Oncology Fundamentals Day 2021

Program

Note: Program is subject to change. 

To view session descriptions click on "More Info" and then click on the presenter's name to view their biography.

Friday
October 22, 2021
All times indicated are Eastern Daylight Times (EDT).

Satellite symposium
Janssen - Enhancing the Patient Experience in Multiple Myeloma: Optimizing Administration of Novel Agents
Presenters
Dominic Duquette
Photo of Dominic Duquette
Photo of Dominic Duquette
Dominic Duquette
M.Sc Pharm
Pharmacy Oncology Coordinator , Centre Hospitalier Universitaire de Québec, Université Laval — Quebec
Dominic Duquette
Centre Hospitalier Universitaire de Québec, Université Laval, Quebec

Learning Objectives:

  1. Recognize features of multiple myeloma, its treatment challenges and the impact of the evolving treatment landscape on patient care;
  2. Assess how the administration and dosing of novel agents can enhance the patient experience and benefit health care; and
  3. Appreciate how to optimize the patient experience through a focus on improving health-related quality of life and supportive care.
     

Saturday
October 23, 2021
All times indicated are Eastern Daylight Times (EDT).

Satellite symposium
AstraZeneca - HER2+ Metastatic Breast Cancer: The Essential Role of Breast Care Nurses & Pharmacists in the Management of Treatment

Learning Objectives:

  1. Discuss the most common adverse events associated with antibody-drug conjugates & tyrosine kinase inhibitors to help educate healthcare professionals & patients;
  2. Recognize the importance of adverse events of “special interest”, including interstitial lung disease/pneumonitis & gastrointestinal events; and
  3. Describe recommendations for monitoring & management of adverse events.
     
Welcoming Remarks
Navigating the Challenges of Oncology Drug Funding Pathways
Presenters
Jennifer Voisey
Photo of Jennifer Voisey
Photo of Jennifer Voisey
Jennifer Voisey
Clinical Pharmacist, Eastern Health — St. John's, Newfoundland and Labrador

Jennifer Voisey completed her Bachelor of Science in Pharmacy at Memorial University in 2016 and joined the pharmacy department at Eastern Health upon graduation. She landed in Oncology in 2017 and has been a Clinical Pharmacist with that program ever since. She currently works in Adult Outpatient Hematology/Oncology where she oversees hematology patients receiving treatment on an outpatient basis. Jennifer enjoys preparing and delivering presentations with a focus on making the material easy for audiences to understand. 

Jennifer Voisey
Eastern Health, St. John's, Newfoundland and Labrador

Navigating the process of accessing a medication for a patient can be confusing and tricky, there’s several different funding bodies and pathways and it’s not always a straightforward process. This presentation will provide an overview of the various pathways of drug access as well as some of the challenges faced along the way. By understanding the drug access process, Pharmacists and Pharmacy Technicians can play an important role in patient care by learning how to access medications when patients need them and reduce mental and financial burden.

Learning Objectives:

  1. Describe the different pathways that can be explored for drug coverage;
  2. Understand some of the challenges of each pathway;
  3. Know the role that Patient Support Programs can have; and
  4. Understand how Pharmacy Technicians can play a role in drug access.
     
The Role of PARP inhibitors in Ovarian Cancer
Presenters
Nadine Glynn
Photo of Nadine Glynn
Photo of Nadine Glynn
Nadine Glynn
Clinical Pharmacist, H Bliss Murphy Cancer Centre, Eastern Health — St. John's, Newfoundland and Labrador

Nadine Glynn graduated from Memorial University of Newfoundland with BscPharm in 2008. After entering community practice upon graduation, she left this setting in 2017 in search of a more clinically based practice and started working at the Health Sciences Centre in St. John’s, NL. Soon after her transition to hospital practice, Nadine accepted a clinical position in outpatient Oncology at the H. Bliss Murphy Cancer Centre. As part of the Gynecologic Oncology team, Nadine works in a specialized and collaborative practice setting that involves caring for and supporting patients at various stages throughout their cancer journey.

