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CME: Renal Cell Carcinoma (RCC): Optimizing Pharmacotherapeutic and Interventional Management Strategies

Activity Description / Statement of Need:

In this online, self-learning activity:

Renal cell carcinoma (RCC) is a cancer that is borne and takes root in the nephrons and is responsible for the vast majority – 85% – of all renal cancers.  With risk factors that include smoking, obesity, cadmium exposure, older age, and genetics, the five year survival rate of those afflicted with kidney cancer overall is 68%. In part because there are not any clear early symptoms associated with kidney cancer, RCC is discovered predominantly after it has already progressed to advanced stages, with the brain, bones, lungs, and liver serving as some of the most common sites of metastases. RCC’s treatment depends on its stage and size, with surgeryutilized for localized tumors and systemic therapy a mainstay of care for metastatic disease. 

RCC has many treatment options, both targeted and non-targeted. The former, including monoclonal antibodies and other forms of immunotherapy, is now a standard of care, although angiogenesis inhibition is also an area of consideration.  Emerging evidence is also suggesting ways in which biomarkers and radiographic indicators of response might shape the course of care.

Target Audience:

The following healthcare professionals: medical oncologists; physician assistants, nurse practitioners, nurses, and pharmacists who practice in oncology; and any other healthcare professionals with an interest in or who clinically encounter patients with RCC.


Commercial Support Disclosure: This activity is supported by educational grants from BTG.

Learners may participate in this activity free of charge.


Release Date: September 11, 2019 -- Expiration Date: September 11, 2021

Faculty: Nazli Dizman, MD

Agenda

Introduction, Disclosures

Definition and epidemiology of RCC:

  • Statistics – snapshots and trends

Clinical Features of RCC [Learning Objective #1]:

  • Pathogenesis and the role of the immune system
  • Clinical presentation (signs and symptoms)

Emerging, immuno- and monoclonal therapy in RCC: within and beyond treatment guidelines [Learning Objectives #2, 3, 4, & 5]

  • How has the postsurgical treatment landscape changed in the last decade and where is it going?
  • Goals of therapy
  • Active surveillance vs. procedures: nephrectomy, ablation
  • Present therapies
  • Immune therapy: nivolumab, interleukin-2 (IL-2; aldesleukin)
  • Tyrosine kinase inhibitors: cabozantinib, lenvatinib, pazopanib, sunitinib, sorafenib, axitinib
  • mTOR inihibitors: temsirolimus, everolimus
  • Atezolizumab
  • Targeted therapies
  • Targeted and immunotherapy vs. conventional cytotoxic chemotherapy: mechanisms of action and impact on biochemical pathways and the cell life cycle
  • Safety profiles: immunotherapy and monoclonal antibodies vs. conventional cytotoxic chemotherapy
  • Immunotherapy and monoclonal antibodies in RCC treatment guidelines
  • Emerging therapies
  • Best practice: putting it all together
  • Patient case(s)

Patient-specific strategies

  • Combatting barriers to adherence
  • Patient, family, and caregiver engagement and education

Summary, conclusions, and best practice recap


Learning Objectives

By the end of the session the participant will be able to:

  • Describe the role of the immune system in cancer and cancer therapy in RCC
  • Describe immuno- and monoclonal therapies´┐Ż mechanisms of action and the biochemical pathways they impact in RCC
  • Identify the treatment modalities currently available for management of RCC and apply them to patient cases using evidence-based medicine
  • Describe the differences in safety profiles between conventional cytotoxic, monoclonal, and immunotherapy in RCC
  • Describe methods for combatting barriers to patient care, including fostering a strong provider-patient relationship

Accreditation

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of  1.00 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Physicians: For applicable courses, to attain maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in the "Accreditation" section on this page, then it does NOT provide MOC credit.

Pharmacists 

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. This activity is approved for 1.00 hours (0.10 CEUs) of continuing education.  Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test.   Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit.  ACPE # 0574-0000-19-035-H01-P.  CPE credit effective 9/21/19 and expires 9/21/21. This is a Knowledge (K)-type activity.

Pharmacists: You must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

 

Faculty Disclosure: Nazli Dizman, M.D. has no relevent financial disclosures. 

 

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevent financial disclosures.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


Additional Courses That Are Related To This Activity

Advanced Prostate Cancer (aPC): Therapeutic Updates, Best Practices, and Emerging Treatments

Pharmacotherapy for Hepatocellular Carcinoma (HCC): Therapeutic Updates, Best Practices, and Emerging Therapies

Advances in Treating Metastatic Colorectal Cancer (CRC): Optimizing Recognition and Pharmacotherapeutic Management Strategies

Advanced prostate cancer: Optimizing management strategies