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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.

Physicians' Education Resource®, LLC, is approved by the California Board of Registered Nursing, Provider #16669, for 1.5 Contact Hours.

Resources

PER Pulse™ Recaps highlight key elements of the Community Practice Connections™: The Next Generation in Renal Cell Carcinoma Treatment: An Oncology Nursing Essentials Workshop online CME activity.

Acknowledgement of Commercial Support

This activity is supported by educational grants from Exelixis, Inc. and Prometheus Laboratories Inc.

Community Practice Connections™: The Next Generation in Renal Cell Carcinoma Treatment: An Oncology Nursing Essentials Workshop

Release Date: July 31, 2017
Expiration Date: July 31, 2018
Media: Internet - based

 

Activity Overview

Community Practice Connections™: The Next Generation in Renal Cell Carcinoma Treatment: An Oncology Nursing Essentials Workshop features a summary of clinical evidence guiding best practices in the treatment of patients with metastatic renal cell carcinoma (mRCC) over multiple lines of therapy and case-based discussions of adverse event management with targeted agents and immunotherapy. Interactive clinical vignettes are followed by short video interviews with leading experts in the management of patients with mRCC. The video interviews address decision points in the clinical vignettes, as well as questions commonly faced in the community oncology practice setting by nursing professionals engaged in the care of patients with mRCC.

Acknowledgement of Commercial Support

This activity is supported by educational grants from Exelixis, Inc. and Prometheus Laboratories Inc.

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/CE 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/CE certificate upon completion of these steps.

Target Audience

This educational activity is directed toward nurses and other healthcare professionals who manage and/or treat patients with mRCC.

Learning Objectives

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

  1. Explain the mechanistic rationale that underlies targeted drug development for the treatment of RCC
  2. Report major findings from landmark clinical trials in advanced RCC and how evidence informs sequencing and switching among different treatment strategies
  3. Apply best nursing practices to proactively manage treatment-related toxicities in patients with RCC
  4. Evaluate case-based clinical scenarios to determine optimal treatment strategies and methods to mitigate treatment-related toxicities when managing advanced RCC in multiple lines of care
  5. Summarize next steps in RCC research and ongoing clinical trials whose results are highly anticipated in the field

Faculty, Staff, and Planners' Disclosures

Faculty

Laura S. Wood, RN, MSN, OCN
Renal Cancer Research Coordinator
Cleveland Clinic Taussig Cancer Institute
Cleveland, OHLaura S. Wood, RN, MSN, OCN
Renal Cancer Research Coordinator
Cleveland Clinic Taussig Cancer Institute
Cleveland, OH

Disclosure: Speakers Bureau: Exelixis, Bristol Myers Squibb, Pfizer

Robert Figlin, MD
Steven Spielberg Family Chair in Hematology-Oncology
Professor of Medicine and Biomedical Sciences
Director, Division of Hematology Oncology
Deputy Director, Integrated Oncology Service Line
Deputy Director, Samuel Oschin Comprehensive Cancer Institute
Cedars-Sinai Medical Center
Los Angeles, CA

Disclosure: No relevant financial relationships to disclose

Nancy P. Moldawer RN, MSN
Samuel Oschin Comprehensive Cancer Institute
Research Program Coordinator
Cedars Sinai- Medical Center
Los Angeles, CA
 

Disclosure: Speakers Bureau: Exelixis Inc.

Virginia J. Seery, MSN, RN, ANP-BC
Nurse Practitioner
Beth Israel Deaconess Medical Center
Boston, MA
 
 

Disclosure: No relevant financial relationships to disclose

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/CE activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME/CE 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/CE 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/CE activity is for continuing medical and nursing education purposes only, and is not meant to substitute for the independent clinical judgment of a physician or nurse 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


1 of 3
PER Pulse™ Recap

First-Line Therapy for Patients With Metastatic Renal Cell Carcinoma

The live continuing education activity The Next Generation in Renal Cell Carcinoma Treatment: An Oncology Nursing Essentials Workshop featured key oncology nurses and physicians Laura S. Wood, RN, MSN, OCN; Nancy P. Moldawer RN, MSN; Virginia J. Seery, MSN, RN, ANP-BC; and Robert Figlin, MD, discussing the changing therapeutic landscape for patients with renal cell carcinoma (RCC). This program featured an overview of current treatment approaches, including targeted therapies and immunotherapy, as well as key considerations for managing the adverse events associated with therapy. This first of 3 PER PulseTM Recaps reviews treatment options for patients with newly diagnosed, metastatic RCC.

