Author(s):
Day two of the 43rd National Oncology Conference featured lively panel discussions on operationalizing CAR T-cell therapy and bispecific antibodies, building sustainable supportive care services, expanding access amid rising patient volumes, as well as presentations from the six 2026 ACCC Innovator Award Winners.
The second day of the 43rd National Oncology Conference (NOC) centered innovation, in both the present and the future of cancer care. The 2026 ACCC Innovator Award Winners shared novel initiatives that are redefining patient care at their institutions, while panel discussions highlighted where the field is going next. From precision medicine to building community trust, the day was filled with actionable insights for the entire care team.
The first panel of the day, moderated by Kirollos Hanna, PharmD, BCPS, BCOP, FACCC, FAPO, FHOPA, Director of Pharmacy at Minnesota Oncology, offered an interactive discussion on the logistical and financial realities of operationalizing chimeric antigen receptor T-cell therapy (CAR T) and bispecific antibodies (BsAbs) across various care settings.
Regarding clinical considerations that had the biggest impact on her program, Zahra Mahmoudjafari, PharmD, MBA, BCOP, FHOPA, Clinical Pharmacy Manager at the University of Kansas Health System, emphasized the need for clear connection points and communication pathways between different departments. "There's no other specialty that brings together disciplines in a way that requires them all to contribute fairly equally to be successful," she said. "No one quite expected it [BsAb therapy] to expand as wide and as quickly as it has.” This rapid acceleration necessitated an operational checklist for Dr. Mahmoudjafari's team, along with regular standardized meeting times with every stakeholder.
For Yonatan S. Resnick, PharmD, Vice President of Pharmacy at New England Cancer Specialists, in the community setting, building cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) monitoring into workflows was top of mind when his team was new to cellular therapy. "We asked ourselves, 'How do we overcome that 24/7, 14-day awareness?' Understanding the internal structure that’s required to create a program that offers safety, consistency, and stakeholder buy-in is critical," he explained.
Panelist Leslie Carlin, PharmD, Lead Specialty Pharmacist, practices at St. Luke’s Cancer Institute—the only program in Idaho that offers stem-cell transplant and CAR T. Her team carefully considered patient-specific factors when designing their program and prioritized thorough caregiver education and support. "As our program continued to grow and our numbers doubled, our need to reach out to patients reduced because patients and caregivers were calling in themselves," she said. "The education was working."
Education among providers and staff across all departments was equally important for several of the panelists. Dr. Mahmoudjafari described a concerted effort at her program to deliver concentrated education on CRS for staff in the emergency department and intensive care unit when rolling out their CAR T program. "When it came time to implement bispecifics, we saw a lot of adjacencies between the two therapies," she said. "You don't have to reinvent the wheel; you can use the pathways that already exist."
Dr. Carlin spoke to the important role of her program's patient navigators and social workers, underscoring the need to get them involved early so they can troubleshoot patient barriers to care, such as the lack of a strong support system at home. Across the board, the panelists agreed that CAR T and BsAbs are no longer novel therapies, but the standard of care that every eligible patient deserves to access.
Whole-person support for patients requires a multidisciplinary approach, but creating a sustainable, scalable model can be daunting. Erin Perejda, MSW, LCSW, OSW-C, Supportive Care Services Manager at Shaw Cancer Center, moderated a panel of experts from four institutions who have successfully operationalized vital services: enhanced suicide screening, outpatient spiritual counseling, fertility preservation, and caregiver support.
For any new supportive care initiative, Donna DiClementi, LCSW, OSW-C, Manager of Outpatient Social Work at Moffitt Cancer Center, noted that there is no one-size-fits-all approach. "You have to be okay with being flexible and adaptable. Implementation is rarely linear," she said. In the case of suicide screening, DiClementi shared that it was a challenge at first to integrate this process into the social worker assessment.
Her team of social workers wanted to work at the top of their license, but many didn't feel that they had adequate training to perform a full suicide risk assessment. But by adding just two questions into the existing workflow, social workers were quickly touching base with far more patients than before and intervening with critical support.
With the implementation of this enhanced screening, Moffitt saw an increase from five suicide risk assessments per month to over 350 initial assessments per month and 50-60 full risk assessments per month. "The data is tremendous," said DiClementi, "but we're still only scratching the surface. It's so important to give social workers the opportunity and the room to have these conversations."
Bill Mejia, LCSW, MSHCM, OSW-C, Director of Cancer Support Services at Lucy Curci Cancer Center, shared his development of an outpatient spiritual care program by building stronger connections with his center's existing chaplain program. Mejia's team created a needs assessment that quickly identified a demand for an on-site spiritual program. From there, they launched a pilot spiritual counseling model, which consisted of six phone sessions and a pre- and post-assessment for distress.
