AXIS Medical Education: Recent Episodes
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Host: Sara M. Tolaney, MD, MPH
This Chairperson’s Perspective will provide an in-depth look at ADC-directed therapies for HR+/HER2-expressing metastatic breast cancer. Participants will explore current treatment options, emerging data, and best practices for selecting and sequencing therapies. The session will also cover strategies for managing adverse events associated with these treatments to optimize patient outcomes. Designed for healthcare professionals, this program aims to enhance clinical decision-making in the evolving landscape of metastatic breast cancer care.
Host: Helena Yu, MD
The treatment of EGFR-mutated advanced non-small-cell lung cancer (NSCLC) that has progressed on EGFR TKI therapy remains a clinical challenge, as traditional therapies have yielded only modest results. However, recent findings show that targeting HER3 can produce dramatically improved clinical outcomes. Data are rapidly emerging from late-phase trials evaluating HER3-directed antibody-drug conjugate therapies, and it is thus crucial for community-based oncologists and interprofessional care team members to be aware of these findings so they can be prepared to integrate these therapies into practice once they are available. In this activity, expert faculty in the field of NSCLC will evaluate recent data supporting the use of HER3-directed ADCs in the treatment of locally advanced and metastatic EGFR-mutated NSCLC that has progressed on EGFR TKI therapy, optimal management strategies for treatment-emergent adverse events related to these therapies, and the potential role of these agents in the current treatment paradigm. Faculty will also discuss best practices for a successful multidisciplinary approach and for optimized shared decision-making with the patient. Finally, case discussions will conclude the program to reinforce key learnings from the didactic section of the activity.
Host: Matthew S. Davids, MD, MMSc
Although covalent Bruton's tyrosine kinase (BTK) inhibitors have proven to be effective in treating chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) or mantle cell lymphoma (MCL), patients still experience poor outcomes after treatment failure or intolerance, necessitating new therapeutic options. Next-generation non-covalent, reversible BTK inhibitors, which have increased specificity and a novel mechanism of action, may address unmet needs and deliver better care. These next-generation BTK inhibitors have been successful in clinical trials and are changing the treatment paradigm as well as practice guidelines. Understanding key differences between the covalent and non-covalent BTK inhibitors, along with recent clinical trial data, will allow the clinical care team to introduce and integrate newly approved practice-altering therapies into current treatment plans to best meet the needs of their diverse patients with CLL/SLL or MCL.
In this educational activity, the expert faculty Chairperson will review the latest clinical evidence supporting the efficacy, safety, and tolerability of reversible, non-covalent BTK inhibitors to enhance incorporation into evidence-driven treatment sequencing for patients with CLL/SLL and MCL. The Chairperson will present a summary of the most relevant and timely advances with non-covalent BTK inhibitors while layering in their own personal, expert perspectives on how community care teams can …
Host: Joshua E. Reuss, MD
Alterations in ERBB2, the gene encoding HER2, have been recognized as drivers in the development of NSCLC. Therefore, HER2 is an actionable biomarker that has emerged in NSCLC diagnosis and treatment. HER2 mutations activate the HER2 signaling pathway, which facilitates oncogenic transformation and increases tumor proliferation. Although practice guidelines recommend molecular testing to identify alterations, the interpretation of tests and application of testing results to treatment decisions remain areas of educational need. Despite HER2 testing and targeted therapies changing the treatment practices for other solid tumors, the previous standard of care for NSCLC has resulted in persistently low 5-year survival rates in contrast to the high rates of survival for breast cancer. However, successful targeting of HER2-activating mutations in advanced NSCLC has now been achieved through the use of antibody-drug conjugates (ADCs) such as trastuzumab deruxtecan (T-DXd). By effectively targeting HER2-activating mutations, ADCs have emerged as a promising treatment approach for advanced NSCLC.
In this educational activity, the expert faculty Chairperson will summarize relevant and timely information on NSCLC with HER2-mutant or overexpressing alterations and highlight the use of HER2-directed ADCs in NSCLC. The Chairperson will also provide their perspectives on the top key takeaways and why they are …
Host: Joseph Kim, MD, MPH
This video brief will discuss quality improvement in myelofibrosis management. To highlight ways to improve care for patients with both primary and secondary myelofibrosis, we’ll examine the experiences of two cancer centers that engaged in quality improvement programs.
