Bernard Marini, PharmD, BCOP is an Inpatient Hematology Clinical Pharmacist at the University of Michigan and an Associate Professor at the University of Michigan College of Pharmacy. In his practice, he primarily sees patients with acute leukemias, aggressive lymphomas, and other challenging hematologic malignancies.
Please tell us about your research interests and the potential impact of your research on patient care.
My research interests are threefold and all tie into improving the care of patients. First, my research looks to improve outcomes in patients with leukemias and lymphomas, by optimizing the selection of therapies for patients and avoiding unnecessary toxicities. For example, our team has done a lot of work examining the optimal treatment of secondary AML, demonstrating in a multicenter, PharmD-led study, that purine analogue-cytarabine-based combinations (e.g., FLAG) perform as well (if not better) than CPX-351, with a better toxicity profile and lower cost. In addition, we continue to optimize the use of asparaginase, by predicting and avoiding key toxicities, and through risk-factor guided dose adjustments using therapeutic drug monitoring.
My second research area focuses on improving outcomes in immunocompromised patients with infectious diseases – in particular looking at risk factors for specific infections, examining early de-escalation of antibiotic therapy in high-risk patients, and optimizing prophylaxis.
Lastly, my final research area has focused on optimizing precision medicine therapy in patients with pediatric brain tumors. We have developed the CNS Targeted Agent Prediction (CNS-TAP) tool, a decision aid to more objectively choose targeted therapies for brain tumor patients with genetic sequencing results. This tool takes into account pre-clinical and clinical data, pediatric dosing information, and most importantly, blood brain barrier penetration data when selecting therapy. This tool is currently being used to help select therapies in ongoing phase II trials of precision medicine therapy in pediatric brain tumor patients.
Who was your mentor and how did they influence your career path?
This question is really tough because I have had so many excellent mentors throughout the years it is impossible to just pick one person. I’ve gotten really lucky to surround myself by so many supportive and brilliant people who were invested in my career path at the University of Michigan – it was like being a rookie on an all-star team.
I remember being a student on David Frame’s rotation as a student and thinking, “wow, this man is brilliant and they look to him before making ANY decision – he’s basically the attending. I want to be like him.” And through great advice, kindness, and mentorship, David pushed my creativity and critical thinking skills to another level.
As a student, resident, and early clinical specialist, I also had the opportunity to be shaped and guided by other brilliant clinical pharmacists – Shawna Kraft, Shannon Hough, Cesar Alaniz, Randy Regal, Peggy Carver, Jim Stevenson, and many others. Then, during my residency, when Anthony Perissinotti joined the team, I found a fantastic mentor (and heme nerd partner in crime) who pushed me to the next level as a clinical pharmacist. He taught me to question everything, how to be a dynamic presenter, and how to make a career in hematology fun.
What is one of the proudest moments of your career?
One of my proudest moments was when I was awarded the HOPA 2018 Foundation Grant for optimizing precision medicine therapy in patients with pediatric brain tumors using the CNS TAP tool. It was a very exciting project that I was very passionate about and had put a ton of work into, but I didn’t think I had a chance for actual grant funding! It was a great collaborative effort that really moved the CNS TAP tool forward, and I was lucky to have great support by my College of Pharmacy colleagues, my fellow hematology/oncology pharmacists, residents, and MD colleagues as well.
How long have you been a member of and how have you been involved?
I have been a member of HOPA since my PGY2 Oncology Residency in 2013. I have been lucky to give several very fun debate talks at HOPA with phenomenal colleagues. I attend the HOPA Annual Meeting nearly every year, supporting my residents and networking with the many great hematology/oncology colleagues across the country. I have recently been involved on the HOPA Publications Committee working on the “Clinical Pearls” and “Highlights of Allied Meetings” columns.
Oncology pharmacists can have a profound influence on their patients and trainees. What would you like your patients, trainees, and colleagues to know about you?
I would like them to know that being a hematology/oncology pharmacist is one of the most rewarding careers one can have. Being able to work with hematology patients and trying to have an impact on their treatment in any way possible is incredibly rewarding and provides fuel for research, as well as the opportunity for training new excited and passionate hematology/oncology practitioners. It’s important to not forget why we do what we do – it’s for our patients.
Also, I’m a huge nerd, and every day I learn something new - sometimes it doesn’t feel like a job, it’s just fun! Embrace your inner nerd, explore the clinical areas that you find most interesting, and you’ll have a fun and rewarding career.
Finally, hematology/oncology pharmacy is a really small world, filled with brilliant, passionate pharmacists, so we have the unique ability to partner with colleagues across the country to make a tremendous impact on care. I can’t think of a single success I’ve had that was not due to collaborations with colleagues and friends – it’s a team effort!