Archived Monthly Oncology Tumor Boards: A Multidisciplinary Approach to Individualized Patient Care - Chronic Lymphocytic Leukemia
Management of CLL/SLL without del(17p)/TP53 Mutation and Histologic Transformation to DLBCL
The therapeutic landscape of CLL has evolved significantly in recent years with the advent of small molecule inhibitors targeted against the key signaling pathways involved in the pathogenesis of CLL; however, the management of histologic transformation of CLL to aggressive lymphomas remains an unmet clinical need since the standard of care is not established. Treatment selection for patients with CLL without del(17p)/TP53 mutation should be individualized based patient’s age, performance status, comorbid conditions, as well as the agent’s toxicity profile. Oncologists and hematologists need to understand the unique challenges associated with the management of histologic transformation of CLL. Precise diagnosis of histologic transformation, establishment of the clonal relationship between CLL and transformed DLBCL as well as accurate diagnosis and management of immune-related adverse events associated with PD-1 inhibitor therapy (nivolumab and pembrolizumab) are essential to develop an optimal treatment plan for patients with histologic transformation. Supportive care for the prevention and treatment of adverse effects should be an integral part of the management of patients with CLL and histologic transformation to DLBCL. Maintaining a current knowledge of recent advances would help oncologists and hematologists incorporate novel therapies into routine clinical practice in the appropriate patient population to improve clinical outcomes.
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:
- Review evidence from clinical trials supporting the use of small molecule inhibitors for the treatment of newly diagnosed and relapsed/refractory CLL without del(17p)/TP53 mutation.
- Develop an individualized treatment plan for CLL without del(17p)/TP53 mutation based on patient’s age, comorbidities and prior therapy (in the case of relapsed/refractory disease).
- Describe the current treatment options and the rationale for the development of more effective strategies for the management of histologic transformation to DLBCL.
Brian Hill, MD, PhD
Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
Christopher D’Andrea, PA-C
Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
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:
Christopher D’Andrea, PA-C
The faculty listed below disclose the following relevant financial relationships:
Brian Hill, MD, PhD
AbbVie, Inc.: Scientific Advisor
AstraZeneca Pharmaceuticals LP: Scientific Advisor
Bayer HealthCare: Scientific Advisor
Celgene Corporation: Scientific Advisor
Genentech, Inc.: Scientific Advisor
Kite Pharma: Scientific Advisor
Novartis Pharmaceuticals Corporation: Scientific Advisor
Pharmacyclics: Scientific Advisor
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; Kathy Ann Smith, CHCP; Sarah Weinstein
The NCCN Clinical staff listed below discloses no relevant financial relationships:
Hema Sundar, 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 0.75 contact hour.
Pharmacists
NCCN designates this knowledge-based continuing education activity for 0.75 contact hour (0.075 CEUs) of continuing education credit. UAN: JA4008196-0000-20-071-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 5/20/2021. 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: I00042154; Approval #: 200137066
Available Credit
- 0.75 AAPA Category 1 CME credit
- 0.75 ACPE contact hours
- 0.75 AMA PRA Category 1 Credit™
- 0.75 ANCC contact hours
- 0.75 CCM clock hours
- 0.75 Participation
Price
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