Nadine Glynn
Eastern Health, St. John's, Newfoundland and Labrador

Ovarian cancer is the eighth leading cause of all deaths in Canadian women, and the fifth leading cause of cancer related death. The majority of women diagnosed with ovarian cancer will be diagnosed with advanced (stage III or IV) disease and are, unfortunately, faced with the reality of high recurrence rates and poor outcomes.

The 1990’s saw the addition of paclitaxel to standard platinum-based therapy, and the 2000’s brought addition of bevacizumab for some select high risk patients. A lack of therapeutic advances clearly highlights the need for new and additional treatment options following standard surgery, chemotherapy, and active surveillance in advanced ovarian cancer.

The identification of gene mutations and subsequent emergence of poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitors serving as maintenance treatment, in both the upfront and recurrent platinum sensitive setting, has changed the treatment approach in advanced ovarian cancer.

This learning activity aims to provide an introductory knowledge of ovarian cancer, concentrating on the role of PARP inhibitors in treatment, and the pharmacist’s role in the management of these patients.

Learning Objectives:

  1. Review introductory concepts of ovarian cancer including general treatment approach;
  2. Describe the role of PARP inhibitors in treatment of advanced ovarian cancer;
  3. Discuss the mechanism of action, safety and efficacy of PARP inhibitors through review of best available evidence; and
  4. Outline the pharmacist’s role in toxicity assessment, monitoring and management of adverse events related to PARP inhibitors.
Car T cell therapy
Presenters
Michelle Boyce
Photo of Michelle Boyce
Photo of Michelle Boyce
Michelle Boyce
Pharmacist, Pharmacy - Transplantation and Cellular Therapy Program, The Ottawa Hospital — Ottawa, Ontario

Michelle Boyce first completed a General Bachelor of Science degree in 2014, followed by a Bachelor of Science in Pharmacy in 2018 at The University of Manitoba. Upon graduation, she moved to Ottawa to complete a hospital pharmacy residency from 2018-2020 at The Ottawa Hospital (TOH). Following completion of her residency, she started working as a Clinical Pharmacist in the area of Transplantation and Cellular Therapy (previously known as BMT) at TOH. She has a passion for this area of specialization and has since been a co-preceptor for TOH Pharmacy Residency Program.

Michelle Boyce
The Ottawa Hospital, Ottawa, Ontario

CAR T-Cell Therapy is a type of immunotherapy where a patient's T-Cells (a type of white blood cell that is a part of the immune system) are first collected via leukapheresis, then genetically engineered and expanded in a laboratory to express chimeric antigen receptors (CARs) on their surface to recognize, bind to and kill cancer cells. Patients receive three days of lympho-depleting chemotherapy prior to the infusion of the CAR T-cells to make room in the immune system. 

Possible adverse effects from CAR T-Cells include: cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Pharmacists play an important role in managing these adverse effects as well as educating patients prior to the CAR T-Cell infusion. 

The Ottawa Hospital (TOH) is one of few cancer centers in Canada that provide CAR T-Cell Therapy. At TOH we currently use two commercially available products (Axicabtagene ciloleucel and Tisagenlecleucel) that are Health Canada approved, in addition to a clinical trial product (Canadian-Led Immunotherapies in Cancer - CLIC-01 Study). All of the above are CD19-directed CAR T-Cell Therapy products.

CAR T-Cell Therapy is a developing area of research with several ongoing clinical trials for solid tumors and various types of blood cancers.

Learning Objectives:

  1. Provide a general overview of what CAR T-Cell Therapy is (i.e. the structure of a CAR, how it works, target antigens, etc.) and the overall process; 
  2. Identify the available CAR T-Cell products in Canada and their approved indications;
  3. Briefly summarize the lympho-depleting chemotherapy regimens prior to CAR T-Cell infusion and the most common chemotherapy associated side effects; 
  4. Discuss CAR T-Cell related side effects and their management, with a focus on cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS); and
  5. Outline the prophylactic medications associated with CAR T-Cell Therapy.
Break
Pharmacogenetics and Pharmacogenomics in the Oncology Setting
Presenters
Tara Leslie
Photo of Tara Leslie
Photo of Tara Leslie
Tara Leslie
Clinical Assistant Professor and Clinical Pharmacist, Pharmacy, University of Alberta — Calgary, Alberta

