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 2.0 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 Eisai Inc., Exelixis, Inc., and Prometheus Laboratories Inc.

Community Practice Connections®: Medical Crossfire®: Crossroads in Advanced RCC Decision- Making: With Many Options, How Will You Treat Your Patient Today?... And Tomorrow?


Release Date: March 29, 2019
Expiration Date: March 29, 2020
Media: Internet - based

Activity Overview

Community Practice Connections®: Medical Crossfire®: Crossroads in Advanced RCC Decision-Making: With Many Options, How Will You Treat Your Patient Today?... And Tomorrow? is a case-based, interactive, online CME activity based on a live symposium that was held adjunct to the 2019 Genitourinary Cancers Symposium in San Francisco. Clinical decision-making in the setting of metastatic renal cell carcinoma (mRCC) has been undergoing dramatic change. The approval of new systemic agents has expanded the lines of therapy available to patients, and raised questions about how rational treatment planning and effective sequencing of new and older standards of care can optimize patient outcomes. Additionally, the benefit of real-world experience and data from subgroup analyses and long-term follow-up of landmark clinical trials continue to refine treatment strategies in RCC.

This program consists of a series of interactive clinical vignettes and short video interviews with leading experts in renal cell carcinoma (RCC). The video interviews address decision points in the clinical vignettes, as well as questions commonly faced in the community oncology practice setting.

Acknowledgement of Commercial Support

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

Instructions for This Activity and Receiving Credit

  • You will need to log in 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 audio files/content until you finish the presentation.
  • At the end of the activity, educational content/audio files will be available for your reference.
  • In order to receive a CME/Ce certificate, you 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.” You may immediately download a CME/CE certificate upon completion of these steps.


Target Audience

This educational program is directed toward medical oncologists, surgical oncologists, radiation oncologists, and urologists involved in the treatment of RCC. Nurse practitioners, physician assistants, nurses, and other healthcare professionals interested in the treatment and management of patients with RCC are also invited to participate.

Learning Objectives

Upon successful completion of this activity, you should be better prepared to:

  • Explain the biologic factors that drive renal cell carcinoma (RCC) and provide the rationale for using targeted agents and immunotherapies as single agents and in combination
  • Evaluate practice-changing and emerging data from RCC clinical trials across the advanced disease continuum
  • Apply best practices to proactively identify and mitigate treatment-related toxicities related to therapy for metastatic RCC
  • Integrate knowledge of patient characteristics, as well as the efficacy and safety of single-agent and combination systemic therapies, into clinical decision-making for patients with metastatic RCC

Faculty, Staff, and Planners’ Disclosures

Laurence Albiges
Laurence Albiges, MD, PhD
Head, Genitourinary Oncology Unit
Department of Cancer Medicine
Gustave Roussy Institute
Villejuif, France

Disclosures: Consultant: Novartis, AMGEN, BMS, Ipsen, Roche, Pfizer, Astellas, Merck.

Toni K. Choueiri
Toni K. Choueiri, MD
Director, Lank Center for Genitourinary Oncology
Dana-Farber Cancer Institute
Professor of Medicine
Harvard Medical School
Boston, MA

Disclosures: Grant/Research Support: AstraZeneca, Alexion, Bayer, Bristol-Myers Squibb/ER Squibb and Sons LLC, Cerulean, Eisai, Foundation Medicine, Exelixis, Ipsen, Tracon, Genentech, Roche, Roche Products Limited, F. Hoffmann-La Roche, GlaxoSmithKline, Lilly, Merck, Novartis, Peloton, Pfizer, Prometheus Labs, Corvus, Calithera, Analysis Group, Sanofi/Aventis, Takeda; Consultant: AstraZeneca, Alexion, Sanofi/Aventis, Bayer, Bristol-Myers Squibb/ER Squibb and Sons LLC, Cerulean, Eisai, Foundation Medicine, Exelixis, Genentech, Heron Therapeutics, Lilly, Roche, GlaxoSmithKline, Merck, Novartis, Peloton, Pfizer, EMD Serono, Prometheus Labs, Corvus, Lilly, Ipsen, Up-to-Date, NCCN, Analysis Group; Other: Honoraria: AstraZeneca, Alexion, Sanofi-Aventis, Bayer, Bristol-Myers Squibb/ER Squibb and Sons LLC, Cerulean, Eisai, Foundation Medicine, Exelixis, Genentech, Roche, Roche Products Limited, F. Hoffmann-La Roche, GlaxoSmithKline, Merck, Novartis, Peloton, Pfizer, EMD Serono, Prometheus Labs, Corvus, Ipsen, Up-to-Date, NCCN, Analysis Group, NCCN, NEJM, Lancet Oncology, Heron Therapeutics, Lilly.

