Session Descriptions

Acute Leukemias 

Speaker Biography

Acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) are caused by a dangerously rapid expansion of immature malignant blood cells.  As the two most common adult acute leukemias, they are quickly lethal if left untreated.  The landscape of treatments available for AML and ALL differ greatly, but have remained relatively static for nearly two decades, with allogeneic (non-self donor) stem cell transplant often the only potentially curative option.  However, the mortality and morbidity associated with this type of stem cell transplant has made the path to cure fraught with peril, and consequently, decisions around the timing of transplant are carefully considered.   Some molecular prognostic markers have further clarified some of this decision-making and have led to improved therapies.  The addition of new cytotoxic strategies, targeted monoclonal antibodies and T-cell therapy, the latter harnessing the patient's own immune system, offer promise acceleration towards a new era of improved survival for acute leukemia patients.

Learning Objectives:

  1. Describe the basic etiology, pathophysiology and sequelae of acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL);
  2. List different treatment goals and options for AML and ALL;
  3. Understand the mechanisms, efficacy and safety of newer targeted treatments; and
  4. Understand the role of cellular and stem cell therapy in treatment planning for AML and ALL.

Non-Small Cell Lung Cancer – Carrie Kung, BC Cancer Provincial Pharmacy, Vancouver, BC

Speaker Biography

Lung cancer is the most common cancer in Canada. More than 80% of all lung cancers are non-small cell lung cancer (NSCLC). While surgery, radiation, and chemotherapy may still have a role in the treatment of NSCLC, the discovery of checkpoint pathway has led to a new era of immunotherapies. Identification of several driver mutations has also changed the treatment approach to NSCLC by utilizing target therapies. These new agents have unique adverse drug reaction profiles and pharmacists across different practice settings may be involved in the care of these patients. 

Learning Objectives:

  1. Name the major pathological types of NSCLC;
  2. Describe the treatment approach to early stage NSCLC;
  3. Describe the treatment approach to advanced stage NSCLC; 
  4. Recommend immunotherapies for advanced stage NSCLC in the first line setting and be able to recognize as well as manage common adverse drug reactions; and 
  5. Recommend target therapies for advanced stage NSCLC in the first line setting and be able to recognize as well as manage common adverse drug reactions.

Metastatic Breast Cancer – Nicole MacDonald, Dr. H. Bliss Murphy Cancer, St. Johns, NL

Speaker Biography

Breast cancer is the most common cancer in Canadian women and represents 25% of all new cancer diagnoses in this population. Breast cancer can also occur in men, with an incident rate of 1.2 out of 100 000 people. For all new breast cancer diagnoses, 5% occur at Stage IV. There are several treatment options available for metastatic breast cancer which can include chemotherapy and targeted therapies. Patients receiving treatment for metastatic breast cancer can experience adverse effects related to their treatment and therefore require education, monitoring, and supportive care from their Pharmacist as part of their overall care.

Learning Objectives:

  1. Define metastatic breast cancer and describe the diagnostic criteria and prognostic factors;
  2. Describe the different treatment options for metastatic breast cancer;
  3. Discuss the role of hormone and targeted therapies in metastatic breast cancer; and
  4. Describe the role of the Pharmacist in patient education, monitoring, and supportive care in metastatic breast cancer.

Concepts of Palliative Care – Vincent Ha, Cross Cancer Institute, Edmonton, AB

Speaker Biography

Palliative care is a unique approach to medicine that aims to improve the quality of life and manage the symptoms of individuals who are suffering from an incurable disease. Although palliative care often has a negative perception related to a “terminal” illness and is only utilized at the end stages of life, this is not the case. In fact, early palliation often improves outcomes. By working within an interdisciplinary team and taking a holistic approach, early palliation aims to not only improve physical symptoms, but also the psychological aspects of patient care. Unlike pain control where there are treatment guidelines to assist practitioners with management, formal guidance for symptoms such as dyspnea, cancer related fatigue, cancer related anorexia-cachexia, and delirium is less well established. With this session, we will briefly discuss the philosophy of palliative care and delve into management strategies for these lesser known symptoms.

