Click on the links below to be directed to specific days:

• Wednesday, April 11
• Thursday, April 12
• Friday, April 13

Wednesday, April 11

Welcome Remarks and Opening Plenary

08:30-10:00 (90 min)

Welcome Remarks by 

Harbans Dhillon, ISOPP President, Kuala Lumpur, Malaysia and 

Bo Yu, ISOPP 2018 Symposium Chair, Shanghai, China

Opening Plenary: The Evolution of Oncology Pharmacy

Harbans Dhillon, ISOPP President, Kuala Lumpur, Malaysia

Pharmacy was compounding in the good old days. The 1900s gave way to commercially prepared pharmaceuticals. Then came the time when pharmacy was only involved in supply and distribution. As time went on, practices from around the world took a change for the better. Oncology pharmacy has come a long way from its early days where oncology drugs were supplied to the wards where nurses compounded it without any personal protective equipment (PPE). There are a lot of risks in handling cytotoxic drugs especially unprotected and this was proven by researchers doing tests to evaluate the amount of cytotoxic drugs in the urine of those handling these drugs. So oncology pharmacy moved from “unprotected personnel” to fully gowned, masked and gloved personnel, as well as proper facilities, and the use of biological safety cabinets, isolators or robots with the use of closed system transfer devices. PPE is used to maximize protection when handling, preparing, administering and disposing cytotoxic drugs.

There were changes from practice norms; from behind the counter to direct patient care, from dispensing a drug accurately to helping the patient making the most of the medication. New opportunities arose with the advent of newer drugs for oncology and tremendous rise in investigational treatments for cancer, moving from traditional intravenous cytotoxic drugs to oral anticancer chemotherapy as well as the rising use of biologics and the emerging biosimilars market. Oncology pharmacists are faced with an ever changing landscape in the field of oncology.

The International Society of Oncology Pharmacy Practitioners (ISOPP) celebrates 30 years of existence this year.  ISOPP’s mission is to promote and enhance oncology pharmacy practice worldwide to improve cancer patient care. This mission is accomplished through development and dissemination of practice standards related to oncology pharmacy practice, as well as the development and provision of oncology pharmacy education. ISOPP supports educational initiatives, holds yearly symposia since 2017, promotes and sponsors oncology pharmacy research and provides a forum for networking for oncology pharmacists around the world. The Journal of Oncology Pharmacy Practice (JOPP), the official publication of ISOPP, provides the opportunity for members to learn of practices and practice innovation thus providing valuable information and ideas.

Learning Objectives

1. Trace the growth of oncology pharmacy from nurses reconstituting cytotoxic drugs to centralized pharmacy using proper facilities and equipment;
2. Outline the growth of treatment modalities and protocols from intravenous drugs to oral chemotherapy, biologics and biosimilars; and
3. Describe the growth of ISOPP as a society over the last 30 years.

 

Concurrent Session 1

Clinical 1: Breakthrough Oncology Pharmacotherapy: CAR-T Cell Therapy

10:30-11:30 (60 min)

Marliese Alexander, Peter MacCallum Cancer Centre, Melbourne, Australia

This presentation will examine available and upcoming CAR-T cell therapies, highlighting breaking trial results from around the globe. Experiences of managing a local CAR-T therapy program, with insights into clinical management, using case presentations, will also be discussed.  

Learning Objectives

1. Describe CAR-T drug therapies available globally and evidence for use across tumour groups;
2. Discuss clinical presentation of toxicities associated with CAR-T cell therapies and appropriate management; and
3. Identify the role(s) of the pharmacist in education, monitoring and managing toxicities. 

Fundamentals 1: Oral Cancer Drugs: Oral Cancer Drug Safe Use and Safe Handling

10:30-11:30 (60 min)

Lisa Holle, Associate Clinical Professor, University of Connecticut, Storrs, USA

Oral anticancer drugs are often hazardous and thus proper handling by the patient, caregiver, and healthcare team is necessary to limit potential human and environmental exposure. This session will discuss the potential risks of handling and disposing oral cancer drugs. It will also describe the current guidelines, regulations and recommendations for the healthcare team when ordering, preparing, administering, dispensing, and educating the patient/caregiver about the appropriate and safe use of oral cancer therapies.

