The Expanding Role of Oncology Pharmacists in Patient Care and Clinical Research at USC

Pharmacy Times® interviewed Amir Ali, PharmD, BCOP, a clinical pharmacist specialist at the University of Southern California (USC) Norris Comprehensive Cancer Center and an adjunct assistant professor of pharmacy practice at USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences in Los Angeles, on the integral role of pharmacists in cancer care. Ali highlighted the integral role pharmacists play in both direct and indirect patient care, including rounding with providers and providing medication management support.

USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences in Los Angeles, California

As adjunct faculty at USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, Ali noted a significant increase in pharmacy students' interest in oncology over the duration of his course, especially in relation to the field’s rapid growth and their potential impact on patients’ lives. Oncology pharmacists at USC contribute to treatment decisions, patient counseling, and specialized areas such as cellular therapies, while also playing key roles in research, including clinical trials and real-world evidence studies. The institution’s quick implementation of cutting-edge therapies, such as CAR T-cell and tumor-infiltrating lymphocyte (TIL) therapies, along with a robust investigational drug services program, help to make the work of the oncology pharmacist unique at USC, according to Ali.

Pharmacy Times: What is the role of the oncology pharmacist on the cancer care team at USC Norris Comprehensive Cancer Center, and how do oncology pharmacists collaborate with other care team members?

Amir Ali, PharmD, BCOP, in front of a USC hedge on campus.

Amir Ali, PharmD, BCOP: My experience working as an oncology pharmacist at USC has been nothing less than tremendous. In fact, I originally did my second year pharmacy residency at USC, and I enjoyed it so much that I decided to stay on ever since.

One of the notable differences that I've seen [here at USC] vs other sites that I've worked at before is really the value that our providers see in terms of our pharmacy practice. One thing that stood out to me is that we often did not start rounding without the pharmacist there. So, the the team would wait for us to be there. We’re very heavily involved in direct patient care and non-direct patient care. So I definitely saw the immense value of pharmacists here. That's one of the reasons why I’m so happy to be at USC in oncology pharmacy.

Pharmacy Times: In your work as adjunct faculty at the USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, do you see many pharmacy students interested in moving into oncology following completion of their degree?

Ali: I am adjunct faculty at the USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, and part of my involvement with the school of pharmacy is really coordinating their oncology courses for pharmacy students. It is a class of 200 students each year.

One of the first questions that I always ask the first class is if [they] are interested in going into oncology, and typically it's about 5 to 10 people that raise their hands [at that first class], and I've been coordinating this course for the past 3 years, and one of the big things that I ask on the last day of the course is the same question: How many of you are now interested in going to hematology/oncology? The numbers typically go up to almost 100 [students] in the class. So, we've been really focusing on sharing the stories that we see with our patients [with cancer], the pharmacy involvement that we have at USC and other institutions, and really the impact that they could have on patients’ lives. Certainly students are observing that. They know how quickly the field of oncology pharmacy is growing, and the impact that they can have.

Pharmacy Times: What is the role of the oncology pharmacist in treatment decisions at USC Norris Comprehensive Cancer Center?

Health care professionals making rounds in a hospital. Image Credit: © KOTO - stock.adobe.com

Ali: Oncology pharmacists can function in many different ways in the health system. One of the ways is working with critically ill patients in the in-patient setting. [Pharmacists are] rounding with the hematology team, the oncology team, and the bone marrow transplant team in cellular therapies. Pharmacists have a key role in managing these patients. We know that oftentimes these patients are admitted with a whole host of medications and are discharged with even more, and our team and our patients heavily rely on pharmacists to make sure that we're managing these medications to their full potential [while] mitigating toxicities if they do occur.

Pharmacists also have the ability to work in the infusion centers, counseling patients on cycle 1 day 1. One of my roles is actually working in the clinics, focusing on cellular therapeutics, focusing on all of hematology, where I'm more in a consult service [role] for these patients and for our providers. [I’m answering] any questions that come up, drug related for not, and making sure that these patients are cared for in a comprehensive manner. So definitely [there are] versatile fields available as an oncology pharmacist at USC.

Pharmacy Times: What makes the experience of working as an oncology pharmacist at USC Norris Comprehensive Cancer Center unique?

Ali: One of our key strengths at USC is that we are pushing the limits in terms of our cancer care, with not only the ability to take on these really complex care agents and the requirements, but we are actually an NCI-designated comprehensive cancer center that is really able to take on a variety of different patient populations. The therapies that we offer are cutting edge. So, the ability to offer various types of CAR T cellular products with our expertise from our providers and from our pharmacists is certainly noteworthy.

The other thing that comes to mind is newly approved TIL therapies that are now being offered at USC for our [patients with metastatic melanoma]. We have robust clinical trials and cutting-edge technologies that are being studied here at USC as well. So we're always pushing our limits here at USC and making sure that we can achieve the impossible for our patients.

Pharmacy Times: What is the role of the oncology pharmacist in research at USC Norris Comprehensive Cancer Center?

Ali: As an oncology pharmacist, you have the ability to really be involved in various research opportunities. I will tell you myself that I am focused on outcomes research. So, I am actually currently the [primary investigator] for about 5 phase 4 studies looking at real-world evidence for newly approved cancer therapeutics. These studies have huge implications for really making sure that the clinical trials are able to be replicated in the real-world setting with our typical [patients].

We also have a really big investigational drug services or IDS department, where we have oncology-trained pharmacists reviewing these protocols and assisting in recruitments at times, so pharmacists really play [key roles] from enrollments to monitoring for these patients on these trials and making sure that we have the available clinical trials out there at USC.