Author(s):
This is the second blog post in a 6-part series recognizing the achievements of the 2026 ACCC Innovator Award winners before their in-depth sessions at the ACCC 43rd National Oncology Conference. Learn more about the innovations being recognized this year and those who pioneered them by joining ACCC in Boston, Massachusetts, from October 21-23, 2026.
Oncolytic viruses are a novel and effective way to treat cancers by infecting and destroying cancer cells. Currently, there is only one FDA-approved oncolytic virus therapy for the treatment of cancer: talimogene laherparepvec (Imlygic®). The University of North Carolina (UNC) Lineberger Comprehensive Cancer Center is a referral center for Imlygic treatment for advanced melanoma, and its staff has noted that a common pain point for patients receiving this treatment is its extensive time requirement.
Despite being an intratumoral injection that takes only a few minutes to administer, patients were spending an average of three to four hours at the clinic to receive treatment. This was largely due to the lengthy pharmacy prep time needed for Imlygic, which required storage of the virus in a -90°C to -70°C freezer, resulting in up to 70 minutes of thaw time. Additionally, patients had two appointments with their provider: the first to assess tolerance and efficacy and order the doses needed for treatment, and the second to administer the treatment.
To minimize patient time spent at the clinic, UNC Lineberger initiated a new approach. One to four days prior to the scheduled treatment, the patient has a telemedicine visit with the clinical pharmacist practitioner to assess for treatment-related toxicities and signs of response or progression. Based on this assessment, the pharmacist prepares the Imlygic orders for the provider’s review. The day before the patient’s treatment, the pharmacist sends the order to the pharmacy to be prepped in advance, then delivers all premixed doses to a specialized refrigerator in the clinic before 8:00 AM on the day of treatment.
Not only has this protocol reduced appointment length for patients and prep time for pharmacists—it has significantly reduced drug waste. One milliliter vial of Imlygic costs more than $8,000, and UNC Lineberger’s premix process allows its pharmacists to know exactly how much of the drug is needed each day, thus preventing the discarding of vials with the active drug remaining. In anticipation of the ACCC 43rd National Oncology Conference this fall, ACCCBuzz spoke with Morgan Gwynn, PharmD, BCOP, CPP, formerly an Oncology Clinical Pharmacist Practitioner at UNC Lineberger Comprehensive Cancer Center, to learn more about the program.
ACCCBuzz: How long has UNC Lineberger Comprehensive Cancer Center been an ACCC member?
Dr. Gwynn: We’ve been a member since 2019.
ACCCBuzz: What do you enjoy most about being an ACCC member? Are there specific programs, resources, or tools that you use at your cancer program?
Dr. Gwynn: I attended and spoke at the inaugural Carolinas Conference in 2024, which was a joining of the ACCC Oncology State Societies for North Carolina and South Carolina. That was exciting for me because we have some phenomenal cancer programs in both states. Conferences are great opportunities to learn from your colleagues about how they approach different treatment modalities, challenges they’re seeing, and creative solutions they’ve developed to overcome them.
I’ve also been following the ACCC Innovator Awards for years and love seeing the winning programs. In oncology, I think we focus a lot on research-based awards that typically have a more clinical impact on patients, whether that’s a new drug or therapeutic approach. But as a pharmacist, seeing other high-level initiatives succeed that are nurse-, advanced practice provider [APP]-, or pharmacist-led is very inspiring and empowering.
ACCCBuzz: What makes your cancer center unique?
Dr. Gwynn: The state of North Carolina has a clinical pharmacist practitioner license. At UNC, our pharmacists obtain that licensure on top of their existing pharmacist license, which requires extra credentialing, training, and continuing education hours per year. We also have at least one oncology pharmacist embedded in clinics for each cancer type. With that licensure, our pharmacists act as APPs and can prescribe medications. We work closely alongside our physicians and APPs to help manage medication therapy, and it lightens the physicians’ load quite a bit.
For example, if a patient is experiencing chronic pain that is not likely to change due to the treatment they’re on, the physician can manage their cancer and their treatment, and the pharmacist can have a visit with the patient to manage their pain, because that’s already a diagnosed issue. Or for a patient starting oral chemotherapy, the pharmacist can ensure they have all the supportive care medications they’ll need and determine the right dose depending on comorbid conditions and drug interactions.
Having these specialized pharmacists embedded in the clinic really adds to the patient care experience, and it’s such an aid to our physicians and APPs. It’s really inspiring to see the collaboration that happens among these specialties when we all recognize the expertise each person brings and lean on each other for that.
ACCCBuzz: It can be challenging for administrators and C-suite members to share a common language with clinicians and others who provide direct patient care. Can you share any tips you used to obtain buy-in and support for your innovation?
Dr. Gwynn: For those of us who are clinic- and patient-facing, we tend to think of that as our primary goal: How do we improve patient care or the clinic workflow? And while that is important to our administrative counterparts, we have to recognize that they have other things that are important to them as well. They have to consider the financial implications and the business side of health care.
For this innovation, I knew that it would be a huge benefit to the patient with fewer clinic visits and less time spent in appointments. But I also had to think about how it would impact the entire cancer center and whether or not it could be scaled. To that end, mitigating drug waste with this very expensive medication was a huge benefit in cost reduction and improved pharmacy efficiency. Because we’re batch-prepping the drug later in the day at a less busy time, our pharmacists can be more efficient during busy hours to get other medications out.
It was also important to highlight for our administrators how this procedure would result in one less visit for the physician and free up that time. I also spoke to the scalability of the project. Currently, we’re involved in clinical trials for other oncolytic viruses that are not yet FDA-approved. If and when those drugs do become available, we will have a system in place that we can adapt and implement for batch-prepping.
ACCCBuzz: ACCC President Una Hopkins, DNP, MSN, FNP-BC, NE-BC, RN, FACCC, centered her theme on Designing Oncology Care to Meet the Needs of a Growing Patient Population. A key component of that theme is Workforce Empowerment and Enablement, which was key to your innovation. Can you share any insights you’ve learned in this area?
Dr. Gwynn: We made it a point to identify areas where the expertise of a pharmacist would lend itself well to a task or procedure that’s currently a time crunch for physicians. In this case, we noted that there were certain billing issues that arose for our physicians with the pre- and posttreatment visits, in addition to the treatment administration itself. We had done this process for years, but it became clear we needed to revisit it because it wasn’t as efficient as it could be.
We agreed that although a pretreatment assessment is necessary, it didn’t necessarily have to be performed by the physician. As a team, we thought that this is a task a clinical pharmacist is well-equipped to perform; they can assess for toxicities and fitness for treatment and adjust the dosage as needed.
That’s an important question to ask: Is this a role for a registered nurse, a pharmacist, or an APP? Or is this something only a physician can perform? Because there are certainly instances when it must be the physician. But there’s a difference between “This is how we do it now” and “This is how we must do it,” and there are opportunities to have another colleague fill a role while maintaining the same quality of care for the patient. When we think about care in that way, we understand our limitations, but we also identify strengths that can be utilized in creative ways within the multidisciplinary care team.
To learn more about UNC Lineberger’s pharmacist-led care model, join Dr. Gwynn and her fellow 2026 ACCC Innovator Award winners in Boston this October for the 43rd National Oncology Conference.
Understanding both the benefits to be had from offering BsAb therapy to its community and the scope of this undertaking, Vanderbilt-Ingram Cancer Center took a novel approach with its APP-led BsAb step-up dosing clinic, which won the program a 2026 ACCC Innovator Award.
