CAPhO Conference 2022

Learning Objectives:
•    Summarize key points about biosimilars that are relevant to their practice and to learn about nuances in practice, from province-to-province
•    Explore best practices, avoidable pitfalls related to biosimilar transitioning
•    Consider how to implement consistent practices with respect to biosimilars in oncology pharmacy, from policy for clinic usage to clinical decision-making
 

Learning Objectives:

1. Understand the evolution of anti-cancer therapies and the challenges/considerations of polypharmacy throughout the journey of a patient with malignancy
2. Discuss the potential implications of GI toxicity for drug absorption and drug-drug interactions and the importance of the pharmacist’s role in the selection of anticoagulation for the management of patients with cancer associated thrombosis
3. Review the latest evidence on bleeding and thrombotic risks when selecting an anticoagulant for the management of patients on anticancer therapies. 

Presentation Summary: 

Recent additions to acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL) treatment armamentariums created a need for the revision of existing treatment algorithms and protocols for patients ineligible for intensive first-line therapies.  
Several novel approaches include combinations of established agents and new molecules (for example, the addition of venetoclax to azacitidine for the treatment of AML) or improved versions of existing classes of drugs (i.e., the novel BTK inhibitor, acalabrutinib, for the treatment of CLL).  The emerging challenges revolve around integrating novel approaches with what is already in place while considering patient fitness, comorbidities, and treatment-related adverse events.  
Through several case studies, this interactive presentation will explore how pharmacists and nurses are adapting their approaches to patient counselling and monitoring while integrating novel approaches into their practice. 

Leaning Objectives: 

1. Identify how comorbidities and advanced age can affect tolerance to treatment
2. Review prevention strategies for treatment-related adverse events such as tumor lysis syndrome (TLS) and infections
3. Outline therapy options for patients ineligible for intensive first-line treatment in AML and CLL

Presentation Summary:

Recent clinical developments in breast cancer led to the approval of several antibody-drug conjugates (ADCs), a new class of targeted agents. This symposium aims to strengthen oncology pharmacists’ knowledge and confidence with ADCs.  It will provide an overview on ADC drug development and highlight the similarities and differences including key characteristics and mechanism of action. The speakers will review the impact these targeted therapies will have on clinical practice, patient selection, management and outcomes.  Patient cases will be used to clarify the role of oncology pharmacists in the monitoring and management of key ADC-associated adverse events.    

Learning Objectives:
•    Enhance awareness of how new and future treatment options are impacting the management of patients with breast cancer
•    Understand differences between ADCs and how this potentially impacts clinical management 
•    Increase clarity and confidence with side effect monitoring and management strategies of different ADCs

Presentation Summary:

Treatment strategies for patients with mature B-cell malignancies are rapidly transitioning away from cytotoxic chemotherapy toward oral targeted therapies.  While newer and better tolerated targeted therapies (BTK inhibitors) are now available, it can be challenging to stay current on emerging data, which can act as a barrier to adoption. Additionally, there is an initial learning curve for clinicians on how to monitor, prevent, and manage adverse events associated with BTK inhibitors. This program is intended to fill these knowledge gaps.

Learning Objectives: 

1. Review the current indication of the 3 BTKi currently on the market
2. Discuss the main dosing information, warnings & precautions, and interactions with BTKis
3. Review the management of most common AEs associated with BTKi
4. Key management & follow up considerations for patients on BTKis
5. Pharmacist’s Advice to patients on BTKis

Presentation Summary:

After nearly 50 years of continuous-infusion cytarabine with an anthracycline (“7+3”) as the mainstay of induction chemotherapy for acute myeloid leukemia (AML), several new agents have been recently approved by Health Canada for this heterogenous hematologic malignancy.  This presentation will provide an overview of some of the newly approved frontline AML treatments, followed by a discussion on supportive pharmaceutical care during intensive induction.

