Advances in Oncology Care: Emerging Therapies, AI Integration, and Access to Investigational Drugs

Acute lymphocytic leukemia (ALL) is a genetically heterogeneous cancer marked by the proliferation of immature lymphoid cells. Predominantly affecting children younger than 5 years, ALL can also affect adults and become more deadly in such cases. In the peer-reviewed literature review on page 31, Basmah Zahid, PharmD, MS, discusses the multiphased treatment process for pediatric patients with ALL (ie, induction, consolidation, and maintenance phases) and the use of chemotherapy, targeted therapies such as monoclonal antibodies, and stem cell transplants for this patient population. New therapies, such as inotuzumab ozogamicin (Besponsa; Pfizer Inc) and chimeric antigen receptor T-cell treatments, have shown promise as well, particularly for relapsed or refractory disease cases.

Image credit: Martinesku | stock.adobe.com

In the peer-reviewed insights paper on page 21, Manale Maksour, PharmD, BCPS; Cassandra Perkey, PharmD, BCOP; Brooke Peters, PharmD, BCOP; Bradley Winegar, PharmD; Nicole McMullen, PharmD, BCOP; and Melody Chang, MBA, RPh, BCOP, highlight the growing demand for artificial intelligence (AI) integration in oncology practices to improve efficiency, enhance diagnostic accuracy, and personalize treatment. However, despite the potential of this technology, challenges such as data privacy, algorithm bias, and the need for proper training and ethical guidelines remain.

In the peer-reviewed literature review on page 36, Emily Hennes, PharmD, BCOP; Berrie Child, PharmD, BCOP; Stefanie Conley, PharmD, BCOP; Dina Dumercy McHenry, PharmD, MBA, BCOP, CSSGB; Sarah Lentz, BCOP; Camille Smith, PharmD, DPLA, CCRP; and Jennifer Murphy, PharmD, BCOP, discuss the challenges of navigating access to investigational or off-label medications for patients who have exhausted standard treatment options. They review 3 alternative pathways, including expanded access, the Right to Try Act, and off-label use. According to the authors, understanding these pathways is essential for institutions and health care providers to support patients effectively.

In the peer-reviewed original research paper on page 24, authors Hunter Sowell, PharmD; Colleen McCabe, PharmD, BCOP; Manuel Cortez, PharmD, BCOP; Rachel Gilmore, PharmD; Elizabeth Davis, MD; and Vicki Keedy, MD, discuss a retrospective cohort study at Vanderbilt University Medical Center in Nashville, Tennessee, examining the ef fects of removing prophylactic mesna from cyclophos-phamide-containing cycles in the VAdriaC-IE (vincristine, doxorubicin [Adriamycin], and cyclophosphamide followed by ifosfamide and etoposide) chemotherapy regimen for treating Ewing sarcoma. The study results showed no increase in the incidence of hemorrhagic cystitis or related urinary symptoms when mesna was removed, aligning with previous findings that mesna offers no additional benefit over saline diuresis at lower cyclophosphamide doses. Additionally, removing mesna resulted in significant cost savings and reduced infusion chair time for patients.

The authors of these peer -reviewed papers collectively emphasize the evolving landscape of oncology treatment. With emerging therapies and AI integration transforming oncology care, challenges remain for access to investigational drugs and cost-effectiveness of treatments. The authors underscore the need for continued innovation balanced by careful ethical and regulatory considerations to improve treatment outcomes in cancer care.