- Molecular Testing
- Symptom Assessment
- Prognostic Risk Assessment
- JAK Inhibitor Therapy
- Shared Decision-Making
- Interprofessional Team-Based Care Coordination
Host: Matthew Lunning, DO, FACP
In the rapidly evolving landscape of treating patients with relapsed or refractory large/diffuse large B-cell lymphoma (R/R LBCL/DLBCL), recent advancements are providing newfound hope. Immunochemotherapy with R-CHOP has long been the standard first-line treatment, but a significant portion of patients experience relapses and refractory disease. Until recently, salvage chemotherapy followed by autologous stem cell transplant (ASCT) was the only curative option. However, the introduction of novel therapies including T-cell engaging therapies has sparked a paradigm shift in R/R LBCL/DLBCL management.
In this transforming landscape, bispecific antibodies (BsAbs) stand out as a remarkable addition. They offer readily available, "off-the-shelf" options that do not require a manufacturing process tailored to each patient, with the advantage of lower rates of severe side effects compared to CAR T-cell therapy, making them a promising choice, particularly for older patients and those with late-stage disease.
This web-based, on-demand activity highlights key clinical trial evidence for bispecific antibodies targeting CD20 and CD3, and how to contextualize the rationale for and clinical utility of integrating CD20 X CD3 bispecific antibodies into community-based clinical practice. Expert faculty offer insights and advice based on their own real-world clinical practice experiences regarding the management and treatment of R/R DLBCL/LBCL and appropriate …
Guest: Kathleen Moore, MD, MS
The establishment of poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitors as an effective therapeutic strategy in ovarian cancer has been made possible through a deepened understanding of the impact of mutations in DNA damage response pathways on tumorigenesis. The success of this approach has led to the regulatory approval of PARP inhibitors for the treatment of patients with advanced ovarian cancer. PARP inhibitors as first-line maintenance therapy demonstrate a substantial and clinically meaningful benefit in progression-free survival among patients with newly diagnosed advanced ovarian cancer, including BRCA-mutated and HRD-positive disease. In some cases, regulatory approvals of PARP inhibitors have brought approvals for companion diagnostics or complementary diagnostic tests. Together, these developments have yielded a wealth of new options for managing ovarian cancer but have also complicated the effectiveness of the multidisciplinary care team, which is essential for the highest standard of cancer care delivery, linking emerging treatments and guidelines with patient education and empowerment. Another vital component of ovarian cancer care is the use of shared decision-making and patient-reported outcomes to increase patient satisfaction, therapy adherence, and quality of life.
In this educational activity, expert faculty will review the role of genetic testing in identifying patients likely to benefit …
Guest: Kathleen Moore, MD, MS
The establishment of poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitors as an effective therapeutic strategy in ovarian cancer has been made possible through a deepened understanding of the impact of mutations in DNA damage response pathways on tumorigenesis. The success of this approach has led to the regulatory approval of PARP inhibitors for the treatment of patients with advanced ovarian cancer. PARP inhibitors as first-line maintenance therapy demonstrate a substantial and clinically meaningful benefit in progression-free survival among patients with newly diagnosed advanced ovarian cancer, including BRCA-mutated and HRD-positive disease. In some cases, regulatory approvals of PARP inhibitors have brought approvals for companion diagnostics or complementary diagnostic tests. Together, these developments have yielded a wealth of new options for managing ovarian cancer but have also complicated the effectiveness of the multidisciplinary care team, which is essential for the highest standard of cancer care delivery, linking emerging treatments and guidelines with patient education and empowerment. Another vital component of ovarian cancer care is the use of shared decision-making and patient-reported outcomes to increase patient satisfaction, therapy adherence, and quality of life.
