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Perspectives for Pharmacy Practice: Optimizing Outcomes and Addressing Adherence Barriers to Oral Therapy in High-Risk HR+/HER2- Early Breast Cancer

This program is jointly provided by The University of Tennessee College of Pharmacy and Catalyst Medical Education, LLC.

This activity is supported by an educational grant from Lilly.

Release date

April 15, 2023

Expiration date

April 15, 2024

Estimated time to complete activity: 1.5 hour


The addition of the CDK4/6 inhibitor abemaciclib to adjuvant endocrine therapy (ET) improves invasive disease-free and distant recurrence-free survival in patients with high-risk hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) early breast cancer (EBC) compared with ET alone. Achieving maximal benefit from these therapies requires years of treatment and, although their oral mode of administration offers convenience, many patients experience significant issues with adherence and persistence throughout the duration of their treatment. This initiative will provide pharmacy professionals with the latest developments and clinical evidence related to the use of CDK4/6 inhibitors in high-risk HR+/HER2- EBC, as well as case-based guidance on strategies to anticipate, address, and counsel patients on potential adverse events (AEs), drug-drug interactions (DDIs), and tolerability considerations that may negatively impact adherence to and persistence with oral therapy.


This activity is primarily intended for pharmacists from all practice settings. No prerequisites required.


Following completion of this activity, the participant (pharmacist) should be able to:

  • Review the efficacy, safety, and recommended use of CDK4/6 inhibitors in HR+/HER2- EBC
  • Assess the pharmacokinetic, AE, and tolerability profile of CDK4/6 inhibitors when used in combination with adjuvant ET in HR+/HER2- EBC
  • Implement pharmacist-led strategies to address AEs, DDIs, and other pharmacotherapy challenges that negatively impact adherence to oral therapy in HR+/HER2- EBC
  • Incorporate communication strategies and educational tools to help patients understand the risks, benefits, and treatment expectations associated with oral therapies used in HR+/HER2- EBC


Erica L. Mayer, MD, MPH (Course Director)
Director of Breast Cancer Clinical Research
Dana-Farber Cancer Institute
Associate Professor in Medicine
Harvard Medical School
Boston, MA

Allison Butts, PharmD, BCOP
Clinical Pharmacist Manager, Oncology
Clinical Pharmacy Specialist, Breast Oncology
Program Director, PGY2 Hematology/Oncology Pharmacy Residency
UK HealthCare Markey Cancer Center
Lexington, KY

Relevant financial disclosures: Dr. Mayer reports being a consultant for Lilly, Novartis, Gilead, and AstraZeneca and Dr. Butts reports serving on an advisory board for AstraZeneca and BeyondSprings. All financial disclosures have been mitigated.


acpeThe 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 application-based activity will provide a statement for 1.5 contact hours of credit (0.15 CEU) and will be available within 48 hours of activity completion. Successfully completing the activity and receiving credit includes: 1) reading the learning objectives and faculty disclosures; 2) participating in the educational activity; 3) submit a CE credit submission form when prompted at the conclusion of the activity. UAN: 0064-9999-23-200-H01-P. CE credit will be submitted to the NABP CPE monitor within 24 hours. 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.

Type of Activity: Application

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

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:


Participants must complete the activity as described above in the Credit Designation Statement.

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 presenters will inform the learner when they discuss or reference an unapproved, unlabeled, or investigational use of a 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.


Please ensure the computer system 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


A participant, provider, faculty member, or other individual wanting to file a grievance with respect to any aspect of an activity provided or co-provided by The University of Tennessee College of Pharmacy may contact the Director of Continuing Professional Development at jwheele4@uthsc.edu. 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.


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.