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Accreditation/Credit Designation

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 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Acknowledgment of Commercial Support

This activity is supported by educational grants from Celgene Corporation and Foundation Medicine, Inc.

Advances in™ Diagnostic Guidelines for Effective Clinical Decision - Making in the Management of Hematologic Malignancies


Release Date: April 30, 2018
Expiration Date: April 30, 2019
Media: Internet - based

 

Activity Overview

This activity, Advances in™ Diagnostic Guidelines for Effective Clinical Decision-Making in the Management of Hematologic Malignancies, developed in PER’s established Advances in™ legacy format, is designed to highlight the rationale for the use of new diagnostic guidelines in hematologic malignancies, provide expert guidance on the interpretation of emerging strategies derived from improved guidelines, and to forecast future application of novel diagnostic and therapeutic strategies in clinical practice. You will hear expert perspectives (from a pathologist and a hematologist) and discussions of recent diagnostic updates that have the potential to advance the treatment of hematologic malignancies in the context of current treatment paradigms to improve outcomes for your patients. You will have the opportunity to enhance your skills through an interactive mix of evidence-based didactic presentations, cases, and discussion.

Acknowledgement of Commercial Support

This activity is supported by educational grants from Celgene Corporation and Foundation Medicine, Inc.

CME Activity Table of Contents

  • Module 1: Basic Concepts Underlying Molecular Testing
  • Module 2: Spotlight on Molecular Testing Use in Clinical Practice
  • Module 3: How Do You Use Molecular Testing in Your Patients?

Instructions for This Activity and Receiving Credit

  • You will need to login to participate in the activity.
  • Each presentation may contain an interactive question(s). You may move forward through the presentation; however, you may not go back to change answers or review videos/content until you finish the presentation.
  • At the end of the activity, “educational content/video files” will be available for your reference.
  • 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 program is directed toward medical oncologists/hematologists and pathologists who treat patients with hematologic malignancies. Nurses, nurse practitioners, physician assistants and other healthcare professions involved in the treatment and management of hematologic malignancies are also invited to participate in the activity.

Learning Objectives

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

  1. Review current testing strategies for patients with hematologic malignancies
  2. Evaluate emerging mutational analysis guidelines in the context of treatment planning for patients with hematologic malignancies
  3. Apply testing approaches to stratify risk and personalize care in the management of hematologic tumors

Faculty, Staff, and Planners' Disclosures

Faculty

Ahmet Dogan, MD, PhD
Pathologist
Chief, Hematopathology Service,
Departments of Pathology and Laboratory Medicine
Memorial Sloan Kettering Cancer Center
New York, NY

Disclosure: Consultant: Novartis, Celgene, Seattle Genetics, Oncology Specialty Group, Roche, PeerView Institute, Pharmacyclics.

Craig H. Moskowitz, MD
Medical Oncologist
Steven A. Greenberg Chair
Clinical Director, Division of Hematologic Oncology
Memorial Sloan Kettering Cancer Center

Disclosure: Grant/Research Support: Merck, Seattle Genetics. Consultant: Celgene, Genentech, Merck, Seattle Genetics.

The staff of PER® have no relevant financial relationships with commercial interests to disclose.

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, treatment, or management 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™

PER Pulse Recap (1 of 3)

In this continuing medical education (CME)‒certified activity, Advances in™ Diagnostic Guidelines for Effective Clinical Decision Making in the Management of Hematologic Malignancies, Ahmet Dogan, MD, PhD, and Craig H. Moskowitz, MD, discuss recent diagnostic updates that have the potential to advance the treatment of hematologic malignancies in the context of current treatment paradigms to improve outcomes for patients.
 
This first of 3 PER Pulse™ Recaps summarizing the online webcast focuses on the fundamentals of molecular testing technologies, including fluorescence in situ hybridization (FISH), polymerase chain reaction (PCR), and next-generation sequencing (NGS). Below are some highlights from the activity featuring Drs. Dogan and Moskowitz:
  • A broad overview of the known molecular basis of hematologic malignancies, including associated mutations, amplifications/deletions, and translocations, and their relevance to clinical practice
  • A review of the applications and limitations of conventional and state-of-the-art methodologies (eg, FISH, PCR, NGS) used to test for a broad range of molecular abnormalities across many hematologic malignancies
  • Discussion of the importance of panels that assess multiple genetic abnormalities as more targetable and prognostic mutations, for example:
    • A new acute myeloid leukemia (AML) panel tests for 9 genes in a single run with variable full exon, partial region, or hot spot coverage (depending on the specific locus).
    • Targeted capture of DNA and RNA, followed by NGS on 3696 samples, accurately identified a broad range of substitutions, insertions, deletions, copy number alterations, and gene fusions—with similar reliability as lower-throughput assays focused on specific genes and types of molecular alterations.
    • NGS was able to detect translocations not detected by FISH in samples from patients with newly diagnosed myeloma.
    • Use of a 34-gene “lymphopanel” on tumor DNA samples from 215 patients with CD20+ de novo diffuse large B-cell lymphoma (DLBCL) provided a clear depiction of DLBCL subtype molecular heterogeneity, including many targetable and/or prognostic biomarkers.
“Next-generation sequencing (NGS) technologies offer a number of advantages compared to previous modalities of targeted testing. …Within the next 5-10 years, it is believed that NGS-based technologies will replace many of the conventional tests we use in clinical practice.”
 — Ahmet Dogan, MD, PhD

