Expert Q&A: Advancing Hematology-Oncology Through Novel Therapies and Biomarker-Driven Care

The hematology-oncology landscape is rapidly evolving, including the introduction of CAR T-cell therapies, bispecific antibodies, and biomarker-guided approaches. As treatments become more personalized and complex, pharmacists are key in ensuring safe use through education and practical tools. Advances in genetic insights continue to shape decision-making and patient outcomes. In this Q&A, expert Sean Hwang, PharmD, clinical pharmacy specialist with the Leukemia Department of Pharmacy at Memorial Sloan Kettering Cancer Center, explained how he keeps up with new literature, supports patients and care teams with complex regimens, and uses genetic information to guide leukemia therapy.

Pharmacy Times: How do you stay current with the latest developments in hematology-oncology, particularly with novel agents like CAR T-cell therapies or bispecific antibodies?

Sean Hwang, PharmD: I use a few different resources to stay up-to-date. I often get new literature updates from the New England Journal of Medicine and Blood. My colleagues and pharmacy residents at Memorial Sloan Kettering have also been an incredible resource. They regularly share exciting new therapies and interesting clinical trials with me.

Pharmacy Times: When a new agent is approved with a complex dosing schedule or monitoring requirement, how do you educate both the patient and the care team to ensure safe and effective use?

Hwang: This is a great question, especially as dosing schedules are becoming increasingly complex with newer CAR-T and bispecific antibody therapies. Manufacturers often provide excellent resources or illustrations, which can be very helpful. In my own practice, I’ve found that creating an individualized patient calendar is one of the most effective ways to clearly visualize and organize the dosing schedule.

Pharmacy Times: With the shift towards highly individualized treatment in hematology, how do you use genetic or biomarker information to optimize a patient's drug therapy?

Hwang: In the context of leukemia, genetic and biomarker information has always been critical for guiding therapy. For example, in acute myeloid leukemia, mutations such as FLT3, IDH1/2, TP53 and recently even KMT2A rearrangements can influence both prognosis and treatment choice. In the future, it would be exciting to see individualized genetic information play a larger role in managing adverse effects, similar to how DPYD testing can contribute to fluorouracil dosing and toxicity management in gastrointestinal malignancies.