papers on solid tumors that were published in 2018. Review of the selected articles will focus on current practice trends, stated objectives, critical evaluation of study design, interpretation of results, and application to clinical practice.
Danielle Roman, PharmD BCOP
BCOP Session (0.1 CEU)
UAN 0465-0000-19-034-L04-P Included in Virtual Meeting
Maintenance Therapy After Hematopoietic Cell Transplantation in AML: The Old, the New, and the Future (BC3)
Despite the recent increase in newly approved agents to treat acute myeloid leukemia (AML), the need for hematopoietic stem cell transplant (HSCT) remains an essential consolidation treatment for high-risk patients. Unfortunately, despite this potentially curable treatment, relapses following HSCT remain a major cause of treatment failure. This session will give an overview of the relapse risk post-HSCT in AML and a detailed review of the currently available literature on the use of maintenance therapy. The presenter will discuss the role of hypomethylating agents azacitidine and decitabine; FLT3 inhibitors sorafenib, midostaurin, and quizartinib; and future agents, including panobinostat and an oral formulation of azacitidine. The challenges in using maintenance therapy in clinical practice will also be addressed.
Amanda Seddon, PharmD BCOP BCPS
Research Grant Award Presentations (209) (0.1 CEUs)
UAN 0465-0000-19-046-L04-P Included in Virtual Meeting
This session will feature HOPA Research Grant Award winner Shawna Kraft, PharmD BCOP, who will share research findings from her study “The Validation of a Novel Adherence Method for Oral Oncolytics.” Dr. Kraft’s research study assessed the use of a smart phone application and an automated dispensing machine to help patients who are taking oral cancer medications develop an easy-to-use system. Come learn about her processes and the findings of this exciting project.
Shawna Kraft, PharmD BCOP