Learning Objectives: 

1. Outline key efficacy and safety data of newly approved frontline AML treatment options
2. Review the common classes of supportive medications used during intensive induction for AML
3. Discuss the rationale and timing of antimicrobial prophylaxis for severe neutropenia
4. Describe the mechanisms of selected drug-drug interactions and management strategies

Presentation Summary:
Oral inhibitors of vascular endothelial growth factor (VEGF) are well established in treatment algorithms for several types of cancer. As newer generation tyrosine kinase inhibitors (TKIs) emerge that may be more potent, it is important to be aware of the drug-induced toxicities that patients may experience while on these therapies and know how to manage them. This symposium will provide an overview of oral VEGF inhibitors, including their mechanisms of action, pharmacokinetics, and adverse event management strategies. The speakers will explore hypothetical patient cases to illustrate the role of oncology pharmacists in managing the dosing of oral VEGF inhibitors to manage toxicity and achieve optimal patient outcomes.

Learning Objectives:

1. Describe the mechanisms of action and pharmacokinetics of oral VEGF inhibitors
2. Discuss the role that oncology pharmacists can play in optimizing therapy with oral VEGF inhibitors
3. Outline tips and tricks for dose adjusting oral VEGF inhibitors and managing toxicity to maintain patients on therapy

Presentation Summary:

In my presentation I will discuss how we figure out if various foods are beneficial or harmful to human health. I will then provide a synopsis of the best available evidence around nutrition and health outcomes in general, with a focus on cancer.

Learning Objectives:

1. Incorporate best evidence to help inform decision making when it comes to nutrition
2. Identify the strengths and limitations of the evidence around nutrition
3. Recognize the responsibility of health professionals to incorporate patient values into the decision-making process when it comes to nutrition

Presentation Summary:

This session will serve as a review of the concepts behind chemoradiotherapy for the management of different cancer types.  In addition, an overview of common toxicities seen in a select number of disease sites and associated treatments will be presented. 

Learning Objectives:

1. Describe the rationale for the use of chemoradiotherapy in specific cancer sites
2. Recall the common toxicities associated with specific treatments and cancer sites
3. Summarize therapeutic approaches to management of toxicities

Presentation Summary:

Pharmacy Technicians as Clinical Informatics Specialists: the link between clinical and technology to improve patient outcomes. This presentation will review how a Pharmacy Technician can provide knowledge, support, and advocacy for best medication practice in an electronic clinical information system.

Learning Objectives: 

1. Describe informatics and how Pharmacy Informatics plays a role in Healthcare. 
2. Recognize the role of Pharmacy Technicians as Clinical Informatics Specialists (CIS)
3. Understand oncology-related challenges that a CIS manages on a day-to-day basis. 

Presentation Summary:

During this session we will be discussing how the care for patients with prostate cancer is rapidly changing.
The evolving treatment of prostate cancer is seeing available therapies being explored in new disease spaces, ever increasing the options available to a patient given their unique situation. Treatments are being sequenced and combined in new, innovative, and increasingly complex patterns. 
Treatment of prostate cancer is requiring an ever more artful, individualized approach to applying applicable evidence, for both anticancer treatment and associated supportive care.

Learning Objectives:  

1. Answer a patients questions regarding emerging options for chemical androgen deprivation
2. Apply aspects of the Canadian Urology Association Best Practice Guidelines on Bone Health to your patient care practice
3. Develop an initial treatment plan for a patient with metastatic hormone sensitive prostate cancer
4. Summarize the role of immunotherapy in the management of prostate cancer

Presentation Summary:

Constructive disruption is a willingness to change, adapt, and create new trends and technologies.  Oncology pharmacists are at a crossroads where evidence-based practice demands re-evaluation of our practice focus and how we deliver care. In many practice settings, constructive disruption may be required for this to be realized. The availability of trustworthy clinical practice guidelines to prevent and manage treatment-related toxicity demands that oncology pharmacists deliver evidence-based supportive care.  This care should focus on the supportive care needs articulated and prioritized by patients themselves.

Learning Objectives:

1. Describe the impact of supportive care on the cancer patient’s experience
2. Recognize the practice changes required to provide meaningful supportive care
3. Champion the delivery of evidence-based, patient-centred supportive care
    

Presentation Summary:

Dr. Nathalie Daaboul and Dr. George Dranitsaris will discuss the current landscape and framework for the use of Real World Evidence (RWE) in evidence-based decision making. They will discuss how patient preferences around treatment management impact clinical outcomes and quality of life. Looking into the future they will share how the RWE will impact patient treatment and potential HTA submissions.

