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 bladder cancer.

OVERVIEW OF ACTIVITY
It is estimated that 76,960 new cases of bladder cancer will be diagnosed in 2016 and 16,390 deaths will be attributable to this disease. Although bladder cancer is a heterogeneous collection of diseases, more than 90% of patients are diagnosed with its most common form, urothelial carcinoma. Optimal treatment of urothelial bladder cancer (UBC) is dependent upon the stage and grade as well as preexisting patient comorbidities. For the segment of patients who present with or develop metastatic lesions beyond the bladder, the goal, as is the case with many other solid tumors, is to prolong the quantity and quality of life. Unfortunately, the only nonprotocol systemic treatment available to these individuals over the past few decades has been chemotherapy. However, it appears that a major breakthrough for this disease has finally materialized in the form of immune checkpoint inhibition.

This development coupled with the diverse clinical presentations of UBC require an in-depth understanding among all of the interdisciplinary treatment team members regarding the optimal workup and treatment of these individuals. As such, it remains imperative that members of the oncology community, including nurses actively involved in the care of these patients, maintain up-to-date knowledge in the face of an increasingly dynamic clinical environment. These video proceedings from the eighth part of an 8-part integrated CNE curriculum originally held at the 2016 ONS Annual Congress feature discussions with leading oncology and urology 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.

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 bladder cancer.

LEARNING OBJECTIVES

• Discuss the benefits and risks associated with various local and/or systemic therapeutic approaches used in the treatment of nonmuscle-invasive, muscle-invasive and metastatic UBC.
• Develop an evidence-based algorithm for the prevention and amelioration of side effects associated with chemotherapeutic agents/regimens used in the management of locally advanced or metastatic UBC.
• Appreciate the recent FDA approval of atezolizumab for the treatment of locally advanced and metastatic UBC, and discern how this therapy can be appropriately integrated into clinical management strategies.
• Recognize immune-related adverse events and other common side effects associated with approved and investigational immunotherapeutic approaches, and use this information to develop supportive management plans for patients undergoing treatment with these agents.
• Identify opportunities to enhance the collaborative role of oncology nurses in the comprehensive biopsychosocial care of patients with UBC.

ACCREDITATION STATEMENT

CNE credit is no longer available for this issue

CREDIT DESIGNATION STATEMENT

CNE credit is no longer available for this issue

ONCC/ILNA CERTIFICATION INFORMATION
The program content has been reviewed by the Oncology Nursing Certification Corporation (ONCC) and is acceptable for recertification points.

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 potential 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 their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

Anastassia Daskalova, MSN, ANP-BC
Genitourinary Medical Oncology
Tisch Cancer Institute
Icahn School of Medicine at Mount Sinai
New York, New York

No relevant conflicts of interest to disclose.

Matthew D Galsky, MD
Director, Genitourinary Medical Oncology
Tisch Cancer Institute
Associate Professor of Medicine
Icahn School of Medicine at Mount Sinai
New York, New York

Advisory Committee: Astellas Pharma Global Development Inc, Genentech BioOncology, Novartis Pharmaceuticals Corporation; Contracted Research: Bristol-Myers Squibb Company, Celgene Corporation; Ownership Interest: Dual Therapeutics.

Leonard G Gomella, MD
The Bernard W Godwin Professor of Prostate Cancer
Chairman, Department of Urology
Associate Director, Jefferson Sidney Kimmel Cancer Center
Clinical Director, Jefferson Sidney Kimmel Cancer Center Network
Editor-in-Chief, Canadian Journal of Urology
Philadelphia, Pennsylvania

Advisory Committee: Abbott Laboratories, Astellas Pharma Global Development Inc, Bayer HealthCare Pharmaceuticals, Merck; Consulting Agreements: Dendreon Corporation, Janssen Biotech Inc, Merck; Contracted Research: Astellas Pharma Global Development Inc.

Elizabeth R Plimack, MD, MS
Director, Genitourinary Clinical Research
Associate Professor, Department of Hematology/Oncology
Fox Chase Cancer Center, Temple Health
Philadelphia, Pennsylvania

Advisory Committee: Acceleron Pharma, Bristol-Myers Squibb Company, Genentech BioOncology, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc; Consulting Agreements: Bristol-Myers Squibb Company, Lilly, Pfizer Inc; Contracted Research: Acceleron Pharma, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, GlaxoSmithKline, Lilly, Merck, Pfizer Inc.

Susan K Roethke, CRNP, MSN, ANP-BC, AOCNP
Genitourinary Medical Oncology
Fox Chase Cancer Center
Philadelphia, Pennsylvania

Consulting Agreements and Speakers Bureau: Pfizer Inc; Nurse Advisory Board: Exelixis Inc.

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, Agendia Inc, Amgen 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, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Teva Oncology, Tokai Pharmaceuticals Inc and VisionGate 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 grantor.

This activity is supported by an educational grant from Genentech BioOncology.

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: August 2016
Expiration date: August 2017

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