Sumanta K. Pal
Sumanta K. Pal, MD
Assistant Clinical Professor
Department of Medical Oncology & Therapeutics Research Co-Director, Kidney Cancer Program
City of Hope Comprehensive Cancer Center
Duarte, CA

Disclosures: Consultant: Pfizer, BMS, Exelixis, Novartis, Ipsen, GSK, Astellas, Medivation; Speakers Bureau: Genentech.

Thomas Powles
Thomas Powles, MBBS, MRCP, MD
Clinical Professor of Genitourinary Oncology (HCC) Experimental Cancer Medicine Centre
Barts Cancer Institute
Barts and The London School of Medicine and Dentistry
London, United Kingdom

Disclosures: Grant/Research Support: MSD, AstraZeneca, Roche; Other: Honoraria: BMS, Merck, Roche, AstraZeneca, Novartis, Pfizer, Ipsen, MSD.

Disclosure Policy and Resolution of Conflicts of Interest (COI)

As a sponsor accredited by the Accreditation Council for Continuing Medical Education (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 create a COI. Additionally, PER® is required by the ACCME to resolve all COI. We have 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 uses 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, and 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® or any of the companies that provided commercial support for this activity.

PER Pulse™ Recaps

1 of 3
Insights From Thomas Powles, MBBS, MRCP, MD—PER Pulse Recap:
Community Practice Connections: Medical Crossfire®: Crossroads in Advanced RCC Decision Making: With Many Options, How Will You Treat Your Patient Today?... And Tomorrow?

In the continuing medical education–certified activity, Community Practice Connections: Medical Crossfire®: Crossroads in Advanced RCC Decision Making: With Many Options, How Will You Treat Your Patient Today?... And Tomorrow?, expert faculty—including Laurence Albiges, MD, PhD; Toni K. Choueiri, MD; Robert Figlin, MD; Sumanta K. Pal, MD; and Thomas Powles, MBBS, MRCP, MD—discuss recent clinical data and treatment decisions in advanced renal cell carcinoma (RCC).

This first of 3 PER Pulse Recaps summarizing the online program focuses on evidence-based, practical guidance regarding locoregional and systemic treatment considerations for patients with metastatic clear cell RCC (ccRCC) who are eligible for nephrectomy. Below are some highlights from the activity featuring Dr. Powles:

  • His evidence-based treatment approaches for a 72-year-old patient with intermediate-risk ccRCC and a 52-year-old patient with ccRCC metastases 5 years after nephrectomy
  • Discussion of the appropriate use of nephrectomy with tyrosine kinase inhibitors, based on data from the phase III CARMENA trial of nephrectomy plus adjuvant sunitinib in patients with metastatic RCC (mRCC) and data from the phase III SURTIME trial of immediate versus delayed nephrectomy in patients with mRCC receiving sunitinib, as well as the role of nephrectomy with immune checkpoint inhibition
  • Review of other interventions beyond surgery currently being investigated, including cryoablation and radiofrequency ablation
  • Key factors to consider when selecting patients with mRCC for cytoreductive nephrectomy

“The thing that’s changed the outcome of patients [with mRCC] in the last 20 years…is the introduction of systemic therapy. Systemic disease should be treated with systemic therapy. If surgery has a role, it needs to be done within the context of a multidisciplinary setting.”
— Thomas Powles, MBBS, MRCP, MD


2 of 3
Insights From Sumanta K. Pal, MD—PER Pulse Recap:
Community Practice Connections: Medical Crossfire®: Crossroads in Advanced RCC Decision Making: With Many Options, How Will You Treat Your Patient Today?... And Tomorrow?

