Pharmacist Discusses Connecting Patients With Cancer to Clinical Trials at Mayo Clinic

Candy Pesky, PharmD, BCPS, BCOP, a cancer center care team pharmacist with Mayo Clinic in Rochester, Minnesota, highlights the pivotal role of oncology pharmacists in patient care and clinical trial research at Mayo Clinic. She shares insights into how pharmacists can facilitate patient access to enrollment in clinical trials, potentially increasing their access to innovative treatments.

Pharmacy Times: What specific aspects of the program at Mayo Clinic captivated your interest and how is it unique?

Candy Pesky: I actually came to Mayo Clinic straight out of pharmacy school. I did my PGY-1 residency here. And when I was interviewing for residencies, I interviewed three different sites. The big thing that brought me to Mayo is that even just shadowing that experience that I had on my interview, and seeing the way that the collaborative approach that we have at Mayo, and the way that the consultants and everybody on the team kind of works together and respected each other. And the same thing happened throughout my residency, and then through the years of practice here.

Pharmacy Times: How does Mayo Clinic’s strong identity impact your work as a healthcare professional?

Peskey: When we talk about Mayo, the first thing that always comes to mind is that the patient comes first. But yeah, another part of that is the education and the research. And all three work together in kind of the group of what makes Mayo, Mayo.

Pharmacy Times: What feedback have you received from patients about their experience at the Mayo Clinic facility and how does that compare to your experience at other facilities?

Peskey: Sometimes when I'm in a visit with a with a patient that hasn't ever seen a pharmacist before, the interesting thing is I go in, and I meet them for the first time, and they say they're disappointed. They wanted to see the doctor. They came in here to see the doctor—why are they seeing a pharmacist? And usually what I say to them is, “okay, well, let's see what we can do to kind of review how you're doing. And then if there's anything at the end that you want to talk to the doctor about, we can go find them or talk to one of the other doctors.” And by the time I get to the end of the conversation, I offer that option. I say, “is there anything that you want to talk to the doctor about?” And they're almost exclusively like, “Oh, my goodness, no, you did such a complete job. I don't have any extra questions that the doctor needs to answer.” And, you know, they're just impressed with what we do.

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Pharmacy Times: Can you expand on the role of pharmacists in patient care and its influence on your work?

Peskey: For my career, I was involved in inpatient for the first seven years that I worked here. And you get a limited amount of direct patient care because working in the hospital, you're seeing the patient went the rounding on the teams and stuff like that. And then I worked in an infusion center where it was a little bit more separated from the patient care. In the last three years now I've been on the team on the ambulatory care side. And that was why I came here to the ambulatory care side, because I wanted to be involved in helping the patient. The providers that I have, the consultants that I work with, allowing me to practice at the top of my license. They give me the autonomy to make decisions about managing side effects. Always knowing that I have that safety net of my providers there that if there are situations that I need their opinion on, they're always available for me.

Pharmacy Times: What is the role of research in your work and how does this impact connecting patients to enrollment in clinical trials?

Peskey: When I came to the clinic, I decided that or one of the things I wanted to work on is trying to increase enrollment in clinical trials, identifying patients that were good candidates, and that might benefit from the trial. And so usually what I tried to do in my clinic, if I have time, is I'll preview the patients for that day. And if there are ones that look to me like they may be a good candidate, I'll bring that up to the consultant before they go in. And say, “hey, this person might be a good candidate for this study. What do you think?” Or “were you thinking of putting them on this drug? Because then we have this study that may or may apply.” And I think that when we reviewed enrollment over the year, before I was in clinic and the year after we had an increase.

Pharmacy Times: How has the rise in patient enrollment in clinical trials improved access to innovative treatments for patients?

Peskey: Sometimes it's hard to see the end of what the end result was. But usually, if we're offering treatments here, it's a treatment that isn't available outside of a clinical trial. Sometimes they're giving us information about our patient population. We had a biomarker study going on in our renal cell cancer patients that helped us collect information that might help us treat patients in the future. So, it's a variety of different outcomes. But it all increases our knowledge base.

Pharmacy Times: What does pharmacy involvement in clinical research and patient care look like at Mayo Clinic?

Peskey: I'm working on trying to get a pharmacist led study off the ground right now, but we've run into some issues with funding and administering it. But it's definitely something that I'm interested in. And I haven't worked there long enough to really get involved in it. Some of my colleagues have more involvement in pharmacist led [research]. Jody and our breast team has some pharmacist led research ongoing or has done some in the past.