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

Physicians' Education Resource®, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Resources

PER Pulse™ Recaps highlight key elements of the Oncology Briefings: Updates in Therapeutic Options and Approaches for Tenosynovial Giant Cell Tumors online CME activity.

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Daiichi Sankyo, Inc.

Oncology Briefings™: Updates in Therapeutic Options and Approaches for Tenosynovial Giant Cell Tumors

Release Date: April 28, 2017
Expiration Date: April 28, 2018
Media: Internet - based

 

Activity Overview

The Oncology Briefings™ is an online interactive monograph that will include an overview of the pathophysiology of tenosynovial giant cell tumors (TGCT) in addition to a review of recent data regarding treatments in patients with TGCT, designed to aid physicians in applying those findings to their practices. Commentary by a thought leader, key take-home points, and pearls for practice will place the content into perspective.

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Daiichi Sankyo, Inc.

CME Activity Table of Contents

  • Background of TGCT
  • Current Treatment Approaches for TGCT
  • Emerging Treatment Approaches for TGCT
  • Importance of Multidisciplinary Team and Patient Counseling

Instructions for This Activity and Receiving Credit

  • You will need to login to participate in the activity.
  • This activity contains an interactive question(s). You may move forward through the activity; however, you may not go back to change answers or review content until you finish the activity.
  • At the end of the activity, an “Educational Content” link will be available for you to download content in PDF format for your reference.
  • If you close the Web browser after you complete the activity, the “Educational Content” link will disappear, and you will need to review the activity in its entirety to once again access the link to the educational content.
  • In order to receive a CME certificate, participants must complete the activity.
  • Complete the posttest and pass with a score of 70% or higher, complete the evaluation and then click on request for credit. Participants may immediately download a CME certificate upon completion of these steps.

Target Audience

This educational initiative is directed toward medical oncologists, surgeons, rheumatologists, and hematologists who treat patients with TGCT. Nurse practitioners, nurses, physician assistants, pharmacists, researchers, fellows, and other healthcare professionals interested in the treatment of such malignancies will also be invited to participate.

Learning Objectives

At the conclusion of this activity, you should be better prepared to:

  1. Identify recent advancements in the understanding of TGCT pathogenesis
  2. Evaluate current clinical trial efficacy and safety data of novel pharmacologic therapies for TGCT
  3. Develop evidence-based treatment plans for the various forms of TGCT
  4. Describe the role of multidisciplinary management as a best practice to optimize outcomes for patients with TGCT

Faculty, Staff, and Planners' Disclosures

Faculty

William D. Tap, MD
Chief, Sarcoma Medical Oncology Service
Memorial Sloan Kettering Cancer Center
New York, NY
 
 

Disclosure: Consultant: Daiichi Sankyo and Plexxikon.

Disclosure Policy and Resolution of Conflicts of Interest (COI)

As a sponsor accredited by the ACCME, it is the policy of PER® to ensure fair balance, independence, objectivity, and scientific rigor in all of its CME activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME activity to disclose all relevant financial relationships with commercial interests. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that creates a COI.

Additionally, PER® is required by ACCME to resolve all COI. PER® has identified and resolved all COI prior to the start of this activity by using a multistep process.

Off-Label Disclosure and Disclaimer

This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical and nursing education purposes only, and is not meant to substitute for the independent clinical judgment of a physician relative to diagnostic or treatment options for a specific patient’s medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER®.

PER Pulse™ Recap


Pathogenesis and Prevalence of TGCT

The online Oncology Briefings™ CME activity, Updates in Therapeutic Options and Approaches for Tenosynovial Giant Cell Tumors, provides oncologists and other healthcare professionals with an engaging presentation on the current and evolving treatment standards in tenosynovial giant cell tumors (TGCTs).

Leading expert William D. Tap, MD, medical oncologist and chief of the Sarcoma Medical Oncology Service at Memorial Sloan Kettering Cancer Center, New York, NY, answers key questions supported by the presentation of clinical science about TGCTs. This first of 3 PER Pulse™ Recaps from this program focuses on the pathology of TGCTs and their prevalence in patient populations.

Dr. Tap discussed the underlying genetic features of TGCTs, and provided his expert perspective on the disease’s prevalence and diagnosis. Key takeaways from Dr. Tap include:

  • Tenosynovial giant cell tumors are characterized by the presence of different cytogenetic rearrangements, including the translocation of the 1p11-13 region affecting the expression of CSF1, a tyrosine kinase receptor, and its ligand CSF1R, as well as the translocation of the 2q37 locus involving the COL6A3 gene.
  • Tenosynovial giant cell tumors are a fairly rare disease, with an incidence of 1.8 cases per million individuals. Dr. Tap expressed his concern that many people are simply unaware that they have TGCT, and remain untreated. Some estimations put the incidence rate as high as 49.7 cases per million.
  • Tenosynovial giant cell tumors can be difficult to properly diagnose due to their shared signs and symptoms with other, more common diseases. Dr. Tap posited that many patients are misdiagnosed with other rheumatological conditions, resulting in increased patient frustration and suffering.
  • Proper diagnosis of TGCT includes examination of histological features, including synovial hypertrophy with subsynovial mononuclear histiocytic reaction, as well as the presence of scattered giant cells and other specific signs. Immunohistochemical markers observed in TGCT include CD68, CD45, CD163, and CD681.