In this educational activity, expert faculty will review potential treatment-related complications that may occur with PARP inhibitor-based therapy. These …
Guest: Michael J. Mauro, MD
Chronic myeloid leukemia is a myeloproliferative neoplasm characterized by disordered growth of myeloid cells. The hallmark of chronic myeloid leukemia (CML) is an acquired reciprocal translocation between the long arms of chromosomes 9 and 22. This translocation results in the BCR-ABL1 fusion protein, with constitutively active tyrosine kinase activity, and is the underlying driver of CML. BCR-ABL1 testing is widely used to confirm the clinical diagnosis of CML and to assess response to TKI therapy. The development of BCR-ABL1 tyrosine kinase inhibitors (TKIs) has revolutionized the treatment of CML, dramatically improving patient outcomes. Although most CML patients experience excellent clinical outcomes, some CML patients (20-30%) exhibit an acquired resistance to treatment during the disease course, often requiring second- or third-line therapy. Novel TKIs designed to overcome TKI resistance have shown efficacy in early clinical trials and are offering promise to CML patients who do not respond to any of the multiple therapeutic options currently available.
AXIS routinely collects and analyzes data gathered from participants in our live activities. These questions and answers provide incredible insight and address
Guest: Sara M. Tolaney, MD, MPH
HER2 is a well-established negative prognostic factor for metastatic breast cancer (mBC) and determining HER2 levels is essential for proper treatment decisions. Several studies have reported scoring inaccuracies for HER2 status, particularly in the low range (0 and 1+), and challenges with IHC assessment and interpretation can lead to the misassignment of many patients for treatment. Antibody-drug conjugates (ADCs), a new and promising class of therapeutics designed as targeted therapy for mBC, target and kill tumor cells while sparing healthy cells. Rapid advances in ADC development are transforming HER2-positive and HER2-low mBC patient outcomes. With recent FDA approvals of HER2-targeting agents and emerging positive trial data, clinicians and pathologists are faced with staying abreast of and integrating new treatment options into real-world clinical practice.
AXIS routinely collects and analyzes data gathered from participants in our live activities. These questions and answers provide incredible insight regarding testing methodologies to classify metastatic breast cancer according to HER2 status, addressing the strengths and limitations of different techniques. The clinical implications of these tests for guiding HER2-targeted therapies such as antibody-drug conjugates will be addressed, as well as evidence-based methods to address challenges such as treatment-associated adverse events and drug resistance, and key …
Guest: Caron A. Jacobson, MD
CD19-directed chimeric antigen receptor (CAR) T-cell therapies are revolutionizing the treatment of aggressive non-Hodgkin lymphoma (NHL), offering patients with refractory/relapsed disease the chance for a potential cure after a single infusion. However, the widespread use of CAR T-cell therapies faces several challenges, from the production of the therapies to the management of toxicities to issues of inpatient vs outpatient administration. While CAR T-cell therapies have historically been given in the inpatient setting, interest in outpatient delivery is growing, and this option may become more feasible if logistical issues and lack of multidisciplinary collaboration between the community provider and the CAR-T cell therapy center can be overcome.
AXIS routinely collects and analyzes data gathered from participants in our live activities. These questions provide incredible insight regarding the persistent challenges that clinicians face when trying to optimize treatment and management of patients with cancer, helping to verify where clinical practice gaps exist. This activity will provide expert answers to questions asked during a recent educational series on CAR T-cell therapies in large B-cell lymphoma regarding practical considerations for CAR T-cell therapies.
Guest: Joyce O'Shaughnessy, MD
By 2040, the global breast cancer burden is expected to increase by 40%, resulting in more than 3 million new cases and 1 million deaths per year. Approximately 65% of cases among women less than 50 years of age and 75% of cases among women over 50 years of age are classified as HR+/HER2-. Although endocrine therapy is employed as standard-of-care treatment for many patients with HR+/HER2- breast cancer, not all such patients respond to endocrine therapy, and many who do initially respond will relapse. CDK 4/6 inhibitors can help overcome mechanisms of endocrine resistance, decrease tumor cell growth, and act synergistically with anti-estrogens. Clinicians are faced with constant change in the breast cancer treatment landscape. Disease heterogeneity, drug resistance, and incorporation of genetic testing into the treatment formula for HR+/HER2- breast cancer patients are all things they must contend with. Understanding practice guideline recommendations and the evidence behind them will allow clinicians to better integrate CDK 4/6 inhibitors into their clinical practice.
