Pharmacy Focus: Insights from a Pharmacy Times Peer Exchange – How to Talk the Talk

Release Date: June 3, 2025

In the final episode of Pharmacy Times' peer exchange feature series on antibody-drug conjugates (ADCs) and HER2-positive breast cancer, experts delve deep into effective patient communication, managing treatment side effects, interdisciplinary collaboration, and addressing social determinants of health that impact patient adherence and outcomes.

1. Effective Communication with Patients about ADC Therapy

Dr. Hunter opens the discussion by emphasizing the importance of clear communication regarding ADC therapy. Prior to beginning treatment, his institution employs a formalized process that includes a dedicated clinic appointment led by a clinical pharmacy specialist. This session focuses on comprehensive chemotherapy education tailored to each patient's needs.

"I usually will extract the respective clinical trial data into some of the paperwork, make it into a more digestible form so the patient is actually seeing what the benefit would be, but more in layman's terms."
— Dr. Hunter [01:09]

Dr. Hunter has developed handouts for each treatment within his subspecialty, ensuring that patients understand both the potential benefits and the associated risks of side effects. This approach addresses common patient concerns, especially in metastatic settings where patients question the tangible benefits of their treatment amidst discussions of side effects and treatment duration.

2. Managing Side Effects and Interdisciplinary Approaches

The conversation shifts to managing the complex side effect profiles of ADCs. Dr. Taraba highlights the importance of follow-up visits where side effects are monitored and managed actively.

"Working with them to help in management and knowing what to expect and kind of letting them know this is kind of a work in progress throughout their different treatments."
— Dr. Taraba [03:09]

Dr. Hill expands on this by discussing the necessity of an interdisciplinary approach. Collaborating with oncology nurses, advanced practice providers, pulmonologists, cardiologists, and ophthalmologists ensures comprehensive monitoring and prompt management of side effects. He underscores the value of strong interdepartmental relationships to facilitate timely specialist consultations, especially critical in rural settings where patients may travel long distances for care.

"Having those good relationships with those other teams within your institution can be really helpful so that when a potential side effect does show up, you have a person to reach out to."
— Dr. Hill [04:52]

The Moderator reinforces these points, highlighting the role of clinical pharmacists in tailoring patient experiences based on their specific side effects and advocating for an individualized approach to toxicity management.

3. Addressing Social Determinants of Health and Adherence Barriers

Transitioning to non-clinical challenges, Dr. DeMarco addresses how social determinants of health (SDOH) significantly affect patient adherence to ADC therapies. He notes that almost every patient faces some barrier related to SDOH, which can overlap and compound challenges related to treatment costs, accessibility, and insurance coverage.

"What is the point of me prescribing a med that they should use for their supportive care if they can't afford that prescription co-pay on top of their medical visit co-pay on top of their infusion co-pay."
— Dr. DeMarco [08:48]

Dr. DeMarco emphasizes the critical role of pharmacists in identifying and mitigating these barriers. Although his institution has a financial advocacy team, the increasing costs of healthcare necessitate a more robust involvement from pharmacists to find cost-effective medication alternatives and supportive care options.

4. Innovative Initiatives to Overcome Barriers

Responding to the challenges outlined by Dr. DeMarco, Dr. Hunter shares his work at Texas Southern and the Memorial Hermann Cancer Center, where they utilize the Phoenix Toolkit—a validated tool for assessing SDOH in breast cancer patients. This initiative aims to identify specific barriers affecting treatment efficacy and patient outcomes.

"The research that I do is really trying to identify which specific social determinants of health are affecting metastatic breast cancer patients most often, and what are the outcomes of those effects and what are ways that we can possibly support them in a better way."
— Dr. Hunter [10:29]

Dr. Hunter’s efforts focus on understanding how logistical issues, such as clinic visit schedules and transportation limitations, impact treatment adherence. By addressing these practical barriers, his team seeks to ensure that disparities in treatment outcomes due to SDOH are minimized.

5. Final Thoughts and Future Directions

As the discussion winds down, each expert shares their perspectives on the evolving landscape of breast cancer treatment and the integral role of pharmacists:

• Dr. Taraba expresses excitement about the rapid advancements in breast cancer therapies and the expanding role of pharmacists in toxicity management.

  "It's an exciting time and excited to see what's. What's to come."
  — Dr. Taraba [13:31]

• Dr. Hill highlights the importance of clinical pharmacists' specialization and supporting one another within the profession to keep pace with the evolving treatment paradigms.

  "Continuing to kind of think about ways that we can support each other within the clinical pharmacy profession instead of the hemonk space."
  — Dr. Hill [14:07]

• Dr. Hunter underscores the significance of minimizing toxicity while maximizing treatment efficacy, particularly in the metastatic setting, to enhance patient quality of life and treatment longevity.

  "The more these agents come about, the less toxicity they have versus the efficacy being maintained or better than what you have. Traditional chemotherapy just push us as the practitioners in a better space to take care of our patients."
  — Dr. Hunter [15:09]

• Dr. DeMarco concludes with optimism about future advancements and the continued importance of addressing social determinants to improve patient outcomes.

  "I'm just, you know, really thankful to be here. I learned a lot from all, all of my brilliant colleagues here and just really excited to see what happens in the future."
  — Dr. DeMarco [16:16]

Conclusion

This episode of Pharmacy Focus provides a comprehensive exploration of the multifaceted approach required to optimize patient care in HER2-positive breast cancer treatment with ADCs. From effective patient communication and managing complex side effects to addressing socio-economic barriers, the discussion underscores the pivotal role of pharmacists and interdisciplinary collaboration in enhancing treatment outcomes and patient quality of life.

For more insights and detailed discussions, listen to the full episode here.