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 an educational grant from Bayer Healthcare Pharmaceuticals Inc.

Oncology Briefings™: Cases and Considerations in the Treatment of Hepatocellular Carcinoma

Release Date: July 31, 2019
Expiration Date: July 31, 2020
Media: Internet - based

Activity Overview

This continuing medical education (CME)-certified online activity, “Oncology Briefings™: Cases and Considerations in the Treatment of Hepatocellular Carcinoma,” is an online interactive monograph that provides an overview of etiologic factors in hepatocellular carcinoma (HCC), the implications of a growing understanding of pathophysiologic considerations as they relate to diagnosis and treatment, and treatment options available for HCC. Arndt Vogel, MD, PhD, discusses current and emerging treatment options for the treatment of HCC, emphasizes the keys to managing adverse events (AEs), and provides strategies to ensure the provision of timely and effective sequencing of therapy to optimize patient outcomes.

Click here for a printable version of this CME activity: https://www.gotoper.com/go/ob19hcc

Benefits of Participating

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

  • Outline advancements in treatment strategies for patients with HCC
  • Evaluate clinical data on efficacy and safety supporting the use of novel treatments, and make informed decisions to optimize clinical outcomes of patients with HCC
  • Educate patients about the disease, treatments, and treatment-related AEs
  • Facilitate the enrollment of patients with HCC in clinical trials that are testing novel therapies for the management and treatment of HCC

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Bayer Healthcare Pharmaceuticals 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 video files/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, 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 activity is directed toward an international audience of medical oncologists who treat or manage patients with HCC. Nurse practitioners, nurses, physician assistants, and other healthcare professionals involved in the treatment and management of patients with HCC are also invited to participate.

Learning Objectives

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

  • Explain the etiologic factors in HCC and the implications of a growing understanding of these pathophysiologic considerations as they relate to diagnosis and treatment.
  • Detail the biologic and mechanistic rationales underlying the use of tyrosine kinase inhibitors, checkpoint inhibitors, and other treatment modalities in HCC.
  • Review efficacy and safety data from the latest practice-changing clinical trials in HCC.
  • Indicate appropriate treatment strategies in HCC to ensure the provision of timely and effective sequencing of therapy to optimize patient outcomes.

Faculty, Staff, and Planners’ Disclosures

Faculty

Arndt Vogel
Arndt Vogel, MD, PhD
Managing Senior Consultant of Gastroenterology Oncology
Department of Gastroenterology, Hepatology and Endocrinology
Hannover Medical School
Hannover, Germany

Disclosures: Consultant: Roche, Lilly, BMS, MSD, AstraZeneca, Eisai, BTG; Speakers Bureau: Roche, Lilly, BMS, AstraZeneca, EISAI, BTG.

The staff of Physicians' Education Resource®, LLC (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 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® or any of the companies that provided commercial support for this program.

PER Pulse Recaps

1 of 3

Insights from Arndt Vogel, MD, PhD, Managing Senior Consultant of Gastroenterology Oncology, Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Germany- PER Pulse™ Recap: Oncology Briefings™: Cases and Considerations in the Treatment of Hepatocellular Carcinoma

In this continuing medical education–certified activity, Oncology Briefings™: Cases and Considerations in the Treatment of Hepatocellular Carcinoma, expert Arndt Vogel, MD, PhD, explains the etiologic factors in hepatocellular carcinoma (HCC) and the implications of a growing understanding of these pathophysiologic considerations as they relate to diagnosis and treatment and details the biologic and mechanistic rationale underlying the use of tyrosine kinase inhibitors (TKIs), checkpoint inhibitors, and other treatment modalities in HCC.

This first of 3 PER Pulse™ Recaps summarizing the online program focuses on the biology, the risk factors, the factors informing clinical decision making for HCC in 2019, and the rationale for the use of targeted therapies for the treatment of HCC.

Below are some highlights from the activity featuring Dr Vogel:

  • The prevalence of HCC, how is it diagnosed, and current clinical challenges in managing and treating patients with HCC is presented.
  • Dr Vogel describes the risk factors associated with HCC.
  • Dr Vogel summarizes the factors informing clinical decision making in 2019.
  • The rationale for the use of TKIs to treat patients with HCC is presented.
  • Dr Vogel discusses the importance of assessing liver function prior to treatment decision.