This Chairman’s Perspective activity features a highlight summary from a nationally recognized expert with relevant and timely information on HR+/HER2- BC, including the latest trial results and accumulating real-world evidence that demonstrates the efficacy and overall safety …
Guest: Neeraj Agarwal, MD, FASCO
Guest: Elena Castro, MD, PhD
Guest: Neal Shore, MD, FACS
Guest: Axel S. Merseburger, MD
While the development of advanced prostate cancers is largely influenced by androgen receptor (AR) signaling, DNA-damage response (DDR) pathways also contribute to disease progression. AR axis-targeted therapies (ARATs) have been the standard of care for first-line mCRPC. Inhibiting PARP activity is an effective strategy for targeting malignant cells with limited DNA repair capacity due to DDR gene mutations, leading to synthetic lethality. There may be a synergy between ARATs and PARP inhibitors (PARPi), as ARATs can induce HRR deficiencies and PARP inhibitors can increase the activity of ARATs through AR-dependent transcription. Recent clinical trial results have demonstrated that the combination of PARPi with ARATs is safe and effective for the first-line treatment of patients with mCRPC, with 3 combinations now FDA-approved: olaparib + abiraterone, talazoparib + enzalutamide, and niraparib + abiraterone.
This activity will provide expert contextualization of evidence from first-line mCRPC clinical trials exploring these combinations, including insights about the differentiation of both treatment and patient selection, as well as management of treatment-related toxicities. Given the differences in approvals and guidelines between the US and European context, this Ryder Cup themed Expert Panel Discussion will compare and contrast the approach in both regions, giving participants comprehensive education on …
Host: Guy Young, MD
Hemophilia A is an inherited or spontaneously occurring secondary hemostasis disorder caused by clotting factor VIII deficiency, which affects the formation and stabilization of clots. If left untreated, hemophilia A can cause recurrent and disabling bleeding, leading to severe arthropathy or life- threatening hemorrhage. Prophylaxis is well-documented for its effectiveness in preventing arthropathy and life-threatening bleeds, and improving total bleeding rates. However, limitations of modern factor replacement treatment result in suboptimal outcomes, poor adherence to prophylactic regimens, and reduced QoL. Novel and emerging prophylactic therapies can mitigate some of the hindrances of traditional replacement therapy and enhance the overall effect of treatment in hemophilia A.
In this educational activity, expert faculty will review recent evidence from key clinical trials of prophylactic therapies that are expanding the armamentarium of therapeutic choices, including a novel high-sustained factor VIII replacement therapy, a bispecific antibody non-factor replacement therapy, and other emerging therapies. Evaluating patients’ goals and preferences will also be discussed, so clinicians can co-create treatment plans using a shared decision approach to improve adherence and reduce bleeding episodes in patients with hemophilia A.
Guest: Ruben Mesa, MD, FACP
MF is a BCR-ABL1–negative chronic myeloproliferative neoplasm (MPN), a collection of heterogeneous cancers that includes primary MF (PMF) and secondary MF that sometimes forms in patients first diagnosed with polycythemia vera (PV) or essential thrombocythemia (ET). The role of the JAK pathway and its aberrant activation in MF has long been appreciated. Importantly, the treatment armamentarium for MF is expanding with the emergence of new agents targeting the JAK pathway alongside other key regulators of immunity and inflammation. As such, treatment selection for MF is increasingly based on patient preference, with consideration given to treatment-related side effects, symptom burden, and transfusion dependency.
This educational initiative will update the interprofessional care team on current and emerging therapies for the treatment and management of MF, including treatment risks and benefits, barriers to adherence, and side effect monitoring and management. These concepts are coupled with education about shared decision-making strategies and other related approaches to achieve increased patient satisfaction, better adherence to treatment plans, and greater treatment engagement, as well as to enhance quality decision-making.