Learning Objectives

1. Describe the potential risks of handling and disposing of oral cancer drugs;
2. Outline regulations governing disposal of hazardous drugs and oral cancer drugs; and
3. Recommend proper disposal of oral cancer drug by patients and healthcare providers.

Research 1: Recent Significant Papers in Oncology

10:30-11:30 (60 min)

Manit Saeteaw, Ubon Ratchathani University, Ubon Ratchathani, Thailand

Clinical advances in cancer treatment have indeed come a long way. From the discovery of nitrogen mustard in the 1940s, to the development of targeted therapy, and most recently the developments in immunotherapy.

With multiple oncology trials and research going on currently, there is a need to identify the ones that can potentially change our treatment practices. This session will highlight the recent significant papers or landmark trials that have impacted the management of cancer. Other recent significant papers on the management of cancer using TCM will also be discussed.

Learning Objectives

1. Identify new treatment options in cancer management; and
2. Consider practice changing options in cancer management.

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Hot Topic Discussions

11:30-12:30 (60 min)

Participants will have the opportunity to discuss two of the eight available topics, each led by a different facilitator. Read below for details on the topics and facilitators for this session. Pre-registration was required.  If you did not pre-register and would like to attend, please go to the session room to see if space is available.

Hot Topic 1: Oncology with other Disciplines e.g. Cardio-Oncology, Mental Health, Pulmonary, Neurology

Lakkana Suwannoi, Mahidol University, Bangkok, Thailand

In the last two decades, there is an undoubted advancement in cancer therapy so that it is not unpredictable in tremendous growth in the number of cancer survivors. It is estimated that by year 2020, there will be roughly 25 million cancer survivors worldwide. These numbers again reflect an immense success of anticancer therapies. Despite the pride of cancer care improvement, this population have a unique challenge in medical issue that must be addressed. Patients with cancer may have a higher risk of developing many complications including, but not limited to, cardiovascular diseases, psychological health and neurological problems, or pulmonary diseases, as cancer therapies may affect several organ systems. It is important to prevent, monitor and treat such complications in cancer survivors and patients to ensure long-term health. This topic aims to facilitate and exchange practices issues regarding these problems in patients with cancer who have, or are at risk for, those diseases.

Hot Topic 2: Strategies to Keep Up with Fast-Growing Information and New Drug Therapies

Evelyn Handel, National Comprehensive Cancer Network, Willow Grove, USA

Keeping up with new drug approvals and treatment guidelines is an ongoing challenge, especially in the field of oncology. It is important for pharmacists to take an active role in keeping their knowledge current, and the purpose of this session will be to discuss various strategies to stay informed in the ever-changing oncology landscape.

Hot Topic 3: Drug Interactions Management with Chinese or Herbal Medicines

Tiene Bauters, Ghent University, Ghent, Belgium

Chinese and traditional herbal medicines are increasingly used worldwide. Patients often use these medicines in combination with chemotherapy and supportive care drugs as part of conventional treatment regimens. Consequently, the possibility of drug-drug interactions with these medicines has become an important safety issue in clinical practice. Often, patients are not aware that these medicines may possess diverse pharmacological activities and do not perceive them as ‘drugs’. Many reports are available on pharmacokinetic and pharmacodynamics interactions, sometimes with severe clinical consequences. The experience with potential interactions among commonly used Chinese or herbal medicines will be discussed in this ISOPP 2018 Hot Topic Discussion.

Hot Topic 4: Biosimilars

Harbans Dhillon, ISOPP President, Kuala Lumpur, Malaysia

This session will hope to provide oncology pharmacists with the necessary information on the principles surrounding the development, use of biosimilars and the future of the emerging biosimilar market. To understand biosimilars, pharmacists must first understand biological products and how they differ from small molecule drugs that are more widely available in the market.

As many more biosimilars hit the market with the patent of many blockbuster biologics running out, it is important for pharmacists to understand how biosimilars will affect the rising cost of health care in cancer patients, providing care to our patients and the need for cost-containment strategies.

