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CME: Ongoing challenges and optimal approaches in the management of metastatic colorectal cancer (mCRC)

Activity Description / Statement of Need:

In this online, self-learning activity:

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the U.S., which, along with China, has the highest incidence of CRC in the world. In the U.S., the disease accounts for an annual mortality rate of over 53,000 and an incidence of over 152,000. The five-year survival rates are approximately 91% for patients with early stages of the disease and 73% for disease that has spread to adjacent lymph nodes or tissues. In contrast, 22% of people are diagnosed with metastatic disease (mCRC), in whom the five-year survival is about 15%, representing an area of ongoing clinical need. And despite recommendations of CRC screening beginning at age 45, the incidence and prevalence of the disease in patients under age 50 is increasing, as is their risk of diagnosis in later stages of the disease.

Target Audience:

HCPs including: medical oncologists, oncology surgeons, and pathologists; physicians assistants, nurse practitioners, and pharmacists specializing in oncology; and other clinicians who are involved in providing diagnostic and therapeutic services for patients with mCRC.


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

This activity is free of charge.


Release Date: October 18, 2024 -- Expiration Date: October 18, 2025

Faculty: Geoffrey Buckle, MD, MPH

Agenda

Faculty introduction, disclosures

Introductory content, screening, and diagnosis

  • Epidemiology, including recent increase in incidence in young adults
  • Common presenting symptoms among patients with early onset CRC
  • Common presenting symptoms among patients with early onset CRC
  • Multigene and next-generation sequencing tests

Treatment of mCRC 

  • Treatment goals, with an emphasis on unresectable disease
  • Brief overview of factors influencing the personalizing of systemic therapy, including: actionable biomarkers; previous therapy; and candidacy for intensive therapy
  • Initial therapy
    • HER2 amplification: consideration of anti-HER2 therapy with signal transduction inhibition vs. fluoropyrimidine ± bevacizumab
    • Impact of RAS/BRAF V600E mutation, side (L/R) of primary tumor, and patient fitness on choice of cytoxic chemotherapy and bevacizumab
    • Deficient MMR, MSI, or polymerase epsilon or delta mutations: checkpoint inhibitor immunotherapy
    • MMR proficient, MSS
  • Second-line therapy
    • Previous therapy’s impact on treatment choice
  • Next-line agents: treatment options after fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, an anti-VEGF medication, and potentially an EGFR inhibitor (if RAS and BRAF wild-type)
  • Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

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

  • Recall factors impacting therapeutic decision-making in the treatment of mCRC, including biomarker and optimal sequencing considerations.
  • Recall best practices in use of tumor genotyping for patients with mCRC.
  • Describe the role of current pharmacotherapies for mCRC, their current or anticipated places in therapy, mechanisms of action, and risk-benefit profiles.
  • Formulate a treatment plan for a patient with mCRC.

Accreditation

ACCME Activity #202837439

ScientiaCME is accredited by the Accreditation Council for Continuing Medical Education (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.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, 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 points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.

Pharmacists

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  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 #0574-0000-24-031-H01-P. This is an Application (A)-type activity. 

PharmacistsYou 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.

Nurses: The American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts AMA PRA Category 1 Credit™ assigned by organizations accredited by the ACCME as satisfying Category 1 CME for National Commission on Certification of Physician Assistants (NCCPA) national certification maintenance. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Board (AANPCB) states that continuing education providers accredited by the ACCME may provide acceptable, accredited Advanced Practice Provider content. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.


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 by ScientiaCME.

Disclosures of Faculty: Geoffrey Buckle, MD, MPH, Assistant Professor, Division of Hematology/Oncology, UCSF, has received financial compensation from VMLY&R, Tech.spert, Capvision, Alpha Insights, IDR, Athenum and Guidepoint for consulting.

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

Faculty WILL NOT discuss off-label uses of a commercial product. 

All relevant financial relationships have been mitigated. 

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

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

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge 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/Linguistic Competence & Health Disparities

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.


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