FDA Approval September 2023: Momelotinib as First- and Second-line Treatment
For the treatment of intermediate or high-risk myelofibrosis, including primary myelofibrosis or secondary myelofibrosis …
Host: Paul P. Doghramji, MD, FAAFP
Guest: Rami Komrokji, MD
Guest: Allan Platt, PA-C, MMSc
Low-risk myelodysplastic syndrome (LR-MDS) is an acquired bone marrow disorder that manifests with symptomatic anemia. Many patients become dependent on red blood cell transfusions. Erythropoiesis-stimulating agents (ESAs) are the first-line treatment, but not all patients with LR-MDS respond to ESAs, and many become refractory to ESAs over time. Although advances have been made in the treatment of anemia in patients with MDS, there remains a significant unmet need for new and better treatment options for patients with ESA-refractory, transfusion-dependent MDS.
Timely identification of patients who become ESA refractory is critical for primary care physicians to promptly request referral to hematology specialists. Delays in referral can contribute to increased disease burden and lower quality of life (QoL) for patients. To achieve optimal patient outcomes requires multi-disciplinary team-based management and collaboration among primary care and hematology specialty care providers. With recent FDA approvals and emerging positive trial data, the multi-disciplinary care teams are faced with learning how to integrate new treatment options and associated guidelines into real-world clinical practice thus making clinical decision-making much more complex.
This educational activity, featuring an expert panel discussion, will review the identification of ESA failure in patients with LR-MDS and the importance of timely referral to …
Host: Mark Socinski, MD
Capitalizing on the advances in the identification of oncogenic driver mutations, genetic testing, and therapeutic approaches that target actionable mutations, targeted therapies are the current standard of care for eligible patients with advanced non–small cell lung cancer (NSCLC). Many targeted therapies are approved for the treatment of metastatic NSCLC with oncologic therapy decisions based on the presence of mutations and gene rearrangements. The National Comprehensive Cancer Center (NCCN) Clinical Practice Guidelines for metastatic NSCLC outline recommendations for molecular testing, now including EGFR mutation (for examples, exon 19 deletion or L858R), EGFR exon 20 insertion mutation, KRAS G12C mutation, ALK rearrangement, ROS1 rearrangement, BRAF-V600E mutation, NTRK1/2/3 gene fusion, METex14 skipping mutation, and RET rearrangement, along with PD-L1 expression level in patients with advanced or metastatic NSCLC. The development of these newer and other investigational targeted therapies provides unprecedented opportunities for improving outcomes for patients with targetable mutations.
This educational activity will address the incorporation of appropriate and timely use of guideline-recommended biomarker testing and optimization of targeted and personalized treatment of patients with NSCLC.
NCCN Guidelines have been updated since the release of this activity regarding ctDNA testing. The use of ctDNA testing is no longer …
Host: Neeraj Agarwal, MD, FASCO
Prostate cancer is a disease characterized by high genomic instability. Prostate cancers with deleterious aberrations in DNA damage repair (DDR) genes, including homologous recombination repair (HRR), such as mutations in BRCA1/2 and ATM, are associated with response to poly(adenosine diphosphate–ribose) polymerase (PARP) inhibition. The US Food and Drug Administration (FDA) has approved PARP inhibitors as monotherapy for the treatment of previously treated patients with HRR gene-mutated (olaparib) and BRCA mutation-associated (rucaparib) metastatic castration-resistant prostate cancer (mCRPC). Despite the advances with PARP inhibitors as monotherapy, primary and secondary resistances are seen, and evidence suggests that PARP inhibitors should be reserved for mCRPC with BRCA1, BRCA2, or ATM mutations. Now, clinical trials are evaluating PARP inhibitors in combination with other treatments such as androgen pathway inhibitors which may expand the clinical use of PARP inhibitors. When PARP inhibition is combined with novel hormonal therapies, a treatment benefit may be observed regardless of the HRR deficiency status.
This educational activity will review emerging clinical evidence and potentially practice-changing advancements in the treatment of mCRPC with PARP inhibitor combination treatment strategies, especially those that include combinations with androgen receptor targeted agents, to improve understanding of the evolving treatment and management of mCRPC.
