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PARP Inhibitors and their Emerging Role in Cancer Therapy
A Guide for the Oncology Pharmacist

This activity was recorded on March 22, 2018, during the HOPA Annual Meeting.

Release Date

June 22, 2018

Expiration Date

June 22, 2019

FACULTY

Jason Bergsbaken, PharmD, BCOP
Pharmacy Coordinator, Regional Oncology Services
University of Wisconsin Hospital and Clinics
Madison, Wisconsin

James M. Ford, MD
Professor of Medicine and Genetics
Director, Stanford Program for Clinical Cancer Genomics
Division of Oncology
Stanford University School of Medicine
Stanford, California

Needs Statement

The DNA damage response (DDR) pathway is an essential mechanism used to maintain genomic integrity in all cells. Nearly all cancers have deficiencies in one or two DDR pathways, resulting in increased dependence on alternate, less accurate pathways.^1,2 Poly ADP-ribose polymerase (PARP) inhibitors are oral agents developed to inhibit these compensatory pathways, resulting in "synthetic lethality," or the death of the DDR defective cell. PARP inhibitors have thus far been shown to be effective in BRCA mutation-positive tumors, including ovarian, breast, and other cancers.³ While these oral agents offer patients increased flexibility, there also is the potential for incorrect administration, increased drug interactions, and decreased adherence.⁴ Oncology pharmacists have extensive knowledge regarding pharmacokinetic, pharmacodynamic, efficacy, and financial aspects of oral chemotherapy and are optimally positioned to play a vital role in the oral cancer therapy management of PARP inhibitors. Thus, it is vital that oncology pharmacists be up-to-date on the latest advances in PARP inhibition, including emerging indications and drug formulations, recognition and management of adverse events, appropriate therapy selection based on genetic testing results, and patient adherence strategies.

The objective of this educational activity is for participants to gain an appreciation of the latest clinical and scientific advances in targeting DDR, including updates on the current and emerging prospects of PARP inhibitors for ovarian, breast, and other cancers. Using a case-based approach, faculty will discuss therapeutic selection, genetic testing and counseling, patient adherence strategies, and the recognition and management of adverse events for patients receiving PARP inhibitors.

¹van Gent DC, et al. Mol Biol Cell. 2016. ²O'Connor MJ, et al. Mol Cell. 2015. ³Cerrato A, et al. J Exp Clin Canc Res. 2016. ⁴Felton MA, et al. J Oncol Pharm Pract. 2016.

Target Audience

This activity is designed to meet the educational needs of oncology pharmacists, pharmacy directors, and pharmacy residents.

Objectives

At the conclusion of this application-based activity, participants will be able to:

1. Analyze the main signaling pathways and key mechanisms in DNA damage repair and how deficiencies in these pathways can lead to tumor proliferation and growth.
2. Examine the pharmacology of PARP inhibitors and how these agents induce tumor cell death by exploiting the concept of "synthetic lethality" in cells with BRCA mutations.
3. Explore evolving data regarding the efficacy and adverse event profiles of PARP inhibitors currently approved and in clinical development for patients with ovarian, breast, prostate, and pancreatic cancers.
4. Using a case-based approach, assess challenging questions regarding PARP inhibitors and discuss the ways that the oncology pharmacist can optimize therapy, anticipate adverse effects, and improve adherence.

Accreditation

CPE
In support of improving patient care, Creative Educational Concepts is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

This application-based activity is approved for 1.50 contact hours (0.150 CEUs) of continuing pharmacy education credit (UAN JA0007101-0000-18-006-H01-P).

Other
Creative Educational Concepts, Inc. certifies this activity for 1.50 hours of participation.

Faculty Disclosure

Planner and Faculty Disclosures
In accordance with the Food and Drug Administration, the speakers have disclosed that there is the potential for discussions concerning off-label uses of a commercial product/device during this educational activity.

Any person who may contribute to the content of this continuing education activity must disclose relevant relationships (and any known relationships of their spouse/partner) with commercial interests whose products or services are discussed in educational presentations. A commercial interest is defined as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Relevant relationships include receiving from a commercial interest research grants, consultant fees, travel, other benefits, or having a self-managed equity interest in a company.

Disclosure of a relationship is not intended to suggest or condone any bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

Planner

Vanessa Carranza, PharmD—has no relevant financial relationships to disclose in relation to the content of this activity.

Authors/Presenters

Jason Bergsbaken, PharmD, BCOP—has no relevant financial relationships to disclose in relation to the content of this activity.

James M. Ford, MD—has no relevant financial relationships to disclose in relation to the content of this activity.

Peer Reviewer

Patrick J. Kiel, PharmD, BCPS, BCOP—has no relevant financial relationships to disclose in relation to the content of this activity.

Activity Instructions

Media: Internet Web Activity (PowerPoint slides and audio)

Instructions

To receive a statement of credit, you must:

1. Read the target audience, learning objectives, and author disclosures.
2. Review the full content of the activity and reflect upon its teaching.
3. Complete the questions and evaluation at the end of the activity.
4. You must have a passing score of 75% on the post-test. You will have two (2) opportunities to complete the post-test.