Hot Topic 5: Drug Wastage Mitigation Strategies – including Stability and Safe Storage of Part Vials / Reconstituted Drugs

Robert Duncombe, The Christie NHS Foundation Trust, Manchester, UK

Waste is a serious issue. There is no clear definition of chemotherapy waste. But the implication of waste is that we are spending money on chemotherapy which is never administered and that money could be spent on newer innovative treatments. This session will start to unpick our understanding of waste – and enable participants to share initiatives aimed at reducing waste.

Hot Topic 6: Implementing Patient Care Programs in your Practice and Pharmacists Expanded Scope of Practice

Melanie Danilak, Alberta Health Services Edmonton, Edmonton, Alberta

Health care is constantly evolving and the role of the pharmacist has changed significantly in many parts of the world over time.  Pharmacists are being challenged to push boundaries by expanding their practice scopes and providing more direct patient care.  While these opportunities are exciting, several barriers can exist.  This session will facilitate sharing of success stories and common challenges encountered when expanding practice scope and implementing patient care programs in oncology practice.

Hot Topic 7: Research about Herbal Medicine including Marijuana – Complementary and Alternative Medications

Suphat Subonkot, Kohn Kaen University, Kohn Kaen, Thailand

Herbal and complementary alternative medications (CAMs) play an important role in cancer symptom management, and patients' quality of life.  Due to the globally increasing use of complementary and Alternative Medications, Research and pragmatic studies should be considered in the acquisition of reliable data based on the regular patterns of ordinary clinical medicine.

Hot Topic 8: Variant vs Deviant? Governance Systems and Patient Centred Care

Shaun O’Connor, Eastern Health, Melbourne, Australia

Variation in medicine is a vital foundation of patient-centred care. In Oncology, with our highly protocolized nature, extra tension is created between the rigidity of our protocols and the need to adopt them for patients. The question of how to examine variation, both at the point of clinical check and as a retrospective audit, are important governance controls to ensure we treat our patients for the best outcomes. This discussion will cover aspects of variation, from detection, management (including escalation) to retrospective auditing.

 

Concurrent Session 2

Clinical 2: Clinical Practice Panel: Interprofessional Collaborative Practice – Challenges and Successes

14:00-15:00 (60 min)

Nick Duncan, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

Naiyarat Prasongsook, Phramongkutklao Hospital, Bangkok, Thailand

Irene Weru, Kenyatta National Hospital, Nairobi, Kenya

Moderator: Melanie Danilak, Alberta Health Services, Edmonton, Canada

Interprofessional collaboration is a cornerstone of modern healthcare. There is a plethora of evidence demonstrating the positive impact that collaborative practice has on patient health and safety outcomes.  Several healthcare and educational institutions as well as health organizations have implemented, or even embraced, this model of practice. Yet, in other settings, a variety of barriers and challenges are preventing the transformation to collaborative practice models.  

During this session, a multidisciplinary panel will explore the topic of interprofessional practice, the roles of collaborative team members, and the integration of pharmacy services into the clinical care team. Discussion will elaborate on success stories and ongoing obstacles in current practices from across the globe. 

Learning Objectives

1. Define interprofessional practice and describe necessary elements required for successful formation and functioning of collaborative teams; and
2. Compare and contrast how pharmacists have been integrated into interprofessional care teams at different institutions globally.

Fundamentals 2: Dose Banding in Oncology

14:00-15:00 (60 min)

Johan Vandenbroucke, Ghent University Hospital, Ghent, Belgium

In this session the principles of dose banding, its background and feasibility in daily practice, will be presented. The pro and cons as well the essential conditions for implementing will be documented and an example of implementation in UZ Gent hospital will be given.

Learning Objectives

1. Understanding the basis knowledge of dose banding;
2. Understanding the steps in an implementation plan; and
3. Understanding the “sine qua non” conditions.

Research 2: Presentation of the ISOPP Research Grant Results

14:00-15:00 (60 min)

Risk Prediction Model and Treatment Guidance Algorithm for the Prevention of Cancer Associated Thromboembolism

Marliese Alexander, Peter MacCallum Cancer Centre, Melbourne, Australia

This presentation will include results of original research conducted with the assistance of the 2017 ISOPP research grant and provide an update on current evidence for the prevention of cancer-associated thromboembolism, with particular focus on advances for patients treated in ambulatory care settings.

