TARGET AUDIENCE
This activity has been designed to meet the educational needs of oncology nurses, nurse practitioners and clinical nurse specialists involved in the treatment of gastrointestinal (GI) cancers.

OVERVIEW OF ACTIVITY
Cancer of the colon or rectum is the fourth most frequently diagnosed malignant neoplasm and the second most common cause of cancer death in the United States (approximately 9% of all cancer deaths). In 2017, it is estimated that 95,520 new cases of colon cancer and 39,910 new cases of rectal cancer will be documented in the US population, representing a continued decline over the past 2 decades thought to be related to improvements in detection and treatment. Although individually less frequently encountered, the collection of noncolorectal GI cancers actually account for more deaths per annum than those attributed to tumors of the colon and rectum combined. Within this collection of distinct diseases, a number have undergone several recent advances that have already drastically altered (or have the potential to alter) current treatment considerations and approaches. While these new options are welcomed by all, they create a challenge for those members of the interdisciplinary treatment team who are required to learn about, explain and appropriately integrate them into standard clinical practice. Educational opportunities relevant to the clinical management of colorectal cancer and select noncolorectal GI cancers — namely gastric, pancreatic and liver cancer — are essential for all healthcare professionals responsible for delivering comprehensive care to these patients.

Although medical oncologists have been routinely responsible for counseling patients with regard to therapeutic decision-making, oncology nurses play an integral role in the successful delivery of systemic anticancer therapy and the preservation of patient physical and psychosocial well-being. These video proceedings from the seventh part of a 7-part integrated CNE curriculum originally held at the 2017 ONS Annual Congress feature discussions with leading GI cancer investigators and their nursing counterparts regarding actual patient cases and recent clinical research findings affecting the optimal therapeutic and supportive care for each patient scenario.

LEARNING OBJECTIVES

• Apply available research data to the therapeutic and supportive care of patients with locally advanced and metastatic colorectal cancer, gastric cancer, pancreatic cancer and GI neuroendocrine tumors (NET).
• Describe the clinical indications and toxicities associated with the use of existing (bevacizumab, EGFR inhibitors, regorafenib) and recently approved (ramucirumab, TAS-102) systemic therapies used in the management of metastatic colorectal cancer.
• Appreciate the recent FDA approval of irinotecan liposome injection (nal-IRI) in combination with 5-FU/leucovorin, and develop effective strategies to integrate this regimen into the management of pancreatic cancer.
• Discuss the benefits and risks associated with existing and recently approved treatments used in the evidence-based management of newly diagnosed and progressive GI NET, including somatostatin analogues, targeted biologic agents and cytotoxic therapy.
• Use clinical characteristics and molecular biomarkers to select optimal treatment strategies for patients with metastatic gastric or gastroesophageal cancer.
• Appraise the rationale for and clinical data with investigational anti-PD-1 and anti-PD-L1 antibodies for patients with various forms of GI cancer.

ACCREDITATION STATEMENT
Research To Practice is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

CREDIT DESIGNATION STATEMENT
CNE credit is no longer available for this issue

ONCC/ILNA CERTIFICATION INFORMATION
CNE credit is no longer available for this issue

FOR SUCCESSFUL COMPLETION
This is a video CNE program.
CNE credit is no longer available for this issue

CONTENT VALIDATION AND DISCLOSURES
Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CNE activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

Holly Bushart, MSN, ACNP-BC, AOCNP
Director of Advanced Practice Providers
Tennessee Oncology
Nashville, Tennessee

Speakers Bureau: Bayer HealthCare Pharmaceuticals, Taiho Oncology Inc.

J Randolph Hecht, MD
Professor of Clinical Medicine
Director, UCLA GI Oncology Program
Carol and Saul Rosenzweig Chair in Cancer Therapies Development
Santa Monica, California

Consulting Agreements: Amgen Inc, Genentech BioOncology, Roche Laboratories Inc.

Brianna Hoffner, MSN, ANP-BC, AOCNP
Lead Advanced Practice Provider, Medical Oncology
University of Colorado Cancer Center
Aurora, Colorado

Advisory Committee: Lilly.

Wells A Messersmith, MD
Professor and Director, GI Medical Oncology Program
Co-Leader, Developmental Therapeutics Program
University of Colorado Cancer Center
Aurora, Colorado

Contracted Research: Celgene Corporation, Genentech BioOncology, Pfizer Inc, Roche Laboratories Inc, Takeda Oncology.

MODERATOR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME/CNE activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals Inc.

RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no relevant conflicts of interest to disclose.

This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

This activity is supported by educational grants from Ipsen Biopharmaceuticals Inc, Lexicon Pharmaceuticals Inc, Lilly, Merck and Taiho Oncology Inc.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
Adobe Flash Player 10.2 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Last review date: July 2017
Expiration date: July 2018

There is no implied or real endorsement of any product by RTP or the American Nurses Credentialing Center.