GrandRoundsNursesBC19


TARGET AUDIENCE
This activity is intended for oncology nurses, nurse practitioners, clinical nurse specialists and other healthcare providers involved in the treatment of ER-positive metastatic breast cancer (mBC).

OVERVIEW OF ACTIVITY
Among the widely acknowledged BC phenotypes, ER-positive disease, which represents approximately 63% of cases, is perhaps the most nuanced with regard to therapeutic decision-making in the advanced disease setting. Specifically, improved understanding of the mechanisms by which breast tumors develop resistance to endocrine therapy has led to the appreciation that several other biologic pathways may be implicated in this process and has in turn fostered a spate of clinical research designed to evaluate novel therapies with inhibitory activity against these potential targets. Significantly, the results of these efforts have now been actualized in the clinic as over the past several years the FDA has granted approval to several unique treatments that, when combined with hormonal therapy (or in some instances on their own), have been shown to enhance efficacy over endocrine intervention alone. Importantly, although the availability of these therapies undoubtedly provides immense benefit to patients, the many related issues (eg, sequencing, side effects) have increased the demands placed on clinicians and created additional areas of uncertainty.

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. This video presentation uses a review of recent relevant publications and presentations to assist oncology nurses involved in the treatment of ER-positive mBC with the formulation of optimal therapeutic and supportive care strategies.

PURPOSE STATEMENT
By providing information on the latest research developments in the context of expert perspectives, this CNE activity will assist oncology nurses, nurse practitioners and clinical nurse specialists with the formulation of state-of-the-art clinical management strategies to facilitate optimal care of patients with ER-positive mBC.

LEARNING OBJECTIVES

  • Describe the influence of estrogen and/or progesterone receptor positivity on long-term outcomes and the selection of systemic therapy for patients with advanced BC.
  • Discuss the benefits and risks associated with existing and recently approved systemic therapies used in the evidence-based treatment of ER-positive mBC, including endocrine agents, chemotherapy regimens and biologic treatments.
  • Recognize the FDA-endorsed indications for the commercially available CDK4/6 inhibitors, and discern how these agents can be optimally employed in the nonresearch care of patients with mBC.
  • Educate patients regarding the unique side effects associated with CDK4/6 inhibitors, and develop preventive and emergent strategies to reduce or ameliorate these toxicities.
  • Understand the biologic rationale for therapeutically targeting the mTOR pathway in patients with ER-positive mBC, and educate patients regarding the FDA-endorsed role and unique side effects associated with everolimus.
  • Appreciate the detrimental effect of poor adherence to treatment, identify and monitor potential causes of this phenomenon and develop a plan to effectively assess and support compliance for patients receiving oral anticancer therapies.
  • Identify opportunities to enhance communication and facilitate ongoing dialogue between the oncology nurse and patients with mBC to optimize clinical and quality-of-life outcomes.

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

CREDIT DESIGNATION STATEMENTS
This educational activity for 1.3 contact hours is provided by RTP during the period of July 2019 through July 2020.

This activity is awarded 1.3 ANCC pharmacotherapeutic contact hours.

ONCC/ILNA CERTIFICATION INFORMATION
The program content has been reviewed by the Oncology Nursing Certification Corporation (ONCC) and is acceptable for recertification points. To review certification qualifications, please visit ResearchToPractice.com/GrandRoundsNursesBC19/ILNA.

ONCC review is only for designating content to be used for ILNA points and is not for CNE accreditation. CNE programs must be formally approved for contact hours by an acceptable accreditor/approver of nursing CE to be used for recertification by ONCC. If the CNE provider fails to obtain formal approval to award contact hours by an acceptable accrediting/approval body, no information related to ONCC recertification or ILNA categories may be used in relation to the program.

FOR SUCCESSFUL COMPLETION
This is a video CNE program. To receive credit, participants should read the learning objectives and faculty disclosures, watch the video, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/GrandRoundsNursesBC19/CNE.

CONTENT VALIDATION AND DISCLOSURES
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 reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

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

Joyce O’Shaughnessy, MD
Chair, Breast Cancer Research Program
Baylor Charles A Sammons Cancer Center
Celebrating Women Chair in Breast Cancer Research
Texas Oncology
US Oncology
Dallas, Texas

Advisory Committee and Consulting Agreements: Agendia Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Eisai Inc, Genentech, Ipsen Biopharmaceuticals Inc, Lilly, Novartis, Pfizer Inc, Puma Biotechnology Inc, Roche Laboratories Inc, Seattle Genetics; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Lilly, Novartis.

EDITOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME/CNE activities from the following commercial interests: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech, Genmab, Genomic Health Inc, Gilead Sciences Inc, Guardant Health, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Oncopeptides, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, a Novartis Division, Sanofi Genzyme, Seattle Genetics, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

RTP CNE PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent reviewers for RTP 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 Lilly and Novartis.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
Adobe Flash Player 27 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Release date: July 2019
Expiration date: July 2020

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