Learning Objectives

1. Describe the pathophysiology of cancer-associated thromboembolism and dynamic changes in patient risk profiles; and
2. Explain available thromboembolism risk prediction models and supporting evidence use in clinical practice.

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Plenary

Chinese Medicine in Cancer Treatment

15:00-15:45 (45 min)

Professor Zhiqiang Meng, Fudan University Cancer Institute, Shanghai, China

Traditional Chinese Medicine (TCM) is a Chinese medical practice with more than 2,500 years of history that includes a variety of practices including herbal medicine, acupuncture, massage, and exercises. TCM enjoys the advantage of its enormous literature, clinical handbooks, medical case histories and studies of material medical. There are growing curiosity in the western world on TCM shifting from gaining isolated technique such as acupuncture and moxibustion towards TCM theories looking at the whole body instead of simply the dysfunctional part and relate to patients as one can help to recover rather than as objects of treatment. Huachansu, a Chinese medicine derived from the skin glands of Bufo bufo gargarizans Cantor or B.melanotictus Schneider and has been used in the treatment of various cancers in China. Aiming to evaluate its clinical efficacy, we conducted a pilot study and prospective randomized phase II study to evaluate Huachansu in the treatment of pancreatic adenocarcinomas. Moreover, we evaluated the major active compound of Huachansu, bufalin, and its role in pancreatic cancer. However, the results of our randomized clinical trial do not support the use of Huachansu in combination with gemcitabine in the treatment of advanced pancreatic cancer. It may be partially due to the fact that TCM is bases on theories developed in ancient China, to a large extent its social system is different from the contemporary world. We do not have to accept all of it or reject all of it without examination. It will be valuable to adapt a new circumstance in views of patients with carefully designed clinical studies and investigation of its theory and underlying basics.

Learning Objectives

1. Describe how TCM provides a valuable source for novel cancer drug development from its long history of practice in China;
2. Identify which in vivo and in vitro studies on the anti-neoplasm effect of Chinese medicine are important for understanding the molecular basis of the drug on cancer; and
3. Describe why large-scaled and well-designed clinical studies are important for the evaluation of the treatment efficacy and investigate the underlying basics of TCM.

 

Concurrent Session 3

Clinical 3: Solid Tumour Updates

16:30-18:00 (45 min each)

Update EGFR Management in Non–Small Cell Lung Cancer: Focusing on T790M Mutation

Manit Saeteaw, Ubon Ratchathani University, Ubon Ratchathani, Thailand

Epidermal growth factor receptor (EGFR) mutations are found 10% in Caucasian patients and up to 50% in Asian patients. Tyrosine kinase inhibitors (TKI), including erlotinib, gefitinib and afatinib, have been approved as a first-line drug in metastatic EGFR mutatated NSCLC. However, resistance to TKI therapy has been reported. EGFR T790M is acquired resistance mutation to TKI occurs in 60% of patients with disease progression after initial response to TKI treatment, approximately 9-13 months after treatment. Moreover, several studies show T790M mutation as the primary resistance to TKI. Osimertinib, a new generation TKI, has been developed to overcome T790M mutation. This session will provide an overview of resistance of EGFR TKIs and also describe the recent FLAURA trial that has shown improved overall survival outcomes and 

better tolerability of osimertinib as a first-line therapy in NSCLC.

Learning Objectives

1. Describe TKI resistance patterns in EGFR mutated NSCLC;
2. Discuss methods for overcoming resistance; and
3. Explain the direction of TKI treatment in the future.

Optimizing Immunotherapy in Cancer: Focus on Management of Toxicity

Rowena Schwartz, James L. Winkle College Pharmacy University of Cincinnati, Cincinnati, USA

The field of immunotherapy continues to evolve at a rapid pace. The insights into the immune system, and subsequent development of strategies to optimize the immune response in cancer, has let to new treatments, treatment strategies and care issues.  During this session the discussion will focus on management strategies to optimize care for individuals receiving immunotherapy for cancer.  This will include a review of common and rare toxicities seen with immunotherapy (e.g., immune checkpoint inhibitors) with an emphasis on monitoring, recognition, grading and management of toxicities.  In addition, we will explore strategies to better engage the comprehensive health care team in toxicity identification and management, including the oncology health care team, primary care practitioners, patients and caregivers.  Although the focus of the discussion will be the immune checkpoint inhibitors currently in clinical practice, this presentation will include discussion on emerging immunotherapies for solid tumours.