Tara Leslie attained her Bachelor of Science in Pharmacy (BSP) degree from the University of Saskatchewan.  After several years of oncology practice in Calgary, she obtained her Board Certification in Oncology Pharmacy (BCOP) in 2010, acquired her Additional Prescribing Authority (APA) in 2013 and attained a Masters of Education in 2020. In 2017, Tara was the recipient of the Larry Broadfield CAPhO Distinguished Service Award for her commitment to CAPhO and contributions to oncology service.  Currently, she is a Clinical Assistant Professor with the Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta where she teaches oncology related curriculum in a variety of courses and is a part of the experiential education team. Tara maintains a clinical practice within an ambulatory hematology/oncology clinic at the Tom Baker Cancer Centre.  She is very passionate about lifelong learning and the important role that pharmacists have in supportive care for people with cancer. 

Tara Leslie
University of Alberta, Calgary, Alberta

In this session, we will re-activate our prior knowledge of basic genetics and explore the impact genetics, both inherited and acquired, have in cancer pharmacotherapy.  With a case based approach, we will discuss genetic polymorphisms that can impact oncology drug efficacy and safety and strategies to mitigate the risks of poor outcomes.  A review of important concepts of selecting targeted therapies based on the genetic profile of the malignancy will also be provided. 

Learning Objectives:

  1. Differentiate between germline and somatic genetic mutations and appreciate their relationship to personalized medicine;
  2. Describe the implications of polymorphisms in drug metabolizing enzymes in oncology drug efficacy and toxicity;
  3. Explain the various mechanisms by which polymorphisms in drug transport genes can impact oncology drug efficacy and toxicity; and
  4. Explain the relevance of acquired gene mutations within a malignancy in the selection of individualized cancer therapy.    
Eligibility Testing for Oncotype DX – A Glimpse into a Technician’s Expanded Scope
Presenters
Aleksandra Britton
Photo of Aleksandra Britton
Photo of Aleksandra Britton
Aleksandra Britton
Oncology Pharmacist, Pharmacy, Saskatchewan Cancer Agency — Saskatoon, Saskatchewan

Ola convocated from the College of Pharmacy and Nutrition at the University of Saskatchewan in 2005.  After 7 years in retail pharmacy, she decided to specialize in oncology. Since 2012, Ola has worked for the Saskatchewan Cancer Agency at the Saskatoon Cancer Centre in various capacities.  Currently she is a Senior Oncology Pharmacist supporting Pediatrics as well as all Clinical Trials.  Ola has also recently been appointed to the CCTG Genitourinary Disease Site Group as the Pharmacist Representative. 

Aleksandra Britton
Saskatchewan Cancer Agency, Saskatoon, Saskatchewan

The Oncotype DX test looks at individual tumor biology by measuring the expression of 21 genes.  The testing is used to help determine whether women with HER2 negative, ER positive early breast cancer would benefit from chemotherapy.  

At the Saskatchewan Cancer Agency, funding for the Oncotype DX testing is sourced from the pharmacy budget, therefore pharmacy is involved in determining eligibility of patients to receive testing.

This role was initially fulfilled by a Senior Pharmacist; however, it was quickly noted that a Senior Pharmacy Technician would certainly be able to fulfill this roll. 

This presentation will describe Oncotype DX testing and how the Pharmacy Technician roll has evolved to include reviewing patient eligibility for testing.

Learning Objectives:

  1. Describe Oncotype Dx testing and it’s importance in determining breast cancer treatment;
  2. Describe criteria required to meet funding for Oncotype Dx at the Saskatoon Cancer Centre; and
  3. Describe the evolution of the pharmacists and pharmacy technicians role in Oncotype Dx; and testing at the Saskatoon Cancer Centre.
Pediatric Oncology
Presenters
Paula Macdonald
Photo of Paula Macdonald
Photo of Paula Macdonald
Paula Macdonald
Pharmacist, Pediatric Oncology, Hamilton Health Sciences — Ancaster, Ontario

Paula graduated from the University of Toronto in 1999 and completed a hospital residency at Hamilton Health Sciences (HHS) in 2000.  She currently works at McMaster Children’s Hospital as a clinical pediatric hematology/oncology pharmacist.  She has presented to medical residents about pharmacology/safety of medications in pediatric patients, provided pediatric palliative care education for community colleagues and continues to provide education on supportive care in pediatric oncology to nurses, medical residents/fellows and pharmacy residents.   She has been an Ontario Cancer Research Ethics Board member since 2018 and continues to be a preceptor for HHS pharmacy residents completing pediatric oncology rotations.  

