Monthly Oncology Tumor Boards: A Multidisciplinary Approach to Individualized Patient Care - Lung Cancer: Immunotherapy
Join Karen L. Reckamp, MD and Carrie Christiansen, RN, MSN, CFNP from City of Hope Comprehensive Cancer Center as they present their expertise on a range of cases pertaining to lung cancer.
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Non-Small Cell Lung Cancer (NSCLC) were recently revised to include recommendations regarding subsequent therapy for patients with metastatic NSCLC based on data about the efficacy of immune checkpoint inhibitors, such as nivolumab and pembrolizumab. The phrase subsequent therapy was recently substituted for the term second-line or beyond systemic therapy in the NCCN Guidelines® for Non-Small Cell Lung Cancer because the line of therapy may vary depending on previous treatment. Immune checkpoint inhibitors are now recommended as preferred agents for subsequent therapy for patients with metastatic NSCLC, because they improve overall survival, have a longer duration of response, and have fewer side effects when compared with cytotoxic chemotherapy such as docetaxel. The NCCN Panel recommends nivolumab (category 1) and pembrolizumab (category 1) as subsequent therapy for patients with metastatic NSCLC based on data from clinical trials and FDA approvals. Nivolumab and pembrolizumab are IgG4 monoclonal antibodies that inhibit the programmed cell death protein—1 (PD-1) pathway, which improves antitumor immunity; PD-1 receptors are expressed on activated cytotoxic T-cells. T-cell activation is inhibited when ligands from tumor cells, such as programmed death--ligand 1 (PD-L1), activate PD-1 pathways; thus, tumor cells are hidden to the immune system.
The NCCN Guidelines® for Non-Small Cell Lung Cancer are updated to reflect the current state of clinical practice for the management of non-small cell lung cancer, based on recent scientific publications and the availability of new treatment options. Some of the recent updates include the addition of atezolizumab and expanded indications for pembrolizumab.
This educational program is designed to meet the educational needs of oncologists, pathologists, nurses, pharmacists, case managers, and other health care professionals who manage patients with cancer.
Karen L. Reckamp, MD
City of Hope Comprehensive Cancer Center
Carrie Christiansen, RN, MSN, CFNP
City of Hope Comprehensive Cancer Center
Disclosure of Relevant Financial Relationships
All faculty and activity planners participating in NCCN continuing education activities are expected to disclose any relevant financial relationships with a commercial interest as defined by the ACCME’s, ANCC’s, and ACPE’s Standards for Commercial Support. All faculty presentations have been reviewed for adherence to the ACCME’s Criterion 7: The provider develops activities/educational interventions independent of commercial interests (SCS 1, 2, and 6) by experts on the topics. Full disclosure of faculty relationships will be made prior to the activity.
The faculty listed below discloses no relevant financial relationships:
Carrie Christiansen, RN, MSN, C-FNP
The faculty listed below discloses the following relevant financial relationships:
Karen Reckamp, MD
Abbott Laboratories: Grant/Research Support
Adaptimmune: Grant/Research Support
Amgen: Consulting Fees, Honoraria
ARIAD Pharmaceuticals, Inc.: Consulting Fees, Honoraria, Grant/Research Support
Astellas: Consulting Fees, Honoraria
Boehringer Ingelheim GmbH: Grant/Research Support
Bristol-Myers Squibb Company: Grant/Research Support
Clovis: Grant/Research Support
Eisai, Inc.: Grant/Research Support
Genentech, Inc.: Grant/Research Support
Pfizer: Grant/Research Support
Xcovery: Grant/Research Support
The NCCN Activity Planning staff listed below discloses no relevant financial relationships:
Mark Geisler; Kristina M. Gregory, RN, MSN, OCN; Kristin Kline Hasson; Rose Joyce; Karen Kanefield; Joan S. McClure, MS; Diane McPherson; Melanie Moletzsky; Deborah Moonan, RN, BSN (employed by NCCN until 2/7/17); Lisa Perfidio; Liz Rieder; Shannon K. Ryan; Kathy Smith; Jennifer McCann Weckesser (employed by NCCN until 2/3/17)
The NCCN Clinical Information staff listed below, who has reviewed content, discloses no relevant financial relationships:
Miranda Hughes, PhD
The ACCME/ANCC/ACPE defines “conflict of interest” as when an individual has an opportunity to affect CE content about products or services of a commercial interest with which he/she has a financial relationship.
ACCME, ACPE, and ANCC focuses on financial relationships with commercial interests in the 12-month period preceding the time that the individual is being asked to assume a role controlling content of the CE activity. ACCME, ACPE, and ANCC have not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME, ACPE, and ANCC defines “relevant’ financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest.
All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation to the tasks and methods of delivery.
Faculty presentations may include discussion of off-label use. Faculty will disclose that the use in question is not currently approved by the FDA per the product labeling.
National Comprehensive Cancer Network is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
National Comprehensive Cancer Network designates this live activity 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.
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 1.0 hour of Category I credit for completing this activity.
National Comprehensive Cancer Network is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
NCCN designates this educational activity for a maximum of 1.0 contact hour.
This program has been pre-approved by The Commission for Case Manager Certification to provide continuing education credit to CCM® board certified case managers. The course is approved for 1.0 CE contact hour. Activity Code: I00025257; Approval #: 170000263
|National Comprehensive Cancer Network is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.|
NCCN designates this knowledge-based continuing education activity for 1.0 contact hour (0.1 CEUs) of continuing education credit. UAN: 0836-0000-17-015-L01-P
- 1.00 CCM clock hours
- 1.00 ACPE contact hours
- 1.00 ANCC contact hours
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Participation
Following this activity, participants should be able to:
- Select the most appropriate second-line and beyond therapy (subsequent therapy) for patients with advanced non-small cell lung cancer who have progressed after platinum-based chemotherapy.
- Evaluate the risks and benefits of including immune-checkpoint inhibitor therapy.
- Manage immune-related adverse events associated with immune-checkpoint inhibitor therapy.