For Mejia, one of the bigger challenges was educating staff about what the chaplain program offered, and how providers could collaborate with these members of the care team. “We had to clarify that this service is not just for end of life or for one particular faith group—it's for everyone," he said.
Scores from pre- and post-assessments yielded about a 40% improvement in spiritual distress since the launch of the pilot program. "Many of our patients, though they're not improving medically, have reported less anxiety and spiritual and emotional distress, and we've received very positive anecdotal feedback," said Mejia.
Dawn Ritzwoller, MPH, Adolescent and Young Adult (AYA) Patient Navigator at Huntsman Cancer Institute, spoke to the importance of integrating onco-fertility early into the care pathway, as fertility preservation is a time-sensitive conversation for AYA patients about to undergo treatment. "They're tasked with making a decision about having children within a few days," she said. "It's not about knowing whether or not they want kids. It's about having the opportunity to make that decision for themselves."
Similar to the chaplain program at Lucy Curci Cancer Center, Ritzwoller shared that fully implementing fertility preservation into the oncology workflow was a challenge because the AYA navigation team was often overlooked, since it was disconnected from the multidisciplinary care team. "What changed the game for us was integrating into the care team by attending tumor boards, sharing information, and being a physical presence in the room," she explained.
As a nonbillable service, demonstrating a financial return on investment for fertility preservation is difficult. "Value isn't always reflected in direct revenue," said Ritzwoller. "We focus on patient outcomes, how many people we're reaching, and quality of care metrics."
Lastly, Laura Polacek, PhD, Clinical Psychologist at the Icahn School of Medicine at Mount Sinai, shared sobering statistics that emphasize the critical—yet often overlooked—role of caregivers in oncology. According to Dr. Polacek, over 50% of caregivers provide medical support at home without training. On average, that constitutes 27 hours of care per week, on top of working full-time, for an average of 5.5 years. Together, this amounts to an estimated$1 trillion in unpaid caregiving work annually in the US.
"With caregiver support, patients are being admitted less often and for less time, with longer life expectancy," she shared. But these outcomes come at a cost, as caregivers report higher rates of depression, PTSD, and significant financial strain.
Gaining institutional buy-in for a dedicated caregiver mental support program proved challenging, as caregiver information used to be built into the patient chart and was therefore not billable as a separate service. To navigate this barrier, each caregiver at Mount Sinai receives a separate medical record number to allow providers to bill for psychotherapy services.
The final panel of the day addressed the reality of rising patient volumes and workforce shortages with practical insights to optimize clinical capacity, led by Anna Rodriguez, MSN, MHA, RN, OCN, NEA-BC, Chief Nursing Officer and Vice President of Nursing and Patient Care Services at Fox Chase Cancer Center.
Facing an institutional shortage of surgeons and subsequent long wait times for surgical appointments for new patients with breast cancer, Ashley Johnson, RN, NP, Outpatient Advanced Practice Provider Manager at Vanderbilt-Ingram Cancer Center, described the creation of the BRAVE (Breast Rapid Access Visit and Education) Program.
"We examined our institutional goal to see new patients within 14 days of a breast cancer diagnosis, and realized with our surgeon turnover, we weren't going to meet them," she said. "The question was not 'How do we get more surgical appointments?' but 'How do we redesign our workflow to accommodate this need?'" The answer was utilizing the existing team of experienced surgical advanced practice providers (APPs) to meet patients for their initial appointment, followed by a consultation with the surgeon weeks later.
While it required a substantial investment in time, training, and the development of tools and scripts for APPs, the initiative reaped the dual benefit of empowering APPs to work at the top of their license and addressing patient needs in a more timely fashion.
Alissa Huston, MD, Co-Medical Director of the Breast Survivorship Program and the Pluta Integrative Oncology and Wellness Center at Wilmot Cancer Institute, also utilized APPs at her program to launch survivorship and high-risk breast clinics. Her team faced the dual challenges of maintaining access for patients with stage 0 and new breast cancer diagnoses, along with turnover in the survivorship program. In answer, her team created an APP-led breast cancer survivorship program with a specialized clinic for high-risk patients that require timely intervention.
"Many of our APPs were already interested in survivorship care, and some had training in areas such as sexual wellness, so it presented an opportunity for them to create a system to address the long-term needs of our survivors," said Dr. Huston.
For panelist Brian Lasonde, PA-C, Advanced Practice Clinician at Palo Alto Medical Foundation, there was no formal survivorship structure in place at his institution. "It often falls to oncologists in surveillance visits to touch on everything in a 20-minute appointment. It doesn't allow time to explain why exercise and healthy eating are important," he said. Lasonde saw an opportunity to meet rising patient volumes by piloting shared medical appointments for survivors, where each patient receives standardized, applicable information.
