Novel Treatments and Operational Innovations Shape the Future of Oncology

Targeted therapies and immunotherapies continue to shape oncology care, offering new hope in historically difficult-to-treat malignancies. In this issue, 3 peer-reviewed articles examine recent advances in hepatocellular carcinoma, synovial sarcoma, and strategies to reduce drug waste in oral oncology therapy.

Kevin Cheng, PharmD; Taylor Drowne, PharmD; and Thuy Nguyen, PharmD, review the evolving treatment landscape of hepatocellular carcinoma (HCC), the sixth-leading cause of cancer-related death in the United States. Advances in systemic therapies, including immunotherapy and anti-VEGF monoclonal antibodies, have significantly altered management strategies over the past 5 years, offering improved outcomes and expanding treatment options for patients with advanced disease.

C. Brooke Adams, PharmD, BCOP; Lauren Bivacca, PharmD, MBA; and Rachel Hatton, PharmD, BCOP, highlight recent progress in the management of synovial sarcoma (SS), a rare and aggressive soft tissue malignancy. Despite initial chemotherapy sensitivity, metastatic SS is associated with poor outcomes, with 5-year survival rates around 10%. The FDA granted accelerated approval in 2024 to afamitresgene autoleucel (Tecelra, Adaptimmune, LLC), a MAGE-A4–directed autologous T-cell immunotherapy for adults with unresectable or metastatic SS whose tumors express MAGE-A4 and meet specific HLA criteria, marking a meaningful advance in a disease with otherwise limited therapeutic options.

Faith L. Sample, PharmD, and Julie MacDougall, PharmD, MBA, BCPS, focus on the operational side of oncology care by addressing the issue of oral oncology drug waste. High costs and frequent therapy changes, due to toxicity or disease progression, contribute to substantial pharmaceutical waste. Their study describes a novel, technician-led workflow in a hospital specialty pharmacy designed to proactively coordinate refills, thereby reducing waste, enhancing patient safety, lessening financial burdens, and mitigating environmental risks.

Together, these articles underscore the evolving and multifaceted role of oncology pharmacists in navigating complex treatment landscapes. From advancing targeted immunotherapies in rare and aggressive cancers to implementing innovative strategies to reduce drug waste, proactive, evidence-based pharmacy involvement remains essential to maximizing patient outcomes and ensuring sustainable care delivery.