Archived Monthly Oncology Tumor Boards: A Multidisciplinary Approach to Individualized Patient Care - Non-Melanoma Skin Cancer

Updates in the Management of Merkel Cell Carcinoma, with a Focus on Systemic Therapy
Although there are no randomized comparative trials demonstrating superiority of checkpoint immunotherapy compared with chemotherapy, checkpoint immunotherapies provide response rates similar to those previously reported for chemotherapy, and may provide greater durability of response. Therefore, avelumab, nivolumab, and pembrolizumab are included as recommended systemic therapy options for treatment of disseminated disease, and use of cytotoxic therapies in this setting is discouraged unless the patient has contraindications to checkpoint immunotherapy or has experienced relapse or progression during or after previous treatment with checkpoint immunotherapy.  Avelumab is FDA approved for MCC and only one other cancer type, so clinical experience with this anti-PD-L1 agent is more limited than for other types of checkpoint inhibitors (targeting CTLA-4, PD-1), and clinicians may not be familiar with its safety profile. Clinician and patient education is critical for safe administration of checkpoint immunotherapies and screening to identify patients who are not suitable candidates for checkpoint inhibitor therapy.

Target Audience

This program is designed to meet the educational needs of physicians, nurses, pharmacists, and other health care professionals who manage patients with cancer.

Learning Objectives

Following this activity, participants should be able to:

  • List considerations for determining the roles of surgery, RT, systemic therapy combined modality approaches for the management of early and advanced Merkel cell carcinoma (MCC).
  • Describe systemic therapy options for stage IV MCC, including patient selection criteria for each option.
  • Describe the safety profiles and recommended precautions among available checkpoint immunotherapies.
Additional information
Supporters: 

This activity is supported by an educational grant from:

  • AstraZeneca
  • Celgene Corporation
  • Clovis Oncology, Inc.
  • Eisai
  • Genomic Health, Inc.
  • Lilly
  • Novartis
  • Sanofi Genzyme
  • Taiho Oncology, Inc
  • TESARO

This activity is supported by an independent medical education grant from:

  • Advanced Accelerator Applications, a Novartis company
  • Bristol-Myers Squibb
  • Pharmacyclics LLC and Janssen

This activity is supported by an independent educational grant from:

  • AbbVie
  • Astellas and Pfizer, Inc.
  • Merck  & Co., Inc.

This activity is supported by a medical education grant from Exelixis, Inc.

This activity is supported by an unrestricted educational grant from Gilead Sciences, Medical Affairs.

Course summary
Available credit: 
  • 0.75 AAPA Category 1 CME credit
  • 0.75 ACPE contact hours
  • 0.75 AMA PRA Category 1 Credit™
  • 0.66 ANCC contact hours
  • 0.75 CCM clock hours
  • 0.75 Participation
Course opens: 
11/26/2019
Course expires: 
11/26/2020
Cost:
$0.00
Part of: 
Archived Monthly Oncology Tumor Boards: A Multidisciplinary Approach to Individualized Patient Care

Paul Nghiem, MD, PhD
University of Washington
Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance

Coley J. Doolittle-Amieva, PA-C
Seattle Cancer Care Alliance
University of Washington

 

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 no relevant financial relationships:
Coley J. Doolittle-Amieva, PA-C

The faculty listed below discloses the following relevant financial relationships:
Paul Nghiem, MD, PhD
4SC: Consulting Fee
Bristol-Myers Squibb Company: Grant/Research Support
EMD Serono: Consulting Fee; Grant/Research Support
Merck & Co., Inc.: Consulting Fee

NCCN Staff Disclosures
The NCCN Activity Planning staff listed below discloses no relevant financial relationships:
Melissa Esplen; Mark A. Geisler; Kristina M. Gregory, RN, MSN, OCN; Kristin Kline Hasson; Rose Joyce; Karen Kanefield; Lisa Perfidio, MS; Shannon Ryan, CMP; Sarah Sinclair; Kathy Ann Smith, CHCP

The NCCN Clinical staff listed below discloses no relevant financial relationships:
Anita M. Engh, PhD; Lydia Hammond, MBA; Rashmi Kumar, PhD

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 0.75 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 0.66 contact hour.

Pharmacists
NCCN designates this knowledge-based continuing education activity for 0.75 contact hour (0.075 CEUs) of continuing education credit. UAN: JA4008196-0000-19-104-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 0.75 AAPA Category 1 CME credit. Approval is valid until 11/26/2020. PAs should only claim credit commensurate with the extent of their participation.

Case Managers
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 0.75 CE contact hour. Activity Code: I00039702; Approval #: 190004227

Available Credit

  • 0.75 AAPA Category 1 CME credit
  • 0.75 ACPE contact hours
  • 0.75 AMA PRA Category 1 Credit™
  • 0.66 ANCC contact hours
  • 0.75 CCM clock hours
  • 0.75 Participation

Price

Cost:
$0.00
Please login or register to take this course.

Required Hardware/software

To complete this activity, users will need:

  • A device with an Internet connection and sound playback capability
    • One of the two latest versions of Google Chrome, Mozilla Firefox, or Safari
    • Internet Explorer is no longer supported
  • Adobe Reader or other PDF reader software for certificate viewing/printing