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Evolving Therapies for Advanced or Metastatic Hormone Receptor Positive (HR+) Breast Cancer: Pharmacist Interventions that Improve CDK 4/6 Inhibitor Therapy Outcomes – Case 2

Provided by The University of Tennessee College of Pharmacy, in cooperation with ASiM.
Supported by an educational grant from Pfizer Inc.


Hormone-receptor positive (HR+) breast cancer is highly responsive to endocrine therapy, and yet many women will progress to metastatic disease. Advanced and metastatic HR+ breast cancer, though it expresses hormone receptors, is more resistant to endocrine therapy. CDK4/6 inhibitors act on the initiation of the cell cycle at the restriction point, at a place where multiple mitogenic pathways converge, including estrogen – estrogen receptor (ER) complex. The first agent in this class was approved in 2016, and 2 others have been approved since then, for the treatment of patients with HR+, HER2- advanced and metastatic breast cancer (MBC). As the medication experts on the oncology care team treating patients with breast cancer, it is necessary for pharmacists to have a detailed understanding of the benefits and adverse effects of these new agents. This activity will focus on the use of CDK4/6 inhibitors as monotherapy and how pharmacists can contribute to the patient care team and improve outcomes.


The goal of this activity is for pharmacists to have a better understanding of the place of CDK4/6 inhibitors in the management of patients with HR+, HER2-negative (HER-2-) advanced and MBC. They will also better understand their potential role when taking care of patients with MBC.


This activity has been designed to meet the needs of oncology, health system, managed care, specialty pharmacists and other pharmacists who manage patients receiving systemic therapy for HR+ breast cancer. No prerequisites required.


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:

  • DESCRIBE the role of CDK 4/6 inhibitors as monotherapy in patients with HR+, HER2- breast cancer that has progressed following endocrine therapy and prior chemotherapy in the metastatic setting.
  • DISCUSS the role of the pharmacist in the management of a patient receiving CDK 4/6 inhibitor monotherapy.


acpe 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 activity will provide a statement for .5 contact hour of credit (0.5 CEU) and will be available at the completion of the activity. Successfully completing the activity and receiving credit includes: 1) reading the learning objectives and faculty disclosures; 2) studying the educational activity; 3) evaluating the activity; and, 4) completing the self-assessment instrument with a score of at least 70%. UAN: 0064-0000-18-204-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.


This statement contains information provided to NABP from the Accreditation Council for Pharmacy Education (ACPE) via CPE Monitor®. ACPE policy states paper and/or electronic statements of credit may no longer be distributed directly to learners as proof of ACPE credit. The official record of credit may be located in the learner’s e-profile in CPE Monitor®. It is recommended that you check your e-profile in CPE Monitor® a few weeks after completion of any CE activity to ensure that your credits are posted. If you don’t see your CE credits correctly displayed from this activity, contact the University of Tennessee College of Pharmacy at jwheele4@uthsc.edu.

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

Type of Activity: Knowledge
Media: Internet
Fee Information: There is no fee for this educational activity.

Estimated time to complete activity: 30 minutes


October 30, 2018


October 30, 2019


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 3 opportunities to pass the post-test.


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 Faculty Author/Chair reported the following:


Larry W. Buie, PharmD, BCOP, FASHP
Adult Residency Program Director/ Manager, Clinical Pharmacy Services
Memorial Sloan Kettering Cancer Center
New York, New York
Dr Buie reports serving as a consultant for Heron Therapeutics Inc and Pfizer Inc.


In accordance with ACPE Criteria for Quality, the audience is advised that authors in this CPE activity may include reference(s) to unlabeled, unapproved, or investigational uses of therapeutic agents or biomedical devices. The faculty author/chair will inform the reader of when they discuss or reference an unapproved, unlabeled, or investigational use of therapeutic agent or biomedical device.


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.


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 preassessment, an interactive case study, and a CPE postassessment, 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.


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



Evolving Therapies for Advanced or Metastatic Hormone Receptor Positive (HR+) Breast  Cancer: Pharmacist Interventions that Improve CDK 4/6 Inhibitor Therapy Outcomes
Larry W. Buie, PharmD, BCOP, FASHP

Postassessment and Evaluation