Learning Objectives:

  1. Review the history and define the philosophy of palliative care;
  2. Recognize causes of dyspnea and identify potential treatment options;
  3. Identify causes for cancer related fatigue and compare the effectiveness of pharmacological and non-pharmacological management;
  4. Define anorexia-cachexia and analyze the literature surrounding pharmacological treatment; and
  5. Differentiate the subtypes of delirium, examine treatment options, and discuss the principle of palliative sedation.

Interpreting Tests for Latent and Opportunistic Infections in Cancer Patients – Irina Rajakumar, Foothills Medical Center, Calgary, AB

Speaker Biography

Antineoplastic agents predispose patients to many different types of infections. Patients’ previous infectious exposure history, including Hepatitis B, C and TB plays a role in the risk of developing an active infection or viral reactivation after exposure to antineoplastic agents. Most appropriate screening strategy for Hepatitis B has not been determined and recommendations differ with specific strategies based on patient risk factors, combination of risk factors and agent specific, and universal screening. It is also important to rule out active infection prior to starting prophylaxis or treatment of latent infection. Cancer patients that are about to initiate immunosuppressive therapy should have their immunizations assessed, as well as screened for certain parasitic infections. 

Learning Objectives:

  1. Understand which patients are at risk of viral hepatitis reactivation and be able to interpret HBV serology results to assess whether prophylaxis or treatment is warranted; 
  2. Understand which test is preferred for diagnosing latent TB infection and the reasons for it; and
  3. Describe other latent infections that may be important in cancer patients.

AINV Management – Stephanie Lovering, The Ottawa Hospital, Ottawa, ON

Speaker Biography

Nausea and vomiting is one of the most common side effects faced by patients undergoing antineoplastic therapy. Antineoplastic-induced nausea and vomiting (AINV) can have a considerable impact on quality of life, significantly impair a patient’s ability to carry out daily activities, and impact the ability to continue treatment. Appropriate prevention strategies can minimize the risk of AINV. This presentation will review the most effective strategies for preventing and managing nausea and vomiting due to antineoplastic agents.

Learning Objectives:

  1. Identify risk factors for antineoplastic-induced nausea and vomiting (AINV);
  2. Define ‘emetogenic potential’ of antineoplastic agents;
  3. Describe the types of AINV with respect to their onset;
  4. List antiemetic therapy agents available for the management of AINV; and
  5. Describe how to assess and select effective pharmacologic strategies for the management of AINV.

Basics of the Canadian Oncology Drug Funding Process – Danica Wasney, CancerCare Manitoba, Winnipeg, MB

Speaker Biography

Systemic therapies for oncology-hematology are increasingly complex, costly and are evolving at a rapid pace. Resources needed to safely implement new systemic therapies are extensive. From the time that clinical trials are conducted to the time that therapies are “funded” for use in Canadian jurisdictions, multiple processes have occurred. In the past number of years, many pan-Canadian/national initiatives have been developed to join efforts toward evaluation and funding of drugs for oncology-hematology. This has resulted in many changes for pharmacy staff to learn as new drugs emerge. This presentation will review the present cancer drug funding process in Canada and the evolving various roles of pharmacists and pharmacy staff in this process. Case studies with theoretical new drugs will provide participants with a “walk through” of the present cancer drug funding process.   

Learning Objectives:

  1. Understand the processes used in Canada to consider a new oncology-hematology therapy for potential public funding;
  2. Recognize the different roles and responsibilities of the organizations/individuals involved in oncology-hematology drug funding (e.g. Health Canada, CADTH, provincial cancer agencies, etc.);
  3. Identify advantages and disadvantages to the present oncology-hematology drug funding processes in Canada; and
  4. Distinguish between the drug funding processes for anti-cancer therapies and supportive care therapies.