Pharmacy Leadership in the Future of Oncology Care

As cancer care continues to shift toward outpatient settings, pharmacists are playing a pivotal role in identifying systemic barriers, optimizing medication use, and improving patient outcomes. Peer-reviewed original research from the University of California, San Diego (UCSD) and a collection of abstracts that will be presented at the 2025 Oncology Pharmacists Connect (OPC) meeting in Austin, Texas, from June 19 to 20, underscore how oncology pharmacists are driving innovation across the care continuum.

Image credit: Tyler Olson | stock.adobe.com

In the UCSD study on page 14, Janine G. Martino, PharmD, BCOP, APh; Kaitlyn Wells, PharmD; Sam Martinez, PharmD, BCOP; and Craig A. Stevens, PharmD, BCPS, assess more than 1200 inpatient admissions for chemotherapy regimens typically suitable for outpatient administration. Findings revealed that approximately 9% of inpatient treatments were due solely to transportation or housing challenges, resulting in more than $7 million in potentially avoidable hospital costs over 5 years. Additional patients were discharged within 24 hours of chemotherapy completion, raising questions about the necessity of inpatient stays. In response, UCSD implemented interventions, including revised order entry protocols, pharmacist-led utilization reviews, and the launch of a donor-sponsored housing initiative to support patients receiving outpatient chemotherapy.

On page 23, the OPC abstracts echo these themes of pharmacist-driven care expansion. Studies from multiple institutions demonstrate the safety and feasibility of outpatient administration of high-risk therapies, including bispecific T-cell engagers. Real-world data from Emilie Aschenbrenner, PharmD, BCOP; and Megan May, PharmD, BCOP, FHOPA, FAPO, showed successful outpatient step-up dosing protocols. Additionally, Cassandra Perkey, PharmD, BCOP; Nicole McMullen, PharmD, BCOP; Manale Maksour, PharmD, BCPS; Melody Chang, RPh, MBA, BCOP; and Cherise Steib, PharmD, HDDP, found no recorded use of tocilizumab (Actemra; Genentech) for cytokine release syndrome in community clinics, suggesting that with proper infrastructure, these therapies can be safely managed outside the hospital.

Several studies addressed the intersection of oncology pharmacy and social determinants of health. Adam Musante, PharmD; Marissa Aquino, PharmD; and Meredith Vigneaux, PharmD, linked transportation barriers to increased febrile neutropenia rates, supporting the need for individualized supportive care planning. Similarly, Laly Havern, PharmD, MS, BCACP; Ann Scalia, BSN; Khadijah Khan, PharmD; and Ed Witt, PhD, discuss an oncofertility initiative that revealed gaps in patient education and oncologist engagement that pharmacists are well positioned to bridge.

Additional research explored clinical optimization. At City of Hope, papers by Klara Kim, PharmD; Alan Flores, PharmD; Jose Tinajero, PharmD, BCOP; and Dat Ngo, PharmD, BCOP, discussed their research evaluating posttransplant graft-vs-host disease patterns and sequencing strategies for secondary acute myeloid leukemia treatments, respectively. Although results are pending, both aim to refine therapeutic decision-making in complex hematologic cases.

Together, these studies and others published in this issue and presented at the upcoming 2025 OPC meeting showcase the growing influence of oncology pharmacists in improving access, reducing avoidable admissions, advancing patient-centered care, and optimizing resource use in the outpatient setting. As institutions expand ambulatory cancer care, pharmacy-led initiatives will remain central to success.