NCCN Pharmacy Updates: Assessment and Management of CAR T-Cell Related Toxicities
Most oncology clinicians are familiar with the Common Terminology Criteria for Adverse Events (CTCAE) to grade toxicities related to anti-cancer therapies and guide treatment decisions, but newly published literature suggests that grading systems specific to the unique toxicities of immune-effector cell therapies provide more uniform consensus and improve outcomes. CAR T cells are the fastest advancing technology in oncology right now with over 90 CAR T-cell therapies being investigated in over 90 ongoing clinical trials worldwide. Because of their superiority to traditional therapies, CAR T-cell products have the ability to completely change the treatment paradigm for hematologic malignancies. These therapies are associated with life-threatening toxicities that require rapid intervention. Newly published consensus statements to better define and grade these toxicities should be incorporated into clinical practice.
This educational program is designed to meet the educational needs of pharmacists, physicians, nurses, nurse practitioners, physician assistants and other health care professionals who manage patients with cancer.
Following this activity, participants should be able to:
- Interpret the etiology and manifestations of CAR T-cell therapy toxicity.
- Show the utility and deficiencies of the currently published CRS and neurologic toxicity grading systems including the Common Terminology Criteria for Adverse Events (CTCAE), Lee and CARTOX criteria and the development of consensus on definition and grading of immune effector cell-associated CRS and ICANS.
- Apply recommendations for monitoring, supportive care, and pharmacologic management of patients with immune effector cell-associated CRS and ICANS.
Helen Marshall, PharmD, BCPS, BCOP
Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
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.
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.
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.
The faculty listed below discloses no relevant financial relationships:
Helen M. Marshall, PharmD, BCPS, BCOP
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:
Ann Karosas, RPh, BCOP
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.
NCCN 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.
NCCN designates this educational activity for a maximum of 1.0 contact hour.
NCCN designates this application-based continuing education activity for 1.0 contact hour (0.10 CEUs) of continuing education credit. UAN: JA4008196-0000-20-082-L01-P
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. PAs should only claim credit commensurate with the extent of their participation.
The Hematology/Oncology Pharmacy Association (HOPA) is accredited by the Board of Pharmacy Specialties (BPS) as a provider of board certification oncology credit (BCOP). A BCOP statement of credit will be issued only upon completion of a post-activity evaluation form and post-test, with a passing grade of 75% achieved.
Disclosure of Conflicts of Interest: The Hematology/Oncology Pharmacy Association (HOPA) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CE activities. All relevant conflicts of interest that are identified are thoroughly vetted by HOPA for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. HOPA is committed to providing its learners with high-quality CE activities and related materials that promote improvements of quality in healthcare and not a specific proprietary business interest of a commercial interest.
Reported Areas of Conflict: Hematology/Oncology Pharmacy Association does not view the existence of relationships as an implication of bias or that the value of the material is decreased. The content of the activity was planned to be balanced, objective, and scientifically rigorous. Occasionally, authors may express opinions that represent their own viewpoint. Conclusions drawn by participants should be derived from objective analysis of scientific data. Unlabeled/unapproved uses of drugs. All faculty have indicated that they have not referenced unlabeled/unapproved uses of drugs and devices.
- 1.00 AAPA Category 1 CME credit
- 1.00 ACPE contact hours
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC contact hours
- 1.00 Participation
This webinar was presented live one time only on Tuesday, August 25, 2020, from 2:00 - 3:00 PM EDT (UTC -4).
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