NCCN Guidelines® Updates: New Immunotherapy Strategies for Improving Outcomes in Non-Small Cell Lung Cancer

Immunotherapy recommendations for patients with non-small cell lung cancer (NSCLC) are rapidly changing, and health care providers need to be aware of the most current recommendations in the NCCN Guidelines to improve outcomes for their patients. New first-line combination immunotherapy regimens are now recommended in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Non-Small Cell Lung Cancer including pembrolizumab (or atezolizumab) plus chemotherapy for select patients with metastatic NSCLC. Health care providers need to be aware of new recommendations regarding biomarker testing and sequencing systemic therapy regimens to improve outcomes for their patients with metastatic NSCLC. They also need to be aware of the latest supportive care recommendations for managing immune‑mediated adverse events in patients who receive immunotherapy.

This information was originally presented at the NCCN 2019 Annual Conference:Improving the Quality, Effectiveness, and Efficiency of Cancer Care™ held in Orlando, Florida, March 21-23, 2019.

Target Audience

This educational program is designed to meet the educational needs of the interprofessional oncology care team, including: physicians/oncologists, nurses, physician assistants, pharmacists, and other healthcare professionals who manage patients with cancer.

Learning Objectives

Following this program, participants should be able to:

  • Identify recommended immunotherapy regimens for select patients with non-small cell lung cancer (NSCLC).
  • Describe new recommendations regarding biomarker testing for programmed death-ligand 1 (PD-L1) for their patients with NSCLC.
  • Discuss the potential for immune-mediated adverse events with their patients with NSCLC who receive immunotherapy.
Additional information
Supporters: 

This activity is supported by an educational grant from:

  • AstraZeneca
  • Bayer HealthCare Pharmaceuticals, Inc.
  • BTG
  • Celgene Corporation
  • Daiichi Sankyo, Inc.
  • Genentech
  • Genomic Health, Inc.
  • Halozyme, Inc.
  • Ipsen Biopharmaceuticals
  • Lilly
  • Novartis
  • Pfizer
  • Prometheus Laboratories, Inc.
  • Puma Biotechnology
  • Taiho Oncology, Inc.
  • TESARO

 This activity is supported by educational funding provided by:

  • Amgen

This activity is supported by an independent educational grant from:

  • AbbVie
  • Astellas
  • Boehringer Ingelheim Pharmaceuticals, Inc.
  • Incyte
  • Merck & Co., Inc.

This activity is supported by a medical education grant from:

  • Exelixis, Inc.
Course summary
Available credit: 
  • 1.00 AAPA Category 1 CME credit
  • 1.00 ACPE contact hours
  • 1.00 AMA PRA Category 1 Credit™
  • 0.88 ANCC contact hours
  • 1.00 Participation
Course opens: 
05/15/2019
Course expires: 
03/01/2020
Cost:
$0.00

Marianne Davies, DNP, RN, CNS, ACNP-BC, AOCNP
Yale Cancer Center/Smilow Cancer Hospital

Matthew A. Gubens, MD, MS 
Helen Diller Family Comprehensive Cancer Center

NCCN Medical Education Disclosure Policy
It is the policy of NCCN that every 12 months, all faculty, moderators, activity planners and all internal planning staff participating in NCCN continuing education activities are expected to disclose any financial relationships with a commercial interest as defined by the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support. In addition, all faculty presentations have been reviewed for adherence to the ACCME’s Standards for Commercial Support (the provider develops activities/educational interventions independent of commercial interests [SCS 1, 2 and 6] by experts on the topics). 

Per the ACCME Standards for Commercial Support, individuals who do not disclose relevant financial relationships will be disqualified from involvement in the CE activity as a content developer, planner, or presenter. A complete list of individuals’ relationships with external entities is available upon request.

Definitions  
NCCN continuing education considers financial relationships to create a “conflict of interest” when an individual has both a financial relationship with a commercial interest and the opportunity to affect CE content about the products or services of a commercial interest with which he/she and/or a spouse or partner has a financial relationship.

NCCN continuing education considers “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. NCCN does 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.

Faculty Disclaimers  
All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation for 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.

Faculty Disclosures

The faculty listed below discloses the following relevant financial relationships:
Marianne Davies, DNP, RN, CNS, ACNP-BC, AOCNP
AstraZeneca Pharmaceuticals LP: Product/Speakers Bureau
Bristol-Myers Squibb Company: Product/Speakers Bureau
Genentech, Inc.: Product/Speakers Bureau
Merck & Co., Inc.: Product/Speakers Bureau

Matthew A. Gubens, MD, MS
AstraZeneca Pharmaceuticals LP: Consulting Fee
Boehringer Ingelheim GmbH: Consulting Fee
Bristol-Myers Squibb Company: Consulting Fee
Celgene Corporation: Grant/Research Support
Genentech, Inc.: Consulting Fee
Heron Therapeutics: Consulting Fee
Merck & Co., Inc.: Grant/Research Support
Novartis Pharmaceuticals Corporation: Grant/Research Support
OncoMed Pharmaceuticals: Grant/Research Support
Roche Laboratories, Inc.: Consulting Fee
Takeda Pharmaceuticals North America, Inc.: Consulting Fee

NCCN Staff Disclosures 
The NCCN Activity Planning staff listed below discloses no relevant financial relationships:
Robert W. Carlson, MD; Melissa Esplen; Mark A. Geisler; Kristina M. Gregory, RN, MSN, OCN; Kristin Kline Hasson; Rose Joyce; Karen Kanefield; Lisa G. Kimbro, MBA, CPA (Employed by NCCN until 8/10/18); Wui-Jin Koh, MD; Joan S. McClure, MS (Employed by NCCN until 8/1/18); Lisa Perfidio, MS; Sarah Sinclair; Kathy Ann Smith, CHCP; Gary J. Weyhmuller, MBA, SPHR

The NCCN Clinical staff listed below discloses no relevant financial relationships:
Miranda Hughes, PhD; Jillian Scavone, PhD; Alyse Johnson-Chilla

In support of improving patient care, National Comprehensive Cancer Network (NCCN) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians
NCCN designates this enduring material 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.

Nurses
NCCN designates this educational activity for a maximum of 0.88 contact hour.

Pharmacists
NCCN designates this knowledge-based continuing education activity for 1.0 contact hour (0.10 CEUs) of continuing education credit. UAN: JA4008196-0000-19-032-H01-P

Physician Assistants
NCCN has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credit.  Approval is valid until March 1, 2020. PAs should only claim credit commensurate with the extent of their participation.

Available Credit

  • 1.00 AAPA Category 1 CME credit
  • 1.00 ACPE contact hours
  • 1.00 AMA PRA Category 1 Credit™
  • 0.88 ANCC contact hours
  • 1.00 Participation

Accreditation Period

Course opens: 
05/15/2019
Course expires: 
03/01/2020

Price

Cost:
$0.00
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Required Hardware/software

To complete this activity, users will need: