The disciplines of oncology, clinical pharmacology, and hepatology have seen rapid growth in their respective literatures that deal with new antitumour agents; pharmacokinetics, pharmacodynamics and pharmacogenomics of cancer therapies; and the liver as a key organ in metabolism of these therapies as well as a frequent target of toxicity. The challenge for physicians caring for oncology patients is to integrate an understanding of this literature with practical considerations of how to prevent, diagnose and treat hepatobiliary problems that arise in the midst of therapy.

The use of specialty pharmacies is expanding in oncology pharmacy practice. Specialty pharmacies provide a channel for distributing drugs that, from the payor perspective, creates economies of scale and streamlines the delivery of expensive drugs. Proposed goals of specialty pharmacy include optimization of pharmaceutical care outcomes through ensuring appropriate medication use and maximizing adherence, and optimization of economic outcomes through avoiding unwarranted drug expenditure. In oncology practice, specialty pharmacies have become a distribution channel for various agents. The use of a specialty pharmacy, and the addition of the pharmacist from the specialty pharmacy to the health care team, may not only provide benefits for care but also present challenges in oncology practice. The NCCN Specialty Pharmacy Task Force met to identify and examine the impact of specialty pharmacy practice on the care of people with cancer, and to provide recommendations regarding issues discussed. This report provides recommendations within the following categories: education and training of specialty pharmacy practitioners who care for individuals with cancer, coordination of care, and patient safety. Areas for further evaluation are also identified.