CAPhO Connections Podcast: Young Patients, Complex Care Plans: Pediatric Oncology Unpacked

Pediatric oncology pharmacy calls for precision, compassion, and innovation to deliver safe, effective, and personalized care for young patients battling cancer. In Ontario, care is uniquely coordinated through the Pediatric Oncology Group of Ontario (POGO), supporting equitable access to specialized therapies and clinical trials. This episode takes a closer look at acute lymphoblastic leukemia (ALL), the most common childhood cancer, and explores how pharmacists navigate complex dosing, formulation challenges, and evolving treatments. Discover how oncology pharmacists shape hope, transform therapy, and change the lives of young patients and their families.

Learning Objectives:

Describe how pediatric oncology care is coordinated through the Pediatric Oncology Group of Ontario (POGO) and its impact on equitable access to specialized treatments and clinical trial participation across the province.
Explain how treatment design is tailored and influenced, including the use of intensive regimens, off-label therapies, and long-term survivorship planning.
Outline the key phases of acute lymphoblastic leukemia (ALL) treatment and discuss how evolving risk stratification and the introduction of agents such as blinatumomab have changed pharmacy practice, including drug administration, monitoring, and funding considerations.
Identify strategies pharmacists use to monitor, prevent, and manage early and long-term toxicities, such as steroid-induced myopathy and vincristine-induced neuropathy and to collaborate with multidisciplinary teams.
Discuss the future of pediatric oncology pharmacy, including innovations in molecularly targeted and immune-based therapies, and the pharmacist’s role in advancing access, safety, and advocacy for young patients and their families.

About the Guest:

Matthew Bui

Matthew Bui is a dedicated pediatric hematology oncology pharmacist and clinical preceptor at McMaster Children’s Hospital. He completed his residency at Hamilton Health Sciences and earned his Doctor of Pharmacy from the University of Waterloo, and Master of Science and Bachelor of Science degrees in Kinesiology and Nursing from McMaster.

Episode Resources:

Pediatric Oncology:
• NCI Cancer in Children and Adolescents: https://www.pogo.ca/clinical-practice-guidelines/
• Pediatric Oncology Care Coordination in Ontario (Pediatric Oncology Group of Ontario): https://www.pogo.ca/our-story/

General ALL Background:
•   Patient Version: https://www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq (May be more helpful for introductory information)
•   Health Professional Version: https://www.cancer.gov/types/leukemia/hp/child-all-treatment-pdq (Provides for evidence based references for upfront therapy, relapsed disease, etc.)
•   NCCN Website: Login then Guidelines --> Treatment by Cancer Type --> Pediatric Acute Lymphoblastic Leukemia
•   History of Pediatric ALL Treatment Review Article (Hayashi et al, 2024): https://pmc.ncbi.nlm.nih.gov/articles/PMC10887299/

B-Cell ALL Trials (Children's Oncology Group Chemotherapy Backbone Trials):
• COG AALL0331 (Standard-Risk B-ALL): https://ascopubs.org/doi/full/10.1200/JCO.19.01086
• COG AALL0232 (High-Risk B-ALL): https://ascopubs.org/doi/full/10.1200/JCO.2015.62.4544

Blinatumomab Immunotherapy in Upfront B-ALL Treatment:
• COG AALL1731: https://www.nejm.org/doi/full/10.1056/NEJMoa2411680

Toxicities (Focus on Standard-Risk 3-Drug Induction):
•   Asparaginase (Hijiya & van der Sluis, 2016): https://pmc.ncbi.nlm.nih.gov/articles/PMC4819847/
•   Vincristine (Triarico et al, 2021): https://pubmed.ncbi.nlm.nih.gov/33923421/
•   Glucocorticoids (Pourhassan et al, 2024): https://pmc.ncbi.nlm.nih.gov/articles/PMC11316706/

Supportive Care (Pediatric Oncology Group of Ontario [POGO] CPGs):
• https://www.pogo.ca/clinical-practice-guidelines/ (Includes antibacterial prophylaxis, antifungal prophylaxis, chemotherapy induced nausea and vomiting, fever and neutropenia, etc.)