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1. Which of the following is the most appropriate outcome for patients who received avelumab maintenance therapy following platinum-based chemotherapy for advanced bladder cancer?

A. Avelumab was inferior to best supportive care (BSC) B. Avelumab demonstrated an overall survival (OS) benefit versus BSC C. Avelumab demonstrated an OS benefit versus BSC only in PD-L1+ patients D. Avelumab improved progression-free survival (PFS) but not OS E. Unsure

2. Which of the following therapies for advanced bladder cancer is associated with an OS benefit following progression on frontline chemotherapy?

A. Pembrolizumab B. Nivolumab C. Durvalumab D. Atezolizumab E. Unsure

3. Which of the following is true regarding the use of immune checkpoint inhibitors (ICIs) as frontline treatment in patients with advanced bladder cancer?

A. Patient should be PD-L1+ or platinum-ineligible to receive pembrolizumab or atezolizumab B. Pembrolizumab or atezolizumab are standard frontline therapy options regardless or PD-L1 expression C. Patients who are cisplatin-eligible require PD-L1+ tumors in order to receive either pembrolizumab or atezolizumab D. Pembrolizumab or atezolizumab may be combined with platinum-based chemotherapy in the frontline setting regardless of PD-L1 expression E. Unsure

4. DH is a 72-year-old woman recently diagnosed with metastatic urothelial carcinoma (mUC) with nodal involvement and liver metastasis. Her past medical history is significant for hypertension, type 2 diabetes, chronic kidney disease (GFR = 20 mL/min), and New York Heart Association (NYHA) class II heart failure. Her urologist does not think she is a good candidate for dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) chemotherapy as she may be too frail. PD-L1 expression testing was negative. Which of the following treatment options is most appropriate for DH as first-line (1L) therapy?

A. Gemcitabine + cisplatin B. Pembrolizumab C. Nivolumab D. Durvalumab E. Unsure

5. BJ, a 64-year old male, is newly diagnosed with stage IV clear cell renal cell carcinoma (ccRCC). His current Karnofsky Performance Status (KPS) is 75% and his complete metabolic panel is within normal limits. His complete blood count (CBC) are within normal limits other than an elevated neutrophil count of 9.8 x 109/L. Which risk category is the most appropriate for BJ?

A. Favorable-risk disease per International Metastatic RCC Database Consortium (IMDC) prognostic criteria B. Intermediate-risk disease per IMDC prognostic criteria C. Poor-risk disease per Memorial Sloan Kettering Cancer Center (MSKCC) prognostic model D. Low-risk disease per MSKCC prognostic model E. Unsure

6. Which of the following should be considered when selecting therapy for patients with renal cell carcinoma (RCC)?

A. Prognostic risk for 1L therapy B. Prognostic risk for 2L therapy C. Cytogenetics D. DNA mismatch repair (MMR) status E. Unsure

7. AD, a 63-year old male, was initially treated with pembrolizumab + axitinib for intermediate risk, stage IV RCC. After 7 months of therapy, he presents to his oncologist and is found to have disease progression. Which of the following would be an appropriate 2L therapy for AD?

A. Avelumab + axitinib B. Sunitinib C. Interferon D. Ipilimumab/nivolumab E. Unsure

8. MJ was recently initiated on ipilimumab/nivolumab for advanced RCC. She presents to your clinic for follow-up and initiation of cycle 2, and it is noted that she is experiencing a mild skin reaction that does not bother her (<10% of body surface; grade 1). She denies pruritus or any other symptoms. Which of the following is the most appropriate management?

A. Discontinue ipilimumab/nivolumab and initiate prednisone 1-2 mg/kg/day B. Continue ipilimumab/nivolumab and initiate topical triamcinolone cream BID-TID C. Continue ipilimumab/nivolumab and initiate infliximab 5 mg/kg once every 2 weeks D. Switch from ipilimumab/nivolumab to sunitinib E. Unsure

9. JG, a 61-year old male, presents to the clinic for Cycle 2 Day 15 of avelumab/axitinib therapy for metastatic RCC. As the oncology pharmacist, you receive a call from the infusion nurse stating that JG has reported 2 to 3 episodes of diarrhea per day over the past 3 days (grade 1) and asks if his infusion should be held. Which of the following is the most appropriate recommendation?

A. Hold avelumab and initiate loperamide 4 mg after the first loose stool followed by 2 mg with subsequent episodes B. Hold avelumab and initiate prednisone 1-2 mg/kg/day followed by a long taper upon resolution of diarrhea C. Continue avelumab/axitinib and initiate loperamide 4 mg after the first loose stool followed by 2 mg with subsequent episodes D. Hold avelumab/axitinib and initiate prednisone 1-2 mg/kg/day and loperamide 4 mg after the first loose stool followed by 2 mg with subsequent episodes E. Unsure

10. BK has recently initiated therapy with cabozantinib + nivolumab for advanced RCC. After 3 cycles of therapy, he reports more fatigue and lethargy than normal, dry skin, and hair thinning. Which of the following would be the most appropriate intervention at this time?

A. Hold therapy and initiate prednisone 0.5-1 mg/kg/day B. Evaluate thyroid function and initiate levothyroxine as appropriate C. Continue therapy and initiate topical corticosteroids D. Hold therapy and initiate infliximab 5 mg/kg once E. Unsure

Evaluation Questions

11. How confident are in your treatment choices for the patients in the posttest?

A. Not at all confident B. Somewhat confident C. Confident D. Highly confident

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. Which of the following is the most appropriate outcome for patients who received avelumab maintenance therapy following platinum-based chemotherapy for advanced bladder cancer?

2. Which of the following therapies for advanced bladder cancer is associated with an OS benefit following progression on frontline chemotherapy?

3. Which of the following is true regarding the use of immune checkpoint inhibitors (ICIs) as frontline treatment in patients with advanced bladder cancer?

6. Which of the following should be considered when selecting therapy for patients with renal cell carcinoma (RCC)?

7. AD, a 63-year old male, was initially treated with pembrolizumab + axitinib for intermediate risk, stage IV RCC. After 7 months of therapy, he presents to his oncologist and is found to have disease progression. Which of the following would be an appropriate 2L therapy for AD?

10. BK has recently initiated therapy with cabozantinib + nivolumab for advanced RCC. After 3 cycles of therapy, he reports more fatigue and lethargy than normal, dry skin, and hair thinning. Which of the following would be the most appropriate intervention at this time?

Evaluation Questions

11. How confident are in your treatment choices for the patients in the posttest?

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. Which of the following is the most appropriate outcome for patients who received avelumab maintenance therapy following platinum-based chemotherapy for advanced bladder cancer?

2. Which of the following therapies for advanced bladder cancer is associated with an OS benefit following progression on frontline chemotherapy?

3. Which of the following is true regarding the use of immune checkpoint inhibitors (ICIs) as frontline treatment in patients with advanced bladder cancer?

6. Which of the following should be considered when selecting therapy for patients with renal cell carcinoma (RCC)?

7. AD, a 63-year old male, was initially treated with pembrolizumab + axitinib for intermediate risk, stage IV RCC. After 7 months of therapy, he presents to his oncologist and is found to have disease progression. Which of the following would be an appropriate 2L therapy for AD?

10. BK has recently initiated therapy with cabozantinib + nivolumab for advanced RCC. After 3 cycles of therapy, he reports more fatigue and lethargy than normal, dry skin, and hair thinning. Which of the following would be the most appropriate intervention at this time?

Evaluation Questions

11. How confident are in your treatment choices for the patients in the posttest?

« Return to Activity

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