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OVERVIEW

Although a large number of tyrosine kinase inhibitors (TKIs) have been approved for the treatment of patients with a variety of different cancer types, patients with advanced disease often become resistant to treatment and eventually develop progressive disease. Considerable recent research has focused on the identification of new treatment options for patients with advanced solid tumors, which has resulted in recent new or expanded indications of TKIs for patients with several cancer types, including renal cell carcinoma (RCC), gastrointestinal stromal tumors (GIST), and differentiated thyroid cancer (DTC). The successful use of TKIs requires a thorough understanding of the unique safety and tolerability profiles of these agents, as well as potential drug interactions and monitoring requirements. As essential members of the multidisciplinary treatment team, pharmacists are critical to ensure that patients receive appropriate treatment and that they are monitored for adverse events, drug interactions, and treatment adherence.

GOAL

The goal of this activity is to provide pharmacists with a thorough understanding of the efficacy and safety of recently approved TKIs for treating patients with various types of solid tumors. Upon completing this activity, participants will be better able to select evidence-based treatment strategies for patients with advanced solid tumors and to identify appropriate monitoring and management strategies for treatment-related adverse events.

TARGET AUDIENCE

This enduring case activity is designed for pharmacists who are involved in the care of oncology patients being treated with TKIs. 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:

• ASSESS the role of recently FDA-approved TKIs in the treatment of DTC, GIST, and RCC, including new approvals and expanded indications.
• IDENTIFY both common AEs and DDIs associated with TKI therapy for DTC, GIST, and RCC
• IMPLEMENT pharmacist-driven strategies to manage AEs and DDIs characteristic of TKI therapy.

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 CEU) 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: 0064-0000-16-226-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: http://www.nabp.net/programs/cpe-monitor/cpe-monitor-service. 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: November 30, 2016
Expires: November 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

Kelley D. Carlstrom, PharmD, BCOP
Clinical Specialist-Hematology/Oncology
Cleveland Clinic, South Pointe Hospital
Warrenville Heights, Ohio
Dr Carlstrom reports serving as a consultant to and on the advisory board for Pfizer Inc, Seattle Genetics Inc, and Spectrum Pharmaceuticals Inc.

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:

• Cabozantinib – First-line treatment for patients with kidney cancer with non-clear cell histology.
• Regorafenib – Second-line treatment for patients with HCC.

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 Powerpoint, Flash Player & HTML5

TABLE OF CONTENTS

• Preassessment
  
  
• Tyrosine Kinase Inhibitors:
  Updates on the use in Differentiated Thyroid Cancer, Renal Cell Carcinoma, and Gastrointestinal Stromal Tumor
  Kelley D. Carlstrom, PharmD, BCOP
  
  
• Postassessment and Evaluation