As a follow-up to the continuing medical education–certified activity, Community Practice Connections: Medical Crossfire®: Crossroads in Advanced RCC Decision Making: With Many Options, How Will You Treat Your Patient Today?... And Tomorrow?, this second of 3 PER Pulse Recaps summarizing the online program focuses on evidence-based, practical guidance regarding clinical decision making for patients with good-risk metastatic renal cell carcinoma (mRCC) at presentation who experience subsequent progression. Below are some highlights from the activity featuring Dr. Pal:

  • His treatment approach for a 65-year-old patient with clear cell RCC who experienced progression 2 years post nephrectomy, including assessing patient risk status and incorporating it into the treatment decision
  • Discussion about why patients with good-risk versus intermediate- or poor-risk status respond better to VEGF tyrosine kinase inhibitors versus immunotherapy, including the impact of data from CheckMate 214 of nivolumab plus ipilimumab versus sunitinib in patients with treatment-naïve mRCC
  • A review of ongoing efforts to optimize VEGF TKI plus immune therapy for patients with mRCC, including the use of the cabozantinib-plus-atezolizumab protocol and discussion of data from the CABOSUN trial of cabozantinib plus atezolizumab in patients with poor- or intermediate-risk mRCC
  • Overview of the impact of data from the 2019 Genitourinary Cancers Symposium on mRCC treatment, such as the use of single-agent cabozantinib in patients with good-risk disease and doublet therapy with nivolumab/ipilimumab or axitinib/pembrolizumab for intermediate- or poor-risk disease

“These risk criteria that we’ve developed are very, very powerful, and we should use them as indicated for treatment allocation. It could really make a big difference whether or not we put a patient on combo therapy versus monotherapy, and it may affect our selection of targeted therapy with immune therapy versus double checkpoint inhibition.”
— Sumanta K. Pal, MD


3 of 3
Insights From Laurence Albiges, MD, PhD—PER Pulse Recap:
Community Practice Connections: Medical Crossfire®: Crossroads in Advanced RCC Decision Making: With Many Options, How Will You Treat Your Patient Today?... And Tomorrow?

As a follow-up to the continuing medical education–certified activity, Community Practice Connections: Medical Crossfire®: Crossroads in Advanced RCC Decision Making: With Many Options, How Will You Treat Your Patient Today?... And Tomorrow?, this third of 3 PER Pulse Recaps summarizing the online program focuses on evidence-based, practical guidance regarding treatment considerations across all lines of therapy for non–clear cell renal cell carcinoma (nccRCC). Below are some highlights from the activity featuring Dr. Albiges:

  • Her diagnosis and treatment approach for a 23-year-old patient with nccRCC, including median expected survival rates, current treatment options, the importance of patient access to clinical trials for nccRCC, and potential therapies beyond the frontline
  • A review of the importance of meeting the supportive care needs of patients being treated for nccRCC, such as nutritional assessments, proper management of hand-foot syndrome, and multidisciplinary care
  • Discussion of ongoing trials and practice-changing data on nccRCC presented at the 2019 Genitourinary Cancers Symposium, including the phase II SUNIFORECAST trial of nivolumab/ipilimumab versus sunitinib in patients with treatment-naïve advanced nccRCC, the phase II KEYNOTE-427 trial of first-line pembrolizumab in advanced nccRCC, and the phase II CALYPSO trial of savolitinib and durvalumab in metastatic papillary RCC

“The good news is that it’s not only clear cell but also the non–clear cell [RCC] world that is evolving quickly. We have more and more trials ongoing that focus on non–clear cell [RCC]…and we are now dedicating trials specifically to subtypes, such as papillary….The field is moving forward, and hopefully we’ll be able to change our standard of care in [the] coming months or years.”
— Laurence Albiges, MD, PhD


Login or Register to Start Activity

Please use the form below to Register or Log In to begin Activity.

*Required Fields
Calendar of Events
SUNMONTUESWEDTHURSFRISAT
1234567
891011121314
15161718192021
22232425262728
2930
Filter By