Learning Objectives: 

1. To understand the sources of RWE and the methodology used to address selection bias, external validity and variability in clinical practice
2. To discuss the application of RWE and quality of life assessments in shared medical decision making
3. To understand the potential use of RWE in terms of label expansion and its role in health technology assessment

Presentation Summary:

Facilitated by key clinical leaders in oncology pharmacy, this session summarizes the essential role pharmacists play in supporting and managing patients with chronic lymphocytic leukemia (CLL) and HER2+ metastatic Breast Cancer (mBC) throughout their treatment journey. The presentation will outline the utilization of BTK inhibitors for the treatment of CLL, how to apply key practical considerations for therapeutic management, counselling best practices for adherence, and proactive and reactive management strategies for common adverse events, including cardiotoxicities. The session will then transition to how pharmacists can improve the patient journey through optimizing management of treatment related adverse events associated with drug therapy used in the management of HER2+ mBC.

Learning Objectives: 

Part 1: 

1. Recognize and understand the role of BTK inhibitors in the treatment of chronic lymphocytic leukemia (CLL) in first-line and relapsed/refractory settings
2. From the Pharmacist perspective, apply key practical considerations for CLL management with BTK inhibitors
3. Counsel patients on proactive and reactive management strategies for the most common and serious adverse events associated with BTK inhibitors

Part 2: 

1. Discuss the most common adverse events associated with antibody-drug conjugates & tyrosine kinase inhibitors 
2. Recognize the importance of adverse events of “special interest”, including interstitial lung disease/pneumonitis & gastrointestinal events
3. Describe recommendations for monitoring & management of adverse events

Presentation Summary: 

In this presentation, I discuss my personal experience as a young adult cancer survivor. I was diagnosed with Acute Myeloid Leukemia at the age of 19 and received a life-saving stem cell transplant, which has allowed me to continue writing and telling my story. My journey with cancer inspired me to become a health care professional and has given me a unique perspective that influences how I practice oncology pharmacy today. I share actionable insights that I’ve gained from a patient perspective and discuss what a second chance at life means to me.

Learning Objectives:

1. Analyze patient case for AML
2. Understand how my experience has influenced my practice
3. Identify actions that health care professionals can take to positively impact patient care
4. Discuss life lessons from the perspective of a cancer survivor

Presentation Summary:

This presentation will describe the journey of a pharmacy technician career pathway, offering insights and guidance to other pharmacy technicians who may be interested in a joyful career pathway with lasting impact on the profession and patient care.  Together, we will learn how to engage in the profession, for personal and professional growth and how self-leadership is a reflective process. By the end of this presentation, pharmacy technicians will be inspired to lead by example, lead through challenging times, and learn how personal development is an intentional process. 

Learning Objectives:

1. Identify the importance of engaging within the profession
2. Recognized how continuous self-improvement can grow you as a professional
3. Demonstrate ways to develop themselves as leaders of self
4. Understand and demonstrate self-reflection as a leadership strategy

Presentation Summary:

In this presentation, we will explore the emergence of psychedelics as an important therapeutic option in the realm of palliative care in the oncology setting. We will discuss implications and opportunities for oncology pharmacists, with a focus on the hallucinogenic psilocybin, while also briefly discussing the use of ketamine in the palliative oncology setting.  

Learning Objectives: 

Provide an overview of psilocybin therapeutics (and briefly on ketamine) as it pertains to the oncology and palliative care realm with a focus on:
•    Introduction and background to the therapeutic use of psilocybin
•    Current known pharmacology of psilocybin
•    Considerations and limitations of current clinical trial evidence and legal status in Canada
•    Practical considerations for administration and dosing of medicinal psilocybin
•    Theoretical drug interactions
•    Safety and toxicity considerations
•    Potential questions from clinicians and patients

Presentation Summary:

While there is a lot in life we cannot control, we can make the best possible daily choices in the areas of cancer prevention and screening to augment our risk of cancer. Join this session to learn how you can PracticePrevention.ca personally and professionally.

Learning Objectives: 

1. Explain the goal of cancer screening
2. Identify the eligible population, risk reduction methods, and access points for each screening program
3. Respond to common questions about cancer prevention and screening
4. Access more information on cancer prevention and screening

Presentation Summary: 

Adults aged 70 years and older account for 45% of cancer diagnoses and have more heterogeneous baseline health than younger patients. Many physiologic changes occur as we age and the number of comorbidities and medications tend to increase. These factors complicate decisions around prescription of oncology drugs, especially oral agents. Physiologic changes can impact dosing and side effects, while polypharmacy increases the risk of drug-drug interactions. These added considerations emphasize the importance of proper drug review and opportunities for deprescribing.