“Patients with HCC [hepatocellular carcinoma] usually have 2 diseases: a chronic liver disease and a tumor. In most other tumors, we can specifically focus on the therapy against the tumor. In HCC, it’s a little bit different because the liver function by itself can have a significant impact on the life expectancy of our patients. So basically, we need to look at both liver function and tumor burden.”
—Arndt Vogel, MD, PhD

“Tyrosine kinase inhibitors and checkpoint inhibitors are frequently applied in HCC. HCC is a very hypervascularized tumor with high levels of angiogenic factors, such as VEGF, and therefore there was clearly a rationale to test these drugs in advanced HCC.”
—Arndt Vogel, MD, PhD


2 of 3

Insights from Arndt Vogel, MD, PhD, Managing Senior Consultant of Gastroenterology Oncology, Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Germany —PER Pulse™ Recap: Oncology Briefings™: Cases and Considerations in the Treatment of Hepatocellular Carcinoma

In this continuing medical education–certified activity, Oncology Briefings™: Cases and Considerations in the Treatment of Hepatocellular Carcinoma, expert Arndt Vogel, MD, PhD, provides an overview of the treatment landscape of hepatocellular carcinoma (HCC), from approved agents to investigational agents and supporting data.

This second of 3 PER Pulse™ Recaps summarizing the online program focuses on the main results of the most relevant phase III clinical data in HCC and their impact on clinical practice.

Below are some highlights from the activity featuring Dr Vogel:

  • Dr Vogel explains the clinical trials behind the approval of sorafenib and lenvatinib for first-line therapy in patients with advanced HCC and presents case scenarios of how and when to apply each treatment.
  • Dr Vogel discusses regorafenib, cabozantinib, and ramucirumab as options in second-line therapy after first-line failure and explains what to consider when choosing the second line of treatment.
  • Dr Vogel describes the adverse effects (AEs) profile of tyrosine kinase inhibitors and provides strategies to manage AEs associated with therapy.
  • The most relevant clinical trials testing immunotherapeutic strategies in patients with advanced HCC are also presented.

“And with sorafenib, we [saw] the first positive trial, phase III trial in HCC [hepatocellular carcinoma], in 2008. And [with] sorafenib, as [with] most of the other drugs, use in HCC is basically [as] a multi–tyrosine kinase inhibitor, which has a specific activity, among others, against the VEGF receptor pathway.”
—Arndt Vogel, MD, PhD

“If you have a patient with a main portal-vein infiltration or higher tumor burden, this could also be a patient [who] may be preferentially treated with sorafenib.”
—Arndt Vogel, MD, PhD

“For patients with failure on sorafenib, we have now 3 options available. We can use regorafenib, we have good evidence for cabozantinib, and we also can use, in specific patients, ramucirumab.”
—Arndt Vogel, MD, PhD


3 of 3

Insights from Arndt Vogel, MD, PhD, Managing Senior Consultant of Gastroenterology Oncology, Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Germany —PER Pulse™ Recap: Oncology Briefings™: Cases and Considerations in the Treatment of Hepatocellular Carcinoma

In this continuing medical education–certified activity, Oncology Briefings™: Cases and Considerations in the Treatment of Hepatocellular Carcinoma, expert Arndt Vogel, MD, PhD, provides guidance for the treatment of patients with hepatocellular carcinoma (HCC) with localized disease, patients with advanced disease, and patients with metastatic disease. Dr Vogel also discusses the adverse events (AEs) associated with these therapies and strategies to manage such events. Additionally, Dr Vogel provides his perspective about engaging patients with HCC in clinical trials that are testing novel treatment approaches.

This third of 3 PER Pulse™ Recaps summarizing the online program focuses on patient case scenarios, best strategies to manage AEs associated with therapies, and optimizing treatment sequence therapies to improve the outcomes of patients with HCC.

Below are some highlights from the activity featuring Dr Vogel:

  • Regarding surgical therapy, Dr Vogel describes which patient groups are eligible for full liver transplantation, orthotopic liver transplantation, and partial resection.
  • Dr Vogel provides strategies to treat patients with resectable HCC.
  • Regarding patients with locally advanced disease, Dr Vogel provides advice on how to treat patients with unresectable HCC in the first line and after first-line failure.
  • Dr Vogel presents dose-reducing strategies to minimize the AEs of therapies using tyrosine kinase inhibitors.
  • Dr Vogel discusses the importance of clinical trial engagement and how and when patients should be engaged in clinical trials that are testing emerging strategies for the treatment and management of HCC.

“And if [adverse] effects occurred, usually dose reduction is necessary to really continue with the treatment. So specifically, with the TKI [tyrosine kinase inhibitor]–related [adverse] effects, it’s important not to continue once [adverse] effects occur because they usually do not go away but increase over time.”
—Arndt Vogel, MD, PhD

“I think there’s clearly still an urgent need today to improve outcome[s] in advanced HCC [hepatocellular carcinoma], and I think we really should include all patients [who] have a good liver function in clinical trials to basically find new combinations, combinations of systemic therapies and local therapies, and maybe also to identify biomarkers, which we can use to really target patients to a specific therapy.”
—Arndt Vogel, MD, PhDM


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