Host: Anthony Mato, MD, MSCE
During the past 10 years, BTK inhibitors are increasingly replacing chemotherapy-based regimens, especially in patients with chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL). Current clinical practice is continuous long-term administration of covalent, irreversible BTK inhibitors, which can be complicated by side effects or the development of drug resistance. Resistance mutations and intolerance contribute to therapy interruption or discontinuation and abrogate clinical benefits associated with continued covalent BTK inhibitor therapy, leading to subsequent care that is suboptimal due to a dearth of effective treatment options (as reflected in lower progression-free survival, overall survival, or response duration). Non-covalent, reversible BTK inhibitors do not bind to C481, therefore providing a potentially effective option to patients with B cell malignancies that have developed resistance to covalent BTK inhibitors. Preliminary clinical studies have suggested that non-covalent BTK inhibitors are effective and well-tolerated.
This educational activity will assist hematology-oncology professionals develop management plans designed to overcome these challenges and offer patients the full benefit of BTK inhibitor therapy. We will discuss the clinical implications of BTK inhibitor selectivity profiles and safety differences; the integration of BTK inhibitors into the management of different B-cell cancer patient populations; and the proactive adaptation of treatment plans to …
Host: Heather Wakelee, MD, FASCO
Standard of care treatment for resectable early-stage NSCLC usually includes surgery in combination with neoadjuvant or adjuvant platinum-based chemotherapy; however, metastatic disease often develops. To lower the risk for recurrence, an area of active research is the use of immune checkpoint inhibitors as neoadjuvant and adjuvant therapy for early-stage NSCLC. Several immune checkpoint inhibitors are now being investigated in early-stage NSCLC, with promising results reported, suggesting a role for the use of neoadjuvant and adjuvant therapy with immune checkpoint inhibitors in early-stage NSCLC.
This educational activity will review the role of immunotherapy in early-stage NSCLC as adjuvant treatment, recent clinical data and the latest advances for immune checkpoint inhibitors as adjuvant treatment, and recent and ongoing clinical trials for adjuvant and neoadjuvant immunotherapy for the treatment of early-stage NSCLC so that clinicians are better able to integrate emerging data and new treatment options into clinical practice and inform, educate, and refer patients to clinical trials when appropriate.
Host: Fuad El Rassi, MD
A common complication of sickle cell disease (SCD), vaso-occlusive crisis (VOC), is characterized by the sudden onset of severe pain and is the most common reason for hospital visits in patients with SCD. Vaso-occlusion is caused by the adhesion of sickled erythrocytes and leukocytes to the endothelium, resulting in vascular obstruction and tissue ischemia. In addition to severe pain, long-term complications of vaso-occlusion may include damage to muscle and/or bone, in addition to vital organs such as the liver, spleen, kidneys, and brain. Vaso-occlusion and VOCs are associated with decreased organ function and can result in life-threatening complications such as acute chest syndrome, pulmonary hypertension, renal failure, and stroke. SCD can also have a profound effect on the quality of life for children and adults.
With increased understanding of the pathophysiology of VOCs, novel therapies that target the pathologic process of vaso-occlusion may reduce cell adhesion and inflammation, leading to decreased incidence of VOCs and prevention of end-organ damage. This educational activity will review the burden of SCD, including VOCs, acute chest syndrome, and end-organ damage in adults and pediatric sickle cell patients, as well as efficacy and safety data of established and novel therapies that target SCD-related complications for …
Host: Kristen Whitaker, MD, MS
Guest: Ricki Fairley, BA, MBA
Guest: Sara M. Tolaney, MD, MPH
For patients with recurrent unresectable or metastatic triple negative breast cancer (TNBC), standard systemic therapy has largely consisted of chemotherapy, though the outlook has improved recently following FDA approval of several targeted therapies and immunotherapeutic options. The management of TNBC remains quite challenging for clinicians, particularly in light of persistent disparities in TNBC care that disproportionately impact specific patient populations (eg, women of minoritized populations). Racial disparities specific to TNBC include a higher incidence, more advanced stage at diagnosis, and increased mortality among black women versus white women in the United States.
This web-based, on-demand, activity will review health disparities and inequities in TNBC and how they impact care, along with the latest evidence for current and emerging antibody-drug conjugates and immunotherapeutic agents, to assist oncology professionals in delivering impartial care to all patients.