Sources
Dubois S, Viailly PJ, Mareschal S, et al. Next-generation sequencing in diffuse large B-cell lymphoma highlights molecular divergence and therapeutic opportunities: a LYSA study. Clin Cancer Res. 2016;22:2919-2928. doi: 10.1158/1078-0432.CCR-15-2305.
He J, Abdel-Wahab O, Nahas MK, et al. Integrated genomic DNA/RNA profiling of hematologic malignancies in the clinical setting. Blood. 2016;127:3004-3014. doi: 10.1182/blood-2015-08-664649.
Jimenez C, Jara-Acevedo M, Corchete LA, et al. A next-generation sequencing strategy for evaluating the most common genetic abnormalities in multiple myeloma. J Mol Diagn. 2017;19:99-106. doi: 10.1016/j.jmoldx.2016.08.004.
Mayo Clinic. Next-generation sequencing (NGS), acute myeloid leukemia. https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/64692. Accessed August 3, 2018.


PER Pulse Recap (2 of 3)

As a follow-up to this continuing medical education (CME)‒certified activity, Advances in™ Diagnostic Guidelines for Effective Clinical Decision Making in the Management of Hematologic Malignancies, this second of 3 PER Pulse™ Recaps summarizing the online program focuses on the evolving clinical use of molecular testing for hematologic malignancies. Below are some highlights from the activity featuring Drs. Dogan and Moskowitz:
  • An overview of IDH mutation and its relationship with acute myeloid leukemia (AML), including its prevalence among patients and relevance as an actionable mutation
  • Emerging data on IDH inhibitors, including:
    • Promising efficacy and safety data from a phase I trial of single-agent IDH1 inhibitor ivosidenib in a cohort of patients with relapsed/refractory, IDH1-mutated AML, showing durable remissions and a tolerable safety profile
    • Safety data from a phase I trial analyzing standard induction therapy with ivosidenib or IDH2 inhibitor enasidenib in patients with AML demonstrating that the combinations are well tolerated
  • Expert commentary on how best to apply National Comprehensive Cancer Network (NCCN) Guidelines for Hematologic Malignancies, testing approaches for specific hematologic malignancies (including B- and T-cell lymphomas, follicular lymphoma, and marginal zone lymphoma), and emerging mutational analysis guidelines for treatment planning
  • Discussion about the evolving landscape of genetic testing for hematologic malignancies and how best to integrate it into clinical practice, including how to determine which patients would benefit the most
  • The importance of immunophenotyping for non-Hodgkin lymphoma and the role of molecular testing in the management of B- and T-cell lymphomas
“Given the importance of genetic changes for diagnosis, determining prognosis, and predictive therapy response in hematologic malignancies, a number of guidelines have become available to allow physicians engaged in the management of these patients to select appropriate testing and, therefore, develop appropriate management plans for their patients.”
 — Ahmet Dogan, MD, PhD

Sources
DiNardo, CD, et al.  Ivosidenib (AG-120) in mutant IDH1 AML and advanced hematologic malignancies: results of a phase 1 dose escalation and expansion study. Blood. 2017;130:725.
Stein EM. Molecular pathways: IDH2 mutations-co-opting cellular metabolism for malignant transformation. Clin Cancer Res. 2016;22:16-19. doi: 10.1158/1078-0432.CCR-15-0362.
Stein EM, et al. Ivosidenib or enasidenib combined with standard induction chemotherapy is well tolerated and active in patients with newly diagnosed AML with an IDH1 or IDH2 mutation: initial results from a phase 1 trial. Blood. 2017;130:726.


PER Pulse Recap (3 of 3)

As a follow-up to this continuing medical education (CME)‒certified activity, Advances in™ Diagnostic Guidelines for Effective Clinical Decision Making in the Management of Hematologic Malignancies, this third of 3 PER Pulse™ Recaps summarizing the online program focuses on practice-based approaches for using molecular testing for patients with hematologic malignancies. Below are some highlights from the activity featuring Drs. Dogan and Moskowitz:
  • An outlook on the future of molecular testing for hematologic malignancies and gaps that must be filled to make further progress, including the need for more continued research in patients with leukemias and lymphomas and improvements in existing molecular testing technologies
  • The faculty’s approaches to using molecular testing for their patients with hematologic malignancies, and the advantages and importance of next-generation sequencing in clinical practice
  • Expert commentary on the emerging importance of the presence or absence of minimal residual disease (MRD) in the diagnosis and treatment decision making for many hematologic malignancies, including mantle cell lymphoma, chronic lymphocytic lymphoma, and diffuse large B cell lymphoma
“[In the future] one could imagine that you would only do an imaging study in a patient who is MRD-positive. That has real implications in the next couple of years and will change lymphoma practicing.”
 — Craig H. Moskowitz, MD

For additional commentary about these topics and others, visit https://www.gotoper.com/online-cme-activities/ai/ to access more resources from the archived Advances in™ Diagnostic Guidelines for Effective Clinical Decision Making in the Management of Hematologic Malignancies.







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