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OVERVIEW

Colorectal cancer (CRC) is the third leading cause of cancer among men and women, and the prognosis is especially poor for patients with metastatic CRC (mCRC), most of whom have unresectable tumors and will experience eventual disease progression on first-line systemic therapy options. Several VEGF inhibitors have recently been approved for treating patients with mCRC and disease progression after firstline therapy, and treatments have shown improvement in overall survival (OS) and other outcomes. As a result, they have been incorporated into recent evidence-based mCRC treatment guidelines. However, the safe and effective use of these agents requires consideration of the patient's prior treatment history, comorbid conditions, general health, and use of concomitant medications. This enduring case-based activity will enhance pharmacists' skills in caring for patients with mCRC who are being treated with VEGF inhibitors, including developing treatment strategies, identifying and managing adverse events, performing long-term monitoring, ensuring treatment adherence with oral therapies, and educating patients and other healthcare providers.

GOAL

The goal of this activity is provide pharmacists with an update on recent developments in anti-angiogenesis therapies for patients with mCRC. Participants will gain a thorough understanding of the efficacy and safety of recently approved targeted agents for patients experiencing progression after first-line therapy. Ultimately, participants will be better able to apply appropriate monitoring and management strategies for treatment-related adverse events.

TARGET AUDIENCE

This enduring case-based activity is designed for pharmacists who are involved in the care of patients being treated for mCRC. No prerequisites required.

LEARNING OBJECTIVES

The University of Tennessee College of Pharmacy takes responsibility for the content, quality, and scientific integrity of this CPE activity. At the conclusion of this activity, the participant should be able to:

• Identify the mechanisms of action of current and emerging targeted therapies for mCRC.
• Recognize appropriate management strategies for patients with mCRC progression after first-line therapy.
• Demonstrate approaches to effectively manage adverse events.

CREDIT DESIGNATION STATEMENT

The University of Tennessee College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Successful completion of this knowledge-based program will provide a statement for 0.5 contact hours of credit (0.05 CEUs) and will be available at the completion of the activity. Successfully completing the activity and receiving credit includes: 1) attending the session; 2) watching, listening to, and participating in the educational activity; 3) completing the self-assessment instrument with a score of at least 70%. UAN: 0064-0000-16-228-H01-P. CE credit will be submitted to the NABP CPE Monitor within 30 days.  It is recommended that you check your NABP CPE Monitor e-profile database 30 days after the completion of any CE activity to ensure that your credits are posted.

NABP e-PROFILE ID NUMBER

Pharmacists or pharmacy technicians with questions regarding their NABP e-Profile or CPE Monitor should refer to the FAQ section on the NABP website: https://nabp.pharmacy/cpe-monitor-service/cpe-monitor-faqs/. To receive credit for your participation in this activity, all pharmacists must include their NABP e-Profile ID number, along with their date and month of birth. If incorrect information is provided, this will result in "rejected" status from the CPE Monitor. It is the responsibility of the participant to notify The University of Tennessee (within the 60 day submission timeframe) of their corrected information. Otherwise, the completed CE will not be accepted by the CPE Monitor.

Please allow up to 30 days for your credit to appear on CPE Monitor.

Type of Activity: Knowledge

Published: December 30, 2016
Expires: December 30, 2017

Media: Internet

Fee Information: There is no fee for this educational activity.

Estimated time to complete activity: 30 minutes

HOW TO EARN CREDIT

Participants must complete the activity as described above in the Credit Designation Statement. To answer the questions, click on your selected choice for each answer then proceed to the next question. We recommend that you print a copy of your answers before you submit them to us. Once completed, click on Submit Post-test at the bottom of the page. Your post-test will automatically be graded. If you successfully complete the post-test (score of 70% or higher), your statement of CE credit will be made available immediately. Click on View Certificate and print the CE statement for your records. If you receive a score lower than 70%, you will receive a message notifying you that you did not pass the post-test. You will have 2 opportunities to pass the post-test.

FULL DISCLOSURE POLICY AFFECTING CPE ACTIVITIES

As an accredited provider by the Accreditation Council for Pharmacy Education (ACPE), it is the policy of The University of Tennessee College of Pharmacy to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The Course Director and Participating Faculty reported the following:

PARTICIPATING FACULTY

J. Aubrey Waddell, PharmD, FAPhA, BCOP (Chair)
Professor
University of Tennessee College of Pharmacy
Knoxville, Tennessee
Oncology Pharmacist
Blount Memorial Hospital
Maryville, Tennessee

Dr. Waddell reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

OFF-LABEL PRODUCT DISCUSSION

In accordance with ACPE Criteria for Quality, the audience is advised that discussions in this CPE activity may include reference(s) to unlabeled, unapproved, or investigational uses of therapeutic agents or biomedical devices, including, but not limited to, the following:

• Nintedanib – For the treatment of patients with mCRC.

DISCLAIMER STATEMENT

The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This activity is produced for educational purposes only. Use of The University of Tennessee College of Pharmacy name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

GRIEVANCE POLICY

A participant, sponsor, faculty member, or other individual wanting to file a grievance with respect to any aspect of an activity sponsored or cosponsored by The University of Tennessee College of Pharmacy may contact the Associate Dean for Continuing Education in writing at gfarr@utasip.com. The grievance will be reviewed and a response will be returned within 45 days of receiving the written statement. If not satisfied, an appeal to the Dean of the College of Pharmacy can be made for a second level review.

ACTIVITY

The following is an interactive case simulation designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, an interactive case study, and a CPE post-test, and evaluation. All 3 sections must be completed to receive CPE credit. A statement of credit will be available online immediately following successful completion of the activity.

REQUIRED COMPUTER HARDWARE/SOFTWARE

Please ensure the computer you plan to use meets the following minimum requirements:

• Operating System: Windows 98 or higher & Macintosh 2.2 or higher
• Internet Browser (Mac &/Windows): Internet Explorer 6.0 or higher, Google Chrome, Safari 5.0.6 or higher, Firefox 3.0.3 or higher & Opera 5 or higher
• Broadband Internet connection: Cable, High-speed DSL & any other medium that is internet accessible.
• Peripherals: Computer speakers or headphones
• Monitor Screen Resolution: 320 x 480 or higher
• Media Viewing Requirements: Adobe Reader, Microsoft Power Point, Flash Player & HTML5

TABLE OF CONTENTS

Preassessment

Updates on the Management of Metastatic Colorectal Cancer
J. Aubrey Waddell, PharmD, FAPhA, BCOP

Postassessment and Evaluation