Paula Macdonald
Hamilton Health Sciences, Ancaster, Ontario

Children are not small adults and cancers affecting pediatric patients are very different from adult cancers.  Dosing of chemotherapy regimens for children is complex for multiple reasons.  The effects of chemotherapeutic agents on infants and young children can be different than in adolescents or adults because of developmental physiological changes that occur throughout childhood affecting pharmacokinetics.  This can result in variable chemotherapy exposure and clearance in children and unpredictable efficacy/toxicity profiles, thus making dosing of chemotherapy challenging, especially in infants and younger children.  While it is standard practice to use body surface area (BSA) to calculate adult chemotherapy doses, this method can greatly overestimate dosing for infants and younger children, thus weight-based dosing is preferred in patients with BSA < 0.6 m2.  The number of orally administered chemotherapy agents continues to increase but pediatric appropriate dosage formulations (i.e. oral liquids or low-dose mini tablets) are limited and extemporaneous liquid formulations are not always available, creating further obstacles for accurate and safe dosing of these medications in children.  Supportive care medications may also vary between pediatric and adult cancer patients due to differences in chemotherapy intensity or toxicities.  Some medications considered standard of care in adults may not be tolerated in children due to side effects or lack of appropriate formulations.  Understanding the factors that impact chemotherapy dosing and supportive care strategies in children will enable better care and monitoring of pediatric patients with cancer.  

Learning Objectives:

  1. Understand the multiple factors influencing chemotherapeutic agents in pediatric patients; 
  2. Understand how chemotherapy dosing in children may differ from adults;
  3. List pediatric specific chemotherapy formulations, alternative dosing regimens when extemporaneous formulations unavailable and other special considerations in children; and
  4. Describe similarities and differences in supportive care medications for pediatric and adult cancer patients.

Break
Complementary Alternative Medicine Use in B-Cell Malignancies
Presenters
Nikki Blosser
Photo of Nikki Blosser
Photo of Nikki Blosser
Nikki Blosser
Pharmacist, Pharmacy, Tom Baker Cancer Centre — Calgary, Alberta

Nikki graduated from Memorial University in 2010 and then moved to Calgary to complete a pharmacy residency with a focus in oncology. Since that time she has been working as a clinical pharmacist in the BMT program at the Tom Baker Cancer Centre and served as the interim clinical research pharmacist in the hematology, oncology and transplant clinic at Alberta Children’s Hospital. She has an interest in survivorship and enjoy participating in research projects with the BMT long term follow-up clinic.

Nikki Blosser
Tom Baker Cancer Centre, Calgary, Alberta

​​​​​​As patients continue to have increasing ease of access to health related information, there is a higher proportion turning to Complementary and Alternative Medicine (CAM) for cancer treatment or symptom management. For the purposes of this presentation, CAM will refer to biologically-based practices, which focuses on consuming things found in nature, including vitamins, botanicals, or special foods. 

While high quality evidence regarding the safety and efficacy of such interventions is often lacking, patient values and goals of care often play a role in their decision to use such therapy and should be incorporated into patient discussions. During this presentation we will discuss factors which impact the use of CAM and how to address these during conversations with patients. We will also review evidence of commonly requested CAM therapies in patients with lymphoproliferative disorders and discuss how to navigate resources with credible information on these agents. 

Learning Objectives:

  1. Describe the use of complementary-alternative medicine (CAM) in patients with a diagnosis of cancer,  specifically CLL and lymphoma; 
  2. Discuss considerations and concerns regarding CAM use in patients with B-cell malignancies;
  3. Review the evidence of commonly requested biologic CAM therapies in this patient population, including vitamin C, green tea (EGCG) and turmeric (curcumin); and
  4. Discuss the importance of engaging in conversations regarding CAM with our patients and review methods to facilitate this dialogue.