Meet Neil Masters, Highly Specialist Advanced Oncology Pharmacist at Sheffield Teaching Hospitals, and find out more about his professional development, and the impact of genomics on his role.
Name: Neil Masters
Job: Highly Specialist Advanced Oncology Pharmacist
Professional Development to date:
I have been an Oncology Pharmacist since 2005 and have worked at Sheffield Teaching Hospitals since 2012. I was the principal pharmacist for cancer services at the trust until May 2022, when I started my current role working within the breast cancer team in a newly created Consultant Pharmacist post. I am currently undertaking Royal Pharmaceutical Society credentialing and working closely alongside medical colleagues in managing patients with early and metastatic breast cancer.
How does genomics impact on your role?
Applying genomic information to inform treatment selection is an integral part of my role within the breast cancer team. Most cases of breast cancer are driven by a unique set of tumour (somatic) mutations acquired during an individual’s lifetime. Some mutations are more commonly found in breast cancer compared to other cancer types, e.g. oestrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) protein amplifications. It’s important to note that a smaller proportion of breast cancers are attributed to predisposition (germline) genetics, e.g. BRCA1 and BRCA2 genes. Identifying genomic changes in a person’s tumour allows us to target treatments and block proteins driving tumour growth.
Additionally, within my practice I routinely review DPYD pharmacogenomic test results when clinically screening fluoropyrimidine based chemotherapy prescriptions. This genomic test works by identifying specific genetic variants in the DPYD gene, and can be used to indicate if an individual lacks the enzyme responsible for breaking down fluoropyrimidine based chemotherapy. DPYD gene testing can help identify people who are at an increased risk of experiencing treatment-related toxicity and inform a tailored treatment approach e.g a lower dose or alternative type of treatment .
How can genomics support tailoring of patient’s treatment?
Another example of how genomics can inform treatment options is tumour profile testing (such as Oncotype DX). In early breast cancer, molecular tumour profiling can be used to predict benefit from chemotherapy treatment and help identify patients who are likely to benefit from adjuvant chemotherapy and avoid treatment for those who may derive little to no benefit. In certain circumstances predicted chemotherapy benefit is less certain, and some patients can find weighing risks against benefits a difficult decision.
How do you envision the role of genomics in oncology pharmacy evolving in the next decade?
Genomics will without doubt continue to be an integral part of the oncology pharmacist’s role and its important oncology pharmacists have the knowledge, skills and experience to utilise genomic technologies. Genomics will likely change the way we traditionally think about developing medicines and design of clinical trials, as well as influence the way treatment choices are funded.
What advice/educational resources would you recommend for aspiring oncology pharmacists interested in specialising in genomics?
My advice is to stay abreast of new developments in genomics in oncology through educational events, CPD opportunities and British Oncology Pharmacy Association (BOPA) resources.
My top resources are:
BOPA Genomics Primer Part One – BOPA – This resource is available for free to BOPA associates and covers the fundamentals genomics and personalised treatment for cancer patients.
Oncology — In the Clinic (hee.nhs.uk). – This is a new ‘just in time’ education resources designed to help healthcare professionals make the right genomic decisions at each stage of a clinical pathway.