Learning Objectives:

1. Outline how physiologic changes associated with aging impact the risk profile of oncology drugs
2. Describe the importance of medication review and assessment for drug-drug interactions
3. Discuss strategies to increase the chance of deprescribing

Presentation Summary:

This symposium will highlight innovative oncology pharmacy initiatives, starting with the 2022 HOPE Award winning presentations.  Additional highlights will include the use of iMD Health and videos for patient education, AND optimizing virtual 'live' health care professional education through the inaugural Addressing Basics in Cancer (ABC) program.  You won’t want to miss this one of a kind symposium highlighting how innovation has (and will continue to) improve the pharmacy oncology space.

Learning Objectives: 

1. Best Practices/Key Learnings from the implementation of a digital platform for Oncology Patient Education at North York General Hospital. 2022 update and follow-up on the implementation of the platform during the COVID pandemic
2. Best Practices/Key Learnings from the implementation of a virtual online learning program for Oncology Pharmacists – The ABC (Addressing the Basics in Cancer) Program 
3. HOPE Awards Winner Presentations: honour and recognize accomplishments of oncology pharmacists across Canada. The HOPE Awards 2022 2nd annual HOPE (Honouring Oncology Pharmacy Excellence) Awards in Pharmacy. 

Presentation Summary:

During this symposium, Dr. Andre Harvin will teach the attendees how to apply strategies for implementing safe handling recommendations and hazardous drug (HD) monitoring, identify technologies available and surfaces for monitoring HD contamination, develop an action place for routine monitoring of surfaces for HD contamination and analyze surface monitoring results to identify opportunities for improving HD safe handling. 

Learning Objectives: 

1. Apply strategies for implementing safe handling recommendations and hazardous drug monitoring
2. Identify technologies and surfaces that should be used for monitoring HD contamination
3. Develop an action plan for routine monitoring of surfaces for HD contamination
4. Analyze surface monitoring results to identify opportunities for improving HD safe handling

This round table will describe current and emerging roles of the oncology pharmacy technician and how this can advance oncology pharmacy practice.

Review implementation and application of IV workflow solutions in ambulatory oncology settings.  Discuss benefits and challenges to inform your own decision-making. 

In this informal discussion, we will discuss emerging multiple myeloma therapies joining the Canadian landscape. We will explore clinical issues that face oncology pharmacists related to this patient population and share insights on supportive care management.  

Presentation Summary: 

Oncology professionals find it difficult to keep up with all the new evidence that is constantly emerging in oncology. This presentation will focus on practice changing articles, breaking down these articles and providing clinical pearls for your practice. These articles will focus on current, evidence-based, practical information which an oncology professional can incorporate into their day-to-day practice. 

Learning Objectives:

1. Apply takeaways from practice-changing articles of 2021-22
2. Recognize some of the practical clinical issues from the recent literature.
3. Demonstrate an understanding of how to apply this new information in daily practice.

Presentation Summary:

There is a paradigm shift happening in the management of patients with unresectable locally advanced or metastatic urothelial carcinoma (aUC). First-line maintenance immunotherapy for eligible aUC patients has become the new standard of care supported by strong clinical evidence and international guidelines. 

Join a multidisciplinary team of experts to explore the current evidence for maintenance immunotherapy in aUC and discuss the practical aspects of effectively integrating this new therapeutic strategy into clinical practice. Using a case-based approach, faculty members will share their unique perspectives on topics relevant to pharmacists, including patient eligibility, treatment initiation, medication adjustments, toxicity management, and long-term follow-up.

Learning Objectives: 

1. Summarize the current evidence for maintenance immunotherapy in the first-line treatment of patients with unresectable locally advanced or metastatic urothelial carcinoma (aUC).
2. Interpret specific criteria that make patients with aUC appropriate candidates for first-line maintenance immunotherapy. 
3. Appraise multidisciplinary perspectives on the effective integration of maintenance immunotherapy into clinical practice, including strategies for patient education, treatment initiation, and adverse event management.