Patients were receptive to the group appointment structure, and the setting allowed for more social connection and support from others, but patients also reported missing the personalization of a one-on-one visit. Taking this feedback into consideration, Lasonde's team plans to pivot to individual initial survivorship visits, followed by a shared medical appointment for follow-up—an idea each participant in the pilot favored.
Continuing the theme of maximizing timeliness and efficiency in scheduling patient visits, Judy Mushlitz, Director of Central Scheduling at St. Luke’s University Health Network, discussed her program's use of analytics to reliably predict which patients were most likely to miss their upcoming mammography appointments. To combat the high rate of no-shows St. Luke's was experiencing, Mushlitz's team identified patients above the 50% threshold for likelihood to miss an appointment and strategically double-booked at select times in the schedule.
"Though we're not clinicians, we're taking care of the patient too, by listening to them and hearing what they need," she said. "That empathy draws us all together, regardless of the job we are doing."
One of the highlights of NOC each year is the dedicated presentations from the ACCC Innovator Award winners. Each recipient has done exceptional work to advance access, quality, and value in cancer care delivery at their institution, and shared their successful strategies with ACCC’s members.
Understanding the need to bring cutting-edge therapies that have become the standard of care to the outpatient setting, Kathryn E. Kennedy, MSN, APRN, ACNP-BC, AOCNP, Outpatient Hematology APP Team Lead at Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, and Michele Nichols, BSN, BS, RN, Senior Director of Quality Services and Compliance at Mary Bird Perkins Cancer Center, shared their care modelsfor BsAbs and CAR T, respectively.
“The challenge is not the therapy [bispecific antibodies], it is how to get it to people," said Kennedy. Her model is an APP-led coordinated pathway, with care anchored across the treatment episode, ensuring a consistent patient journey begins before the first dose.
"Healing happens best when patients remain connected to their support system," said Nichols, emphasizing the importance of staying close to home while receiving BsAb therapy. "Building a strong caregiver educational component is essential, as the support they give their loved one is key to the success of our program."
At the University of Texas MD Anderson, Cathleen Hernandez-Vita, BSN, RN, ONN-CG, Associate Director of askUTMDAnderson Navigation Services, and Karina Saavedra-Lewis, OPN-CG, MHA, Supervisor of the Pre-Intake Navigation (PIN) Team, saw that patients were experiencing barriers long before their first appointment—in the form of financial and insurance-related barriers.
"The PIN model was designed to identify patients facing these challenges earlier, and it evolved into a proactive navigation model to improve insurance education and early access to care," said Hernandez-Vita.
Theresa W. Gillespie, PhD, MA, FAAN, Professor and Associate Director for Community Outreach and Engagement at Winship Cancer Institute of Emory University, described how an embedded community staff model fundamentally reshaped cancer prevention and control across rural Georgia by funding community partners to hire and supervise local staff who live and work in the communities they serve.
"If you live and work in the community, you know what resources are available, and you bring deep knowledge of the culture, needs, and priorities of that setting," said Dr. Gillespie.
Innovators Laura Perry, RHIT, CRC, Supervisor of Coding; Lacy Sheets, MBA, Director of Patient Financial Navigation; and Wesley Sandvik, RN, BSN, Clinical Documentation Specialist Senior, St. Luke’s Revenue Cycle Operations at St. Luke’s Regional Medical Center, noticed a reliance on non-clinical authorization workflows to interpret clinical guidelines, often leading to treatment delays, provider burden, and costly denials.
“Behind every authorization is a patient waiting, and behind every delay is time they cannot get back,” said Perry. The team devised a new role in denial prevention to solve this operational challenge, designed to put clinical judgment in the right hands and move the review before the denial.
Morgan Gwynn, PharmD, BCOP, CPP, Oncology Clinical Pharmacist Practitioner at the University of North Carolina Medical Center, UNC Lineberger Comprehensive Cancer Center, shared another solution to an operational burden: excessive patient wait times for oncolytic virus treatments. By shifting toxicity assessment, clinical review, and dose planning to pretreatment telemedicine visits, the pharmacist team eliminated unnecessary clinic visits, reduced average treatment time by more than two hours per session, and cut costly drug waste by avoiding unused medications.
"A critical distinction for innovation is differentiating between 'This is how we do it now' and 'This is how we must do it,'" said Dr. Gwynn.
Find more content on the ACCCBuzz Blog and CANCER BUZZ podcast from all six Innovators and discover how to replicate their critical work in other care settings:
Stay tuned for the final blog covering the 43rd National Oncology Conference, featuring panel discussions on precision medicine and policy, a Global eXchange conversation with cancer programs outside the US, and a town hall with ACCC’s membership team.
