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Accreditation/ Credit Designation

Physicians' Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This activity is not approved for AMA PRA Category 1 Credit™.

Acknowledgment of Commercial Support

This activity is supported by an educational grant from AstraZeneca.


Community Practice Connections™: Nursing Opportunities to Improve Outcomes in the Application of Immuno-Oncology Strategies: A Practical Approach to Care - PER Pulse™ Recap
PER Pulse™ Recap

Resources

Community Practice Connections™: Nursing Opportunities to Improve Outcomes in the Application of Immuno-Oncology Strategies: A Practical Approach to Care
Earn up to 2.0 AMA PRA Category 1 Credits™
This educational activity is geared toward practical applications of treatment strategies in the clinic. Key data related to a live symposium held at a recent oncology nursing meeting, that focused on the use of immuno-oncology strategies, are now available as downloadable slides. Participants can test their knowledge through interactive clinical vignettes and view short video clips from the faculty to understand expert perspectives on clinical scenarios that are faced in the care of patients when using these novel approaches to treat cancer.

PER Pulse™ Recap
PER Pulse™ Recaps for the Nursing Opportunities to Improve Outcomes in the Application of Immuno-Oncology Strategies: A Practical Approach to Care symposium focus on the expanding array of immune checkpoint inhibitors for patients with cancer and general differences in toxicity and response kinetics compared with standard therapies.



PER Pulse™ Recap

PER Pulse™ Recap


1 of 3
PER Pulse™ Recap
Expanding Availability of Immune Checkpoint Inhibitors in Cancer

The live continuing medical education activity Nursing Opportunities to Improve Outcomes in the Application of Immuno-Oncology Strategies: A Practical Approach to Care featured key oncology nurses and physicians Joanne Riemer, RN, BSN; Karen Matijevich, RN; Patrick Forde, MD; and Jason Luke, MD, FACP, describing approaches to improve the implementation of immunotherapies in patients with cancer. This program featured an overview of data leading to approval of immunotherapies, the unique adverse events and response kinetics of immunotherapies, and managing toxicities of immunotherapy. This first of 3 PER Pulse™ Recaps reviews key approvals of immune checkpoint inhibitors, as discussed by Jason Luke, MD, FACP, and Patrick Forde, MD.

  • Melanoma:
    • Ipilimumab, which targets CTLA-4, became the first of the current immune checkpoint inhibitors to be established, gaining approval in March 2011.
    • Pembrolizumab and nivolumab, both of which target PD-1, both received accelerated approval in late 2014.
    • The combination of nivolumab and ipilimumab received accelerated approval in September 2015.
  • Non–small cell lung cancer (NSCLC):
    • Nivolumab was approved in March 2015 for patients with NSCLC and squamous histology; in October 2015, approval was extended for all histologies of NSCLC.
    • Pembrolizumab received accelerated approval in October 2015 for patients with NSCLC of any histology with PD-L1 expression.
  • Other tumor types: Nivolumab has also been approved for patients with renal cell carcinoma and Hodgkin lymphoma (accelerated approval for the latter); accelerated approval has been granted to the anti-PD-L1 antibody atezolizumab for patients with bladder cancer.

2 of 3
PER Pulse™ Recap
Unique Adverse Events With Immune Checkpoint Inhibitors

The live continuing medical education activity Nursing Opportunities to Improve Outcomes in the Application of Immuno-Oncology Strategies: A Practical Approach to Care featured key oncology nurses and physicians Joanne Riemer, RN, BSN; Karen Matijevich, RN; Patrick Forde, MD; and Jason Luke, MD, FACP, describing approaches to improve the implementation of immunotherapies in patients with cancer. This program featured an overview of data leading to approval of immunotherapies, the unique adverse events and response kinetics of immunotherapies, and managing toxicities of immunotherapy. This second of 3 PER Pulse™ Recaps reviews basic principles regarding immune-related adverse events (irAEs), as discussed by Joanne Riemer, RN, BSN, and Karen Matijevich, RN.

  • Immune checkpoint inhibitors can result in irAEs that affect any organ.
  • Inhibitors of the PD-1 pathway are generally well tolerated, but certain irAEs, including pneumonitis, can be of particular significance in patients with lung cancer.
  • Inhibitors of CTLA-4 are associated with colitis, hypophysitis, uveitis, and dermatitis.
  • The irAEs are included in differential diagnostic procedures and are often diagnosed by exclusion.
  • General proactive approaches include patient assessment before each dose and instructing patients to call upon developing symptoms, including cough, dyspnea, diarrhea, nausea, vomiting, or headaches.
  • A low threshold for consultation with an organ specialist is highly recommended.

3 of 3
PER Pulse™ Recap
Kinetics of Response and Toxicity With Immune Checkpoint Inhibitors

The live continuing medical education activity Nursing Opportunities to Improve Outcomes in the Application of Immuno-Oncology Strategies: A Practical Approach to Care featured key oncology nurses and physicians Joanne Riemer, RN, BSN; Karen Matijevich, RN; Patrick Forde, MD; and Jason Luke, MD, FACP, describing approaches to improve the implementation of immunotherapies in patients with cancer. This program featured an overview of data leading to approval of immunotherapies, the unique adverse events and response kinetics of immunotherapies, and managing toxicities of immunotherapy. This third of 3 PER Pulse™ Recaps reviews general characteristics of response kinetics and general times to categories of irAEs with immune checkpoint inhibitors, as discussed by Joanne Riemer, RN, BSN, and Karen Matijevich, RN.

  • The time to response with immunotherapy can differ from standard approaches, such as chemotherapy and targeted agents.
  • In some cases, radiographic progression may occur prior to tumor response (ie, pseudoprogression):
    • Pseudoprogression is less common in patients with lung cancer (~5%), compared to patients with melanoma.
    • Patient symptoms should also be evaluated, so that pseudoprogression is not confused with real progression; continuation of immunotherapy may be possible if the patient is clinically stable.
  • On average, dermatologic irAEs are the first to occur, generally at 5 to 6 weeks, followed by gastrointestinal toxicities at 6 to 8 weeks.


Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This activity is not approved for AMA PRA Category 1 Credit™.

Supported by an educational grant from AstraZeneca.




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