In recognition of National Cancer Survivors Month, we spoke with Amir Ali, PharmD, BCOP, a hematology and oncology therapy clinical pharmacist at the USC Norris Comprehensive Cancer Center. As committed to fostering future pharmacists as he is to patient care, Ali is an adjunct assistant professor at USC Mann and directs the USC Mann postgraduate year two (PGY-2) oncology pharmacy residency program at Norris. In these capacities, he has mentored numerous USC Mann students through research projects and residencies.
Can you walk us through a typical day as an oncology pharmacist?
My day begins with independently working up patients, reviewing their medical history, labs and therapy plans. Once the clinic opens, I begin seeing patients to provide medication counseling, education on therapies and supportive care planning. I also assist with multidisciplinary rounds and monitor for toxicities, evaluate drug-drug interactions and proactively manage complications. Every day is a balance of patient-centered care, education, research and system-level innovation.
What inspired you to specialize in oncology pharmacy, and what advice do you have for students considering this field?
Interestingly, during my time at University of California, San Francisco, I didn’t enjoy the oncology course. I found the material overwhelming and convoluted. It wasn’t until my clinical rotations and shadowing oncology pharmacists that I truly appreciated the impact we can make. Witnessing pharmacists help patients navigate some of the most difficult moments of their lives made a lasting impression on me. That experience fueled my decision to pursue a PGY2 residency in oncology—which led to my passion for teaching.
Why do you think oncology pharmacy is increasingly popular as a specialization?
What makes this field especially attractive is its versatility. Oncology pharmacists can work in inpatient, outpatient, ambulatory, investigational drug services, academia, payor side, the pharmaceutical industry and more. The global rise in cancer rates has also created an urgent demand for pharmacists trained to manage complex and costly therapies, making this an exciting and essential area to specialize in.
How do oncology pharmacists collaborate with other healthcare professionals?
Oncology pharmacists are integral members of the multidisciplinary team, collaborating with physicians, nurses, dietitians and case managers to optimize care plans, help with transitions of care and identify appropriate treatment options. We participate in daily rounds, provide drug therapy recommendations, manage supportive care and counsel patients on their regimens. Beyond the direct care, we assist with clinical trials, conduct real-world evidence studies and complete insurance appeals to help patients access high-cost therapies. We also serve on bone marrow transplant patient and donor selection committees, where we contribute pharmacologic expertise to eligibility discussions.
Pharmacists are often involved in hospital pharmacy and therapeutics committees, playing a key role in formulary decisions and institutional initiatives, especially when it comes to managing expensive oncology therapies—such as cellular therapies that can cost $2 million to $3 million. Our input is critical in balancing clinical benefit with financial sustainability for the health system.
What unique skills or qualities are essential for success in oncology pharmacy?
You need a strong foundation in clinical knowledge, critical thinking and adaptability. Staying up to date is crucial because the oncology landscape changes rapidly with frequent Food and Drug Administration approvals and evolving guidelines.
While the field is incredibly rewarding, it can be emotionally intense. You will see patients—including young adults and children—facing devastating diagnoses. Being able to support them, while also staying focused and objective, requires emotional strength and maturity. Finally, working well in teams and having a commitment to lifelong learning are key, as collaboration and continuous education are at the heart of oncology pharmacy practice.
Can you share a memorable experience or case that shaped your perspective on patient care?
One of the most impactful cases in my career involved a 21-year-old woman with acute myeloid leukemia who had exhausted all standard therapies. Her disease was rapidly progressing, and she was preparing to transition to hospice. I reviewed her case and was able to identify a clinical trial that matched her disease profile. She was enrolled and ultimately achieved a complete remission.
Today, she is cured of AML. This experience underscored the powerful role pharmacists can play not only in managing therapy but also in helping identify lifesaving options for patients who may feel out of time. It reminded me why I chose this field—to offer hope when it feels like there is none.
What advances or emerging trends in oncology pharmacy are you most excited about?
The future of oncology pharmacy is incredibly promising. Personalized medicine, including genomically driven therapies, is revolutionizing how we treat cancer. Cellular therapies like chimeric antigen receptor t-cell (CAR-T) and tumor-infiltrating lymphocyte (TIL) therapies are offering curative options where none previously existed. The integration of AI into clinical decision making is also a trend with significant potential to improve patient outcomes.
As pharmacists, we have a critical role in implementing these innovations safely and effectively. We help design treatment protocols, educate providers and patients, monitor for adverse effects and assess outcomes. Our ability to adapt to new therapies and guide institutions in their safe adoption positions us as key leaders in this evolving space.
What early steps can pharmacy students take to prepare for a career in oncology pharmacy?
Take advantage of elective rotations in hematology/oncology and pursue shadowing opportunities with oncology pharmacists to gain early exposure. Participating in oncology-related research projects and attending professional conferences can help develop a deeper understanding of the field and build your professional network.
Subscribing to the FDA’s oncology drug approvals list and listening to oncology podcasts can also help students stay informed about the latest therapies. Finally, connecting with mentors and asking questions about the field can open doors and provide direction as you shape your path. Oncology pharmacy is a challenging but deeply fulfilling career, and early engagement can make a world of difference.
—David Zong