By Esin Aysel Kandemir, Turkish Medicines and Medical Devices Agency

After having attended to ISOPP Symposium 2019, now I am flying back home and thinking all the amazing things about this experience. The 2019 ISOPP Symposium took place in London, the UK, October 10-13. The symposium chair and task forces created an excellent program including workshops, courses, presentations on oncology pharmacy practice topics ranging from clinical sessions about cancer associated thrombosis, renal cell cancer treatment landscape, management of chronic lymphocytic leukemia, management of cancer pain, medical cannabis, immunotherapies, HPV and non-HPV associated head and neck cancers; fundamental and research sessions about updates from ESMO, ISOPP position paper draft, dose banding, statistics and personalized medicine; plenary sessions about key developments in cancer treatment, global access to good quality medicines and cancer fundraising.  

This symposium is excellent for oncology pharmacy practitioners to advance their practice and to make connections with oncology pharmacy practitioners around the world. As a pharmacist working in a governmental position focusing on oncological drug supply and access, I can surely say, that I was able to make the most of it and return with many take-away lessons and research ideas in mind. My practice includes off-label use of oncology drugs, which is very common in oncological settings. Off-label uses are case by case approved by our agency and can be reimbursed by the health insurance companies. So it is very much related to drug access and drug supply which is an ever-growing area as the new oncology drugs come to the market or the results of newer clinical trials are published in the journals. It has both clinical aspects to consider and also sets the evidence-based medicine as priority. Because of its nature, staying up to date with oncological therapies and current practices is very important. 

On the first day, I attended the introduction to oncology pharmacy course which was very helpful to outline general knowledge of clinical oncology information for those who are new in the field and to summarise the basic knowledge and refresh for those who are already practicing in the oncological settings. This was also very good for me in a way that it touched on clinical aspects like oncological emergencies, management of nausea and vomiting, radiotherapy side effects and methods of administration. The opening plenary starting with key developments in cancer treatments in 2020s focused on the most recent developments in oncology like 5-year survival with combined nivolumab and ipilimumab in advanced melanoma and the ongoing renal cell cancer studies and the impact they may have on clinical practice in the future. 

The session about the changing landscape of renal cell cancer summarised very well the current new treatment options and the early access program in the UK which includes pembrolizumab and axitinib for renal cell cancer patients which has also interested me from the point of view that we also come across with this patients commonly in our practice. The great idea of designing an application to understand more and empathise with renal cell cancer patients shows the importance of patient-oriented care and that drugs we use are treating the patients rather than the disease. This gave me the thought that embedding the patient experience to our practice can also be useful.  Global access to good quality medicines session speaking about drug access and its importance has given me a new insight of drug access and related issues. ESMO MCBS tool which facilitates and supports the decision making regarding the accessibility and clinical benefits of oncological drugs is especially beneficial for third parties like government and health insurance companies. One of the game changing impacts of immunotherapies in melanoma was also spoken about at the symposium. The effectiveness of immunotherapy in melanoma is breath-taking and seems to be included in the therapy regimens also in the future. The cancer associated thrombosis session especially interested me as I am also dealing with this subject on my master thesis. The thing the speaker talked about that cancer patients being almost all the time educated in issues like sepsis, neutropenic fever etc, but there isn’t an effort to make patients to be aware of the thrombosis risk they have is also true in our practice when I look back to the days I used to work in clinics. This had implied the patient information/education need about cancer-associated thrombosis once more given the burden of the disease on patients and given the fact that we cannot protect our patients from its burden when the patients don’t have an idea or clue about it. It has also touched on uses of NOACs in cancer patients as well as drug interactions and safety issues coming with this newer drugs where pharmacists can have an impact on anticoagulation therapy with NOACs. Pharmacy practitioners as researchers panel was very motivating and inspirational which encouraged me to work more efficiently and hardworkingly. This session has highlighted the clinical pharmacist’s position and ability to detect clinical problems, unmet healthcare needs and to go beyond pharmacy in order to improve the quality of life of cancer patients and to make a difference in their lives. The poster sessions was a good way to interact with colleagues around the world who are trying to improve cancer patients’ management in their countries and the conversations I had with exhibitors was also exciting to gain an idea of healthcare system and drug market and availability in the UK. There were plenty of posters from around the world in oncology pharmacy subjects ranging from clinical pharmacy services, non-medical prescribing, immunotherapy toxicities and supportive care of cancer patients. I was also very pleased to present two posters of mine about the anticoagulant therapies of cancer patients. 

All the sessions I was able to attend was very good in scientific quality and clinical significance. I am also very excited to be able to watch other sessions’ recordings on the ISOPP website and I am looking forward to it. All in all, it was very nice to attend the ISOPP 2019 Symposium which gave me newer ideas about my practice and made me more aware of the future of oncology pharmacy what is awaiting us on the horizon. Lastly, I would like to whole-heartedly thank to the “Awards and Travel Grants Annual Task Force” for choosing me for an ISOPP travel grant which gave me this big opportunity to attend the ISOPP Symposium. Now I’m looking forward to attending the next ISOPP symposia and hopefully they will be great like this symposium in 2019. 
 

Esin Aysel Kandemir Turkish Medicines and Medical Devices Agency