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Precision medicine in oncology: New practice models and roles for oncology pharmacists
Christine Walko1, Patrick J Kiel2, Jill Kolesar3,4
1DeBartolo Family Personalized Medicine Institute, Moffitt Cancer Center, Tampa, FL.
Purpose:
Three different precision medicine practice models developed by oncology pharmacists are described, including strategies for implementation and recommendations for educating the next generation of oncology pharmacy practitioners.
Summary:
Oncology is unique in that somatic mutations can both drive the development of a tumor and serve as a therapeutic target for treating the cancer. Precision medicine practice models are a forum through which interprofessional teams, including pharmacists, discuss tumor somatic mutations to guide patient-specific treatment. The University of Wisconsin, Indiana University, and Moffit Cancer Center have implemented precision medicine practice models developed and led by oncology pharmacists. Different practice models, including a clinic, a clinical consultation service, and a molecular tumor board (MTB), were adopted to enhance integration into health systems and payment structures. Although the practice models vary, commonalities of three models include leadership by the clinical pharmacist, specific therapeutic recommendations, procurement of medications for off-label use, and a research component. These three practice models function as interprofessional training sites for pharmacy and medical students and residents, providing an important training resource at these institutions. Key implementation strategies include interprofessional involvement, institutional support, integration into clinical workflow, and selection of model by payer mix.
Conclusion:
MTBs are a pathway for clinical implementation of genomic medicine in oncology and are an emerging practice model for oncology pharmacists. Because pharmacists must be prepared to participate fully in contemporary practice, oncology pharmacy residents must be trained in genomic oncology, schools of pharmacy should expand precision medicine and genomics education, and opportunities for continuing education in precision medicine should be made available to practicing pharmacists.
Insights
Oncology pharmacists are leading innovative precision medicine models. These models guide patient-specific cancer treatment using tumor mutations and serve as crucial training grounds for future practitioners.
Area of Science:
- Oncology
- Genomic Medicine
- Precision Medicine
Background:
- Oncology uniquely utilizes somatic mutations for both tumor development and targeted therapy.
- Precision medicine models facilitate interprofessional collaboration for patient-specific treatment strategies.
Purpose of the Study:
- To describe three precision medicine practice models developed by oncology pharmacists.
- To outline strategies for implementing these models and educating future practitioners.
Main Methods:
- Implementation of three distinct precision medicine practice models: clinic, clinical consultation service, and molecular tumor board (MTB).
- Models developed and led by oncology pharmacists at University of Wisconsin, Indiana University, and Moffit Cancer Center.
- Focus on interprofessional involvement, institutional support, clinical workflow integration, and payer mix considerations.
Main Results:
- Commonalities across models include pharmacist leadership, specific therapeutic recommendations, off-label medication procurement, and research components.
- Models serve as interprofessional training sites for pharmacy and medical students and residents.
- Molecular tumor boards (MTBs) are identified as a key pathway for genomic medicine implementation in oncology.
Conclusions:
- Oncology pharmacists play a vital role in precision medicine practice models.
- Training in genomic oncology is essential for current and future oncology pharmacy practitioners.
- Expanded education in precision medicine and genomics is recommended for pharmacy schools and continuing education programs.
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