Learning Objectives

1. Discuss clinical presentation of toxicities associated with immune checkpoint inhibitors and identify the role(s) of the pharmacist in education, monitoring and managing toxicities;
2. Describe approaches to optimize care in patients receiving combination cancer therapies that include immunotherapy (e.g., chemotherapy + immunotherapy, chemotherapy followed by immunotherapy); and
3. Outline key patient and caregiver education required for immune checkpoint inhibitors and other immunotherapies used in the management of solid tumours.

Fundamentals 3: Role of the Pharmacist in Investigational Drugs

16:30-18:00 (45 min each)

Marliese Alexander, Peter MacCallum Cancer Centre, Melbourne, Australia

This presentation will explore the pharmacist’s scope of practice and discuss how to push the boundaries of conventional pharmacy services by integrating the role of the pharmacist in investigational drugs. The presenter will draw on reports from pharmacy practice research literature and experiences of pharmacist integration within the clinical trials unit of an Australian cancer hospital.

Learning Objectives

1. Describe the defined scope of practice within your country;
2. Give examples of areas for potential expanded practice within the clinical trial / investigational drug services setting; and
3. Identify additional training and skill assets required to practice in these settings.

Bo Yu, Fudan University Shanghai Cancer Centre, Shanghai, China

Research 3: Panel: Shared Experiences of Student Research Projects

16:30-18:00 (90 min)

Alexandre Chan, ISOPP President Elect, National University of Singapore, Singapore

Bruce Burnett, University of Central Lancashire, Preston, UK

Zhi-Sheng Zhang, Fudan University Shanghai Cancer Centre, Shanghai, China

Moderator: Lisa Holle, University of Connecticut, Storrs, USA

Both oncology pharmacists and pharmacy students can benefit from working together on research projects. In some cases, however, it can be difficult to collaborate with students to conduct meaningful research because of their limited educational background of research methodology and data analysis and/or the timeframe in which they are available to conduct research. Thus, historically many institutions have utilized students to conduct audit-type research instead. This session is aimed at identifying how best to have students involved in collaborative research that is meaningful to improving oncology patient care or the value of the oncology pharmacist and best suits advancing the research knowledge of our students.

Learning Objectives

1. List common pitfalls and successes of student research from the student and the preceptor’s perspectives;
2. Discuss the ideal setting and preceptor and student qualities for successful student research; and
3. Identify suitable types of research that meet both student and researcher needs, including collaboration with third parties.

Welcome Reception amongst the Exhibits and Posters  

18:00-19:00

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Thursday, April 12

Plenary

The Equity Imperative in the Drive for Nation Action on Cancer - Introducing UICCs Treatment for All Campaign

08:30-09:15 (45 min)

Mélanie Samson, Union for International Cancer Control (UICC), Geneva, Switzerland 

Building on the commitments of the Cancer Resolution adopted in 2017 during the World Health Assembly, UICC launched the “Treatment for All” campaign with a view to translating these global cancer commitments into concrete national actions. Operationalizing these commitments in light of the equity imperative will require united actions by local cancer stakeholders to advocate for the targeted efforts and health systems strengthening so that patients can have access to quality information, early detection and diagnosis, timely treatment and care services. With more than 60% of cancers occurring in Africa, Asia and Latin America, it is more than urgent to address disparities in access to care.

In particular, equitable access to technologies and medicines will be critical to have an impact at the population level, and for advancing cancer patient care. Oncology pharmacy practitioners have a critical role to play in ensuring that quality and safety, as well as effectiveness, are implemented along the pharmaceutical chain as a cornerstone of health system strengthening for cancer control. Many developing countries lack the capacities and resources to build and maintain strong pharmaceutical systems. This is where the sharing of best practices, through the dissemination of internationally validated standards and through tailored support in terms of technical assistance, can make a difference. ISOPP, as an organisation should be leading the call for action and through its members’ expertise, join the Treatment for All campaign and to reinforce national action on pharmaceutical infrastructure and processes.

