By Tom McFarlane, Board of Directors member and Research Chair, CAPhO

This past April, the 24th annual conference of the Canadian Association of Pharmacy in Oncology (CAPhO) was convened on Canada’s east coast in beautiful Halifax, Nova Scotia. This is a meeting that has grown tremendously in size and scope since its inception in 1996, and now welcomes several hundred delegates each year. In addition to the main program running Friday and Saturday, the conference also includes many ancillary educational events running on Thursday and Friday. This year’s conference theme was “Personalized Medicine”, and several expert speakers presented on a plethora of topics relevant to the changing landscape of oncology pharmacy.

The conference opened with a well-attended and well-received workshop on oncology drug interactions, facilitated by oncology pharmacists Jennifer Jupp, Glenn Myers, and Tara Leslie. This is an event that has now been held for the last few conferences, and participants were able to work through several cases in groups, including scenarios on proton pump inhibitor usage, smoking, and antiretroviral drug interactions, learning how to prioritize and assess interactions and communicate recommendations within a multidisciplinary team framework. The session was accredited by the Canadian Council on Continuing Education in Pharmacy (CCCEP) and was open to both pharmacists and technicians.

Friday at CAPhO has traditionally been a day of satellite symposia presented by the pharmaceutical industry, and this year included a variety of interesting topics, including talks on biosimilar use and implementation, the changing landscape of evidence in cancer-associated thrombosis, and advances in the management of chronic lymphocytic leukemia, breast cancer, and renal cell carcinoma. The day concluded with the opening wine and cheese reception, where delegates were able to wander through the posters presented at the conference, visit the pharmaceutical sponsors’ booths, and network with other conference participants.

The main conference program opened on Saturday morning, and Dr. Ron MacCormick, a prominent medical oncologist from Sydney, Nova Scotia, gave a fascinating and informative opening plenary covering the history of the treatment of breast cancer and how we as clinicians have arrived to where we are today. Dr. MacCormick gave a very deft summary of what is a huge topic and even those of us who have been practicing oncology for a long time came away with some intriguing bits of trivia (Adriamycin was named after the Adriatic Sea? Who knew?). This was followed by an excellent plenary on the rapidly changing landscape of multiple myeloma by Dr. Darrell White, hematologist and professor of medicine at Dalhousie University in Halifax.

CAPhO 2019 participants engage in a plenary session	CAPhO 2019 participants discover new information exploring the posters

The presentation of this year’s CAPhO awards was next, which included receipt of the Preceptor/Mentorship Award by Sally Waignein of the BC Cancer Agency, the Volunteer Recognition award by Lori Emond of CancerCare Manitoba, the Technician/Assistant award by Michelle Koberinski of BC Cancer Agency, the CAPhO Merit Award by Esther Jadusingh of Alberta Health Services, and the Student Member Award by Ashley Jang, who is a student at University of British Columbia. Delegates were then treated to the next plenary session on reduction of infertility in cancer patients, an important and unrecognized topic. This was an outstanding talk given by Dr. Mike Ripley, an obstetrician and gynecologist specializing in the fertility management of women receiving cytotoxic treatment at Atlantic Assisted Reproductive Therapies in Halifax. This is not a topic that is always top of mind for pharmacists, but Dr. Ripley’s talk demonstrated that we can be an important part of the multidisciplinary team in recognizing this problem and referring patients to the appropriate resources. 

After an excellent plenary presentation in the afternoon by Christine Chambers on the power of social media in health care, the breakout sessions began. The CAPhO conference provides delegates a wide variety of topics to choose from each year, and this year these included optimization of patient education, an overview of CAR-T cell therapy, NAPRA compliance issues, and the use of radiation therapy in patients, as well as topics on palliative care, pharmacogenomics, and geriatric care in oncology.

Over the last couple of years, the conference organizers have included a running group and yoga sessions to end the afternoon by exercising the body (a nice break after all the expending of mental energy that comes before). These sessions are typically quite popular and this year was no exception, although unfortunately the majority of those signed up shied away from the run, as it happened to be very cold and raining sideways in Halifax at the time. Only four hardy souls braved the conditions (including myself) and it was a rather bracing experience.

Onward we went to the CAPhO awards gala and entertainment, which took place in a unique venue this year, the Canadian Museum of Immigration at Pier 21. Between 1928 and 1971, one in five Canadians immigrated to the country using this location as their primary port of embarkation, no doubt including many family members of the conference delegates. Our dinner package included admission to the museum, and it was fascinating to stroll around looking at the many exhibits. A superb gala dinner followed, with the Larry Broadfield Distinguished Service Award being presented to Rick Abbott of the H. Bliss Murphy Cancer Centre in St. John’s, Newfoundland, and fellow status in CAPhO (FCAPhO) being awarded to Mario de Lemos of the BC Cancer Agency in Vancouver. The fun continued well into the night with local music, dancing, and a photo booth to keep delegates entertained.

An evening of fun recognizing excellence in CAPhO	Award recipients receiving recognition during the Awards Gala

Sunday dawned slightly brighter, and after a town hall style breakfast where participants were able to raise and discuss issues or suggestions for CAPhO as an organization, the poster award winners were asked to give brief presentations on their work. This year’s winners included the following:

Jordan Stinson of Sunnybrook Health Sciences Centre in the Administrative category, for his poster “Old Habits Die Hard...Updating Policies to Reflect Current Evidence-Based Antiemetic Guidelines at a Regional Cancer Centre”;

Alia Thawer of Sunnybrook Health Sciences Centre in the Pharmacy Practice category, for her poster “Financial Implications for Patients Associated with the Out-Of-Pocket Costs for Oral Anticancer Medications”;

Lauren Salsbury of The Ottawa Hospital in the Research-Clinical category, for her poster “Optimizing Pharmacy Learner Rotations to Improve Clinical Productivity: A Study Assessing Three Pharmacy Layered Learning Practice Models within an Inpatient Tertiary Care Oncology Unit; and

Jason Wentzell of The Ottawa Hospital in the Research-Non Clinical category, for his poster “Assessing the Impact of an Immune Checkpoint Inhibitor Workshop for Front-Line Pharmacists; a Pre- and Post-Intervention Survey and Recommendations.

All winners gave outstanding presentations and the session was a testament to the tremendous quality of research that CAPhO members are engaged in.

The conference was then split into a number of round table discussions, which allowed participants to ask questions and share best practices in a number of pre-arranged topics. These included safe use of high dose methotrexate, anti-emetic drug interactions, patient education around immune checkpoint inhibitors, innovative tools for preparation of systemic therapy, the OnTarget website, drug shortages in oncology, best practices in sterile work, technician certification for chemotherapy checking, and safe work practices for cytotoxic spills.

Finally, delegates were treated to two final plenary sessions. The first was a really interesting exploration of the role of the gut microbiome in immunotherapy given by Dr. Stephanie Snow, a medical oncologist in Halifax. This is an emerging area of research and Dr. Snow gave us a very intriguing and engaging look at how certain microbiomes are related to better outcomes in patients, as well as some theories as to why this might be. The second was a talk on adolescent and young adult cancer care, an area that often gets overlooked in our therapeutic area. The talk was by Dr. Amirrtha Srikanthan of the University of Ottawa Faculty of Medicine and was recorded but still provided a lot of great information.

And so, another great CAPhO conference drew to a close. Next year is a big one for us, as we will be celebrating 25 years as a conference back where it all began, in Toronto. Until then!

Exploring the Exhibit Hall during a quiet moment	Discovering what is on offer at one of the exhibit booths