For additional information and commentary on this topic, as well as audio and supporting text, visit http://www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefings-updates-in-therapeutic-options-and-approaches-for-tenosynovial-giant-cell-tumors.

For information on other topics, visit www.gotoper.com.



2 of 3
PER Pulse™ Recap

Current Treatment and Management Strategies in TGCT

The online Oncology Briefings™ CME activity, Updates in Therapeutic Options and Approaches for Tenosynovial Giant Cell Tumors, provides oncologists and other healthcare professionals with an engaging presentation on the current and evolving treatment standards in tenosynovial giant cell tumors (TGCTs).

Leading expert William D. Tap, MD, medical oncologist and chief of the Sarcoma Medical Oncology Service at Memorial Sloan Kettering Cancer Center, New York, NY, answers key questions supported by the presentation of clinical science about TGCT. This second of 3 PER Pulse™ Recaps from this program focuses on the treatment and management strategies considered standard in the field of TGCT.

Dr. Tap elaborated on the standard treatment options and outcomes for TGCT, depending on their location, as well as the role of radiotherapy in treating TGCT. Key takeaways from Dr. Tap include:

  • The recurrence rate for TGCT after treatment may be as high as 50%, and the disease is considered difficult to cure with the passage of time. Treatment for TGCT varies on the location of the tumor, and options are limited due to lack of specific clinical data.
  • Surgery is considered the gold standard of treatment for TGCT. Synovectomy may be either partial or complete, and while both arthroscopic surgery and open surgical excision may be performed, a decreased recurrence rate has been reported with the more invasive, open surgical excision.
  • Dr. Tap expanded on some controversy surrounding the use of radiation in conjunction with synovectomy, specifically the use of 90-Yttrium-labelled colloid. Although the relapse rate for TGCT with radiosynovectomy is 30% for tumors of the knee and significantly lower for tumors of other locations, potential for secondary disease is a risk that many physicians do not take.

For additional information and commentary on this topic, as well as audio and supporting text, visit http://www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefings-updates-in-therapeutic-options-and-approaches-for-tenosynovial-giant-cell-tumors.

For information on other topics, visit www.gotoper.com.


3 of 3
PER Pulse™ Recap

Emerging Treatment and Management Strategies in TGCT

The online Oncology Briefings™ CME activity, Updates in Therapeutic Options and Approaches for Tenosynovial Giant Cell Tumors, provides oncologists and other healthcare professionals with an engaging presentation on the current and evolving treatment standards in tenosynovial giant cell tumors (TGCTs).

Leading expert William D. Tap, MD, medical oncologist and chief of the Sarcoma Medical Oncology Service at Memorial Sloan Kettering Cancer Center, New York, NY, answers key questions supported by the presentation of clinical science about TGCT. This third and final PER Pulse™ Recap from this program focuses on the emerging treatment and management strategies in the field of TGCT.

Dr. Tap detailed emerging treatment options for patients with TGCT, including immunotherapy and systemic targeted therapy options. The importance of a multidisciplinary team was also stressed. Key takeaways from Dr. Tap include:

  • The biology of TGCT has been increasingly understood, resulting in rational drug design and development. Macrophages and inflammatory cytokines, such as TNF-α, have been found in the synovium of affected patients. As such, immunotherapy treatments with TNF-α‒blocking agents are being investigated.
  • Systemic targeted therapy of the CSF1-CSF1R axis is also being investigated. Imatinib has been reported to block CSF1R activation. In affected patients, it almost universally reduced pain. Further, nearly three-quarters of patients had stable disease, and almost 5% reached complete remission under imatinib treatment.
  • Pexidartinib, an oral inhibitor of CSF1R, has shown response or stable disease in over 80% of patients and an overall response rate more than double that of imatinib in separate studies. Dr. Tap expressed the anticipation within the field of the results from the phase 3 ENLIVEN study investigating this agent. Other targeted drugs under investigation include nilotinib and emactuzumab.

For additional information and commentary on this topic, as well as audio and supporting text, visit http://www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefings-updates-in-therapeutic-options-and-approaches-for-tenosynovial-giant-cell-tumors.

For information on other topics, visit www.gotoper.com.







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