Why Oncology Pharmacists Should Be at the Helm of Precision Medicine in Oncology

Pharmacy Times interviewed Andre Harvin, PharmD, MS, executive director of Pharmacy, Oncology Services at Cone Health, on an ATOPP session he will be moderating titled ‘putting precision medicine into practice’ and why this is an important topic right now.

Question: Could you tell me a bit about the focus of the session you’ll be moderating titled ‘putting precision medicine into practice’ and why this is an important topic right now?

Andre Harvin: Absolutely. Well, I'm really excited about our precision medicine topic. We actually have 2 this year, with the one that I'll be moderating, focusing on, ‘Well, how do you actually get it up and running?’ I think that's the big question that's at the top of everyone's mind is that, ‘Well, we understand we think it's valuable, but there's always this question of how do you convince your organization or maybe your service line focusing on oncology, that we need to have this investment within precision medicine?’ That's really where it started for me.

So I'm at a smaller cancer center, and we've had several conversations, and then you get to the table with the C suite, and they say, ‘Okay, well, what's the return on investment of a precision medicine program,’ and it feels sometimes like a really difficult conversation to have, because you think, well, this is what everyone's doing, and oncology, and we understand that there are all these new targets coming out with new medications, and we need to ensure that we're doing the best for patients.

What this session aims to do is really let us articulate the why behind precision medicine. So something that resonates across the board. So regardless of who you're standing in front of, whether it's other providers, your pharmacy team, your C suite, and even your patients, that's what this is going to bring us to the table.

We've got a fantastic expert Howard McLeod that's done this across the country at places like Moffitt Cancer Center, he's now at the at Intermountain Precision Genomics helping them get their program up and running, and had a very successful career helping these programs up across the nation. He's going to really get down to brass tax, what's that conversation look like, what resources do you need, how do you think about things like the reporting structure, when does pharmacy come into play, where do you get the funding for it, are there ways to combine your efforts with third-party organizations that may help assume some of those costs for you, what are some of the more IT related aspects that need to be considered, is your electronic medical record ready for precision medicine—a lot of those questions that we have and we just maybe haven't been exposed to it if it's not at an organization that we currently work. So I'm just really excited about it because this is going to be a powerful session. We know precision medicine is our future, and this is going to help us bridge that gap.

Question:What would you like pharmacists in the field to know or understand about adopting precision medicine into their practices?

Andre Harvin: Yeah, it's a great question. Precision medicine, we know, is going to be part of our future for oncology care. Really what I would love pharmacists to know if they feel like they want to be on the sidelines to hear a little bit more about it, or there's any level of anxiety when it comes to precision medicine, this is that time to really get off the sidelines and get right into the court. It's a really exciting and developing area that we know is really important to oncology care, but the great thing about precision medicine is it can really be applied across a gamut of different disease states, not just oncology. We know a lot of targets are in oncology, but we're going to see the value of understanding and adopting precision medicine across all of our patients that we serve at some point in time. So why not be at the forefront of that? Why not attend things like ATOPP that’s going to talk about precision medicine and our role there, because it really helps you be on the forefront to help develop your own career.

From that, we're going to have people that have done formalized training in precision medicine, we're going to have additional conversations about what it's like for different institutions that have got it up and running, what those pharmacists wish they knew before they had precision medicine up and running, and what kind of advice they would give someone if they were getting that program up and running now. So it's a lot of great information.

Again, for myself coming from a smaller cancer center, my hope is that I have members of my team that are in attendance and can bring that back to us on how do I need to prepare, what do I need to do in terms of education, what questions can I help answer up front as we go down our precision medicine journey, and then how do I ensure that we position ourselves when I say we, I mean pharmacy as a department pharmacy is progression, that we position ourselves that we're at the table at the very, very beginning. We don't want these programs up and running as precision medicine. And then others are filling in those roles that we know we are the most qualified for. I mean, who better than pharmacists to really understand medications and how they all relate together, as it refers directly to a patient's genetic or cellular structure. We need to be at the table, and this session helps prepare us to be there.

Question:What do you predict precision medicine in oncology will look like 5 or 10 years down the line or even further into the future?

Andre Harvin: When I think about precision medicine over the next decade, I think it's very easy to actually just look towards the FDA. When you look at their accelerated acceptance pathway, it is being dominated right now by oncology drugs. That accelerated pathway means that we're able to get these drugs quicker to market because the data is so compelling.

They've also noted that by 2025, they expect to approve anywhere between 10 to 20 new cellular or genetic therapies each year at that point in time, which means there becomes ample opportunities. I mean, precision medicine is going to be what we really lean into, it's going to be what a lot of development is out there for oncology patients.

For us, it's something that should be exciting. I mean, we have seen a fantastic development and oncology over the last decade—more drugs, more target, we're seeing that disease burden decrease, people living longer than they did previously. But that disease burden in oncology is still there, and that's really where precision medicine can help us accelerate and amplify the games that we've received over the last 10 years.

So for me, I'm excited about it. I think the next 5 to 10 years are going to be pivotal in oncology, and really, pharmacy needs to be at the forefront of that space, we cannot vacate the space. When it comes to precision medicine to other groups, we need to stand up and say, ‘We can do this, we are qualified.’ If there's additional education that needs to occur, we are the best group to do that. We understand therapy and drug management for oncology patients better than anyone else can, maybe outside of the medical and radiation oncologists. So we need to be at the forefront of that and that's why I'm really excited about this session.