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CME: Advances in Treating Triple-Negative Metastatic Breast Cancer: Optimizing Pharmacotherapeutic Management Strategies

Activity Description / Statement of Need:

In this online, self-learning activity:

Over a quarter million women and almost 2,700 men in the U.S. are diagnosed with breast cancer each year, and it is the second leading cause of cancer death in women. The prognosis associated with breast has improved in the last few decades due in larger part to earlier detection. Detection at the loco-regional stage is associated with a five-year overall survival (OS) rate of ≥ 85% in contrast to 27% for distant or metastatic breast cancer (MBC).

Because it is not curable, the goals of care in MBC are: palliation of symptoms, improvement of quality-of-life, and extension of survival. Hormone receptor positivity has traditionally conferred a better prognosis. In contrast, the presence the human epidermal growth factor receptor 2 (HER2) is associated with a more negative prognosis. Finally, there remains a basal-like group lacking in those markers, miscellaneously labeled triple-negative (TNBC), with some cancers observed to be more aggressive, but with the overall population similar in prognosis to hormone-positive breast cancer, owing to TNBC’s heterogenous nature.

Target Audience:

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

Commercial Support Disclosure: This program is supported by an educational grant from Eisai.

This activity is free of charge.

Release Date: May 20, 2020 -- Expiration Date: May 20, 2022

Faculty: Kevin Kalinsky, MD, MS


Faculty introduction, disclosures


Introduction content: cursory refresher and review

  • Epidemiology: statistics by severity, current trends, and associated healthcare costs
  • Causes and risk factors
  • Pathogenesis, including biochemical pathways and their effects on the cell life cycle
  • Clinical features, presentation, and histopathology
  • Updates in diagnosis
  • Staging, comorbidities, and complications

TN MBC treatment

  • Goals of therapy
  • Therapy
  • BRCA-associated disease: PARP inhibitors, platinum agents
  • Cytotoxic chemotherapy
  • Emerging therapies
    • Epithelial growth factor inhibitors
    • Angiogenesis inhibitors
    • PARP inhibitors
    • Immunotherapy
  • Safety profiles of present and emerging agents
  • Emerging models of care
  • Challenges and barriers to care
  • Patient case(s)

Summary, conclusions, and best practice recap


Learning Objectives

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

  • Describe the prognostic and treatment implications of TN status in the diagnosis and treatment of MBC.
  • Describe treatment options presently available for TN MBC, including safety, and apply them to patient cases using evidence-based medicine.
  • Describe emerging treatment options presently available for TN MBC, their mechanisms of action and safety, and anticipated place in therapy.
  • Discuss barriers patients with TN MBC experience in attempting to access care, including burden of disease and adverse consequences of therapy, and propose ways to ameliorate them.


ACCME Activity #0

This activity has been planned and implemented in accordance with the accreditation standards 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 1.0 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: 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.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. 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 # 0574-0000-20-016-H01-P.  ACPE Accreditation effective 5/20/2020, expires 5/20/2022. This is a Application (A)-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: Kevin Kalinsky, MD, MS, Herbert Irving Associate Professor of Medicine, Columbia University Irving Medical Center, has no relevant financial discloses.

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

Commercial Support Disclosure: This program is supported by an educational grant from Eisai.


  • 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.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
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.

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