Faculty introduction and disclosures

Clinical landscape of R/M HNSCC [Learning Objective 1]

• Head and neck subsites and why presentation, natural history, and treatment differ across them
• Global incidence and mortality, and HPV-driven trends in oropharyngeal cancer by sex and birth cohort
• HPV vaccination and primary prevention
• Survival in HPV-positive versus HPV-unrelated disease, and the rate, timing, and pattern of recurrence
• Prevalence of HPV-positive disease among patients with recurrent or metastatic HNSCC

Systemic treatment of R/M HNSCC [Learning Objectives 2 and 5]

• KEYNOTE-048 and guideline-based first-line treatment selection by PD-L1 combined positive score
• Real-world immune checkpoint inhibitor use: optimal treatment duration beyond two years, and rechallenge after progression
• Implications of checkpoint inhibition in the perioperative setting for later-line decision making

Recognition, prevention, and management of immune-related adverse events [Learning Objective 3]

• Structured monitoring for early recognition, and corticosteroids as first-line treatment
• Pre-treatment assessment, including autoimmune history and the risk of flare in pre-existing autoimmune disease
• Organ-specific grading and management, and prophylaxis during prolonged immunosuppression
• Rechallenge after an immune-related adverse event
• Patient education resources supporting self-recognition and prompt reporting
• Whether immune-related adverse events predict response in HNSCC, and the immortal time bias in that literature

Biomarker-guided treatment selection [Learning Objectives 2 and 5]

• Available biomarkers in R/M HNSCC: PD-L1 combined positive score, EGFR expression, and HPV status
• HPV circulating tumor DNA and treatment outcomes, and its use in detecting recurrent disease
• Next-generation and tumor-informed circulating tumor DNA assays, including in HPV-negative disease
• Ongoing and planned circulating tumor DNA-guided treatment trials
• Integrating biomarker results with guideline recommendations to individualize a treatment plan

Investigational agents and emerging therapies [Learning Objective 2]

• Bispecific antibodies directed at EGFR paired with LGR5, TGF-beta, or MET; an anti-HGF monoclonal antibody; and an HPV16-directed mRNA therapeutic vaccine
• Trial design, early efficacy signals, and safety considerations for each

Role of the multidisciplinary team in R/M HNSCC [Learning Objective 4]

• Composition of the multidisciplinary team, and the proportion of patients needing two or more treatment modalities
• Evidence that multidisciplinary care improves outcomes, from meta-analysis and quality-improvement data
• Survivorship burden and patient-reported barriers to receiving survivorship care
• A structured multidisciplinary survivorship model, including screening for second primary tumors

Summary, conclusions, and key practice points

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

• Summarize the epidemiology and clinical burden of recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) and challenges to its optimal management
• Apply current treatment guidelines and clinical trial evidence to select pharmacotherapy for patients with R/M HNSCC
• Describe strategies for recognizing, managing, and monitoring immune-related and treatment-related adverse events in R/M HNSCC
• Formulate an individualized treatment plan for a patient with R/M HNSCC, integrating biomarker results and guideline recommendations
• Explain the role of the multidisciplinary team in optimizing treatment planning and care coordination for patients with R/M HNSCC

ACCME Activity #203769482

ScientiaCME is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.25 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

ABPath Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn Lifelong Learning (Part II) credits in the American Board of Pathology's (ABPath) Continuing Certification / Maintenance of Certification program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABPath credit.

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 and ABPath.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.25 contact hours (0.125 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 #0574-0000-26-033-H01-P. This is an 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.

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 1.25 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 1.25 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 1.25 AMA PRA Category 1 Credit(s)™.

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.

Disclosure of Faculty: Lori Wirth, MD, Professor of Medicine, Harvard Medical School, has received financial compensation from Eisai Inc, Fore Biotherapeutics, Leo Pharma, Merck, Novartis, Pyxis Oncology, Summit Therapeutics, Tubulis for consulting services; and grant/research support to Fore Biotherapeutics, BioNTech, Ellipses Pharma, and Novartis.

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

Faculty will NOT discuss off-label uses.

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 AVEO Pharmaceuticals.

• 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.

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