Learning Objectives

1. Introduce key global commitments on access to quality cancer care, in particular advances in the field of essential cancer medicines;
2. Provide an overview of principles of the “Treatment for All” campaign to implement these commitments at the national level, and of how they apply to all stakeholders involved in the health system, specifically pharmacists;
3. Identify the critical role of standards and quality assurance of cytotoxics as part of health system strengthening within the “Treatment for All” Campaign; and
4. Discuss opportunities for ISOPP for bringing expertise and engagement to achieve the objectives of the "Treatment for All" campaign at the global and local levels.

 

ISOPP Member Recognition

09:15-09:30 (15 min)

Concurrent Session 4

Clinical 4: Symptom Management / Supportive Care Panel: Opioid Addiction in Cancer Patients

10:15-11:45 (90 min)

Vincent Ha, Cross Cancer Institute, Edmonton, Canada

Lakkana Suwannoi, Mahidol University, Bangkok, Thailand

Bo Yu, Fudan University Shanghai Cancer Centre, Shanghai, China

Moderator: Lisa Holle, University of Connecticut, Storrs, USA

With the rising opioid crisis that is occurring in many countries worldwide, oncology professionals are struggling with how to best care for patients given the new issues they are facing. These issues include patients who refuse to use opioids because of fear of addiction, changes in access to opioids for treatment of pain, managing patients with previous addiction to “street” opioids, and how countries who are not in a crisis are poised to deal with a crisis if it arises.

Learning Objectives

1. Discuss the status of the opioid use and addiction concerns, including which countries are most affected by this addiction crisis;
2. Describe the role of pharmacists educating patients about opioid addiction and methods to managing those at high risk for addiction (eg opioid contracts, naloxone);
3. Discuss prevention strategies for opioid abuse, including individual efforts at each region;
4. Identify best practices for assessing and managing patients with recent drug use who arrive for anticancer treatment and for those who have addiction to “street” opioids; and
5. Describe the use of pain-free wards in Chinese oncology care.

Fundamentals 4: IV Safe Handling

10:15-11:45 (45 min each)

Future of IV Cyotoxic Preparation in Developing Countries in Asia

Lita Chew, National Cancer Centre, Singapore, Singapore

Oncology pharmacy practice began in Asia around 1990s. Enhancing safety and quality of IV cytotoxic preparation remain a key focus.  Most developing countries in Asia have embraced the IV preparation of cytotoxic drugs as part of drug management systems and this is a responsibility of pharmacy department in the organization.

Whilst in some places there may already be protocols, procedures or guidelines for safe handling, there was a general lack of regulatory framework to guide practice, monitor standard and quality of IV cytotoxic preparation. Healthcare provision remains challenging in developing countries in Asia due to the costs required as well as various social, cultural, political and economic conditions.

Nevertheless, there are certainly no shortage of opportunity for oncology pharmacy practitioners. Inpatient chemotherapy administration is no longer standard of care. This has given way to ambulatory setting for chemotherapy treatment and has expanded to include therapy for patient at home. Information technology, automation and economics of health care will continue to influence pharmacy services, including the IV preparation of cytotoxic drugs.

Learning Objectives

1. Describe the current state of practice;
2. Discuss the challenges facing the practice sites; and
3. Identify the desired future of IV cytotoxic preparation in these practice sites.

Safe Handling of HDs, Use of Technology to Streamline Practice

Hisanaga Nomura, Pharmacist, National Cancer Center Hospital East, Kashiwa Chiba, Japan

The number of people who handle anticancer drugs in their profession is increasing. Anticancer drugs, which are hazardous drugs (HD), exert cytocidal effects on cancer cells, but many have also been shown to have mutagenicity, teratogenicity and carcinogenicity; therefore, safe handling of anticancer drugs is necessary. In July 2015, the first Japanese guidelines for exposure control measures, namely, the "Joint Guidelines for Safe Handling of Cancer Chemotherapy Drugs", were published jointly by 3 societies. Our guideline is the creation of the Japanese Society of Cancer Nursing (JSCN), Japanese Society of Medical Oncology (JSMO) and Japanese Society of Pharmaceutical Oncology (JASPO) and has a historical significance. This lecture will talk about the necessity of safe handling of anticancer drugs, Japan's recent movement of safe handling, the introduction of joint guidelines of safe handling of anticancer drugs.