  • The discovery that RCC is associated with inappropriate signaling through the vascular endothelial growth factor (VEGF) pathway and the mechanistic target of rapamycin (mTOR) pathway led to the development of targeted agents to inhibit these molecules.
  • Category 1 recommendations in national guidelines for newly diagnosed patients include inhibitors of the VEGF receptor (pazopanib, sunitinib), antibodies to VEGF (bevacizumab plus interferon), and inhibitors of mTOR (temsirolimus for poor-prognosis patients).
  • Cabozantinib, which is currently approved for previously treated patients, has been directly compared with sunitinib as first-line therapy in the phase 2 CABOSUN trial. The primary endpoint of progression-free survival was superior in the cabozantinib arm, leading to filing of a supplemental New Drug Application with the US Food and Drug Administration.

For additional commentary about this topic and the The Next Generation in Renal Cell Carcinoma Treatment: An Oncology Nursing Essentials Workshop symposium, please visit www.gotoper.com.


2 of 3
PER Pulse™ Recap

Management of Patients With Previously-Treated, Metastatic Renal Cell Carcinoma

The live continuing education activity The Next Generation in Renal Cell Carcinoma Treatment: An Oncology Nursing Essentials Workshop featured key oncology nurses and physicians Laura S. Wood, RN, MSN, OCN; Nancy P. Moldawer RN, MSN; Virginia J. Seery, MSN, RN, ANP-BC; and Robert Figlin, MD, discussing the changing therapeutic landscape for patients with renal cell carcinoma (RCC). This program featured an overview of current treatment approaches, including targeted therapies and immunotherapy, as well as key considerations for managing the adverse events associated with therapy. This second of 3 PER PulseTM Recaps reviews subsequent lines of therapy for patients with metastatic RCC.

  • In the post–targeted therapy setting, the mechanistic target of rapamycin inhibitor everolimus became a standard of care based on the RECORD-1 trial, and subsequently became the reference regimen for the development of next-generation therapies.
  • The immune checkpoint inhibitor nivolumab received regulatory approval based on superior overall survival (OS) compared with everolimus in the phase III CheckMate 025 trial, although there was no significant difference in progression-free survival (PFS).
  • Subsequently, the phase III METEOR trial demonstrated superior PFS and OS with cabozantinib compared with everolimus, leading to approval.
  • The combination of lenvatinib and everolimus was also approved for previously treated patients based on a phase II trial comparing the combination to single-agent everolimus.

For additional commentary about this topic and the The Next Generation in Renal Cell Carcinoma Treatment: An Oncology Nursing Essentials Workshop symposium, please visit www.gotoper.com.


3 of 3
PER Pulse™ Recap

Managing Adverse Events in Patients With Renal Cell Carcinoma

The live continuing education activity The Next Generation in Renal Cell Carcinoma Treatment: An Oncology Nursing Essentials Workshop featured key oncology nurses and physicians Laura S. Wood, RN, MSN, OCN; Nancy P. Moldawer RN, MSN; Virginia J. Seery, MSN, RN, ANP-BC; and Robert Figlin, MD, discussing the changing therapeutic landscape for patients with renal cell carcinoma (RCC). This program featured an overview of current treatment approaches, including targeted therapies and immunotherapy, as well as key considerations for managing the adverse events associated with therapy. This third of 3 PER PulseTM Recaps summarizes commentary from the experts in this activity for mitigating and managing adverse events in patients with metastatic RCC.

  • Although inhibitors of the vascular endothelial growth factor receptor (VEGFR) and the mechanistic target of rapamycin (mTOR) are targeted agents, they have distinct toxicity profiles. Adverse events associated with mTOR inhibitors include pneumonitis, hyperglycemia, and hypercholesterolemia, while VEGFR inhibitors are associated with hand-foot syndrome, diarrhea, and hypertension.
    • For mTOR inhibitors, patients should be monitored for shortness of breath and cough.
    • li<>In terms of VEGFR inhibitor–associated hypertension, daily blood pressure monitoring is recommended, along with providing the patient with specific systolic and diastolic readings that would prompt alerting the health care team.
  • Diarrhea is a toxicity that occurs with targeted agents as well as immunotherapy. However, the mechanism is different; while steroids are rarely required for diarrhea associated with targeted agents, steroids are routinely used for immunotherapy-associated diarrhea. Given that both targeted agents and immunotherapy are used in the continuum of care for patients with metastatic RCC, it is important to educate the patient in this area.
  • For immune-related adverse events (irAEs), a given symptom may not seem severe, but might be the sign of a life-threating side effect. Therefore, it is important to recognize and quickly report irAEs. Furthermore, it is ideal to call during a time of day that would allow clinical staff familiar with the patient to address the symptoms.

For additional commentary about this topic and the The Next Generation in Renal Cell Carcinoma Treatment: An Oncology Nursing Essentials Workshop symposium, please visit www.gotoper.com.







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