Host: Miguel A. Escobar, MD
Guest: Cindy Leissinger, MD
Guest: Guy Young, MD
Hemophilia A is an X-linked genetic disorder characterized by a deficiency in normal factor VIII resulting in an increased risk of bleeding. Repeated bleeds, notably in the joints, lead to chronic pain and loss of function. Joint damage can be prevented, at least in part, with prophylactic factor VIII replacement. Although factor VIII can be replaced, its intravenous administration is burdensome, which may impair adherence. Furthermore, about 30% of patients treated with factor VIII will develop inhibitors—neutralizing alloantibodies to factor VIII—making factor VIII replacement ineffective. Although patients with inhibitors can be treated with bypassing agents, these agents are expensive and less predictable than factor VIII.
However, there is now another option for both patients with and without inhibitors: bispecific antibody non–factor replacement prophylaxis. It is important for the interprofessional care team to be aware of how this treatment compares with traditional prophylactic agents, its safety and efficacy data, and how to appropriately incorporate prophylaxis therapy based on the latest real-world clinical data.
In this educational activity, an expert faculty will review and provide their interprofessional perspectives on currently approved prophylaxis therapy in hemophilia A, including the benefits of prophylaxis and adherence, real-world experience, and patient quality of life factors.
Host: Matthew S. Davids, MMSc, MD
Many CLL treatments cause a high risk for tumor lysis syndrome (TLS), an oncologic emergency due to the release of intracellular contents of tumor cells characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. These electrolyte imbalances may be severe enough to cause acute renal failure, cardiac arrhythmias, seizures, loss of muscle control, and even death. In addition, neutropenia is a common side effect associated with CLL therapies, which increases the risk for infection and can disrupt or delay treatment, ultimately affecting patient outcomes.
A greater understanding of assessment and management of TLS and neutropenia is critical for reducing the likelihood of life-threatening complications in patients with CLL, which allows patients to continue to receive treatment.
AXIS routinely collects and analyzes data gathered from participants in our live activities. These questions provide incredible insight regarding the persistent challenges that clinicians face when trying to optimize treatment and management of patients with cancer to verify where clinical practice gaps exist. This activity will provide expert answers to questions asked during a recent educational series on preventing and managing tumor lysis syndrome and neutropenia in CLL.
Host: Hyunseok “Hyu” Kang, MD, MPH
Guest: Jochen Lorch, MD
Although multi-kinase inhibitors (MKIs) have been the standard of care for the treatment of thyroid cancer, they produce excessive “off-target” clinical adverse effects and toxicity that limit their use in some patients, leading to drug discontinuation or dose reduction. The introduction of RET inhibitors into the thyroid cancer treatment landscape offers novel, efficacious therapies for patients who previously had limited treatment options.
This online, on-demand educational activity will review RET alterations in thyroid cancer, molecular diagnostic testing, and recent and emerging clinical data on novel therapies targeting RET-altered or RET-driven thyroid cancer. A Virtual Case Clinic Video Exercise will highlight and demonstrate the translation of these RET-targeted therapies into real-world clinical practice for the treatment of patients with thyroid cancer.
Guest: Adam M. Brufsky, MD, PhD
Guest: Nina Thomas, MD
Interstitial lung disease (ILD) is a heterogeneous group of diseases that produce inflammation and fibrosis of the parenchyma, affecting the alveolar, interstitial, and vascular spaces. Drug-induced (DI) ILD is associated with a range of novel targeted therapies for the treatment of multiple cancer types, including immune checkpoint inhibitors, CDK 4/6 inhibitors, EGFR tyrosine kinase inhibitors, HER2 targeted therapies, and mechanistic target of rapamycin inhibitors.
Although management of low-grade or asymptomatic ILD with corticosteroid treatment and/or treatment interruption may slow or reverse ILD progression, higher-grade/symptomatic ILD requires permanent discontinuation of therapy. Therefore, it is critical that the interprofessional care team is prepared to monitor for and detect anti-cancer therapy–induced ILD. This educational activity will review the latest evidence and strategies for the early detection of medication-induced ILD and pneumonitis and appropriate management strategies to overcome these treatment challenges in patients who receive select anti-cancer therapies. Expert thought leaders will present relevant information about cancer therapy–induced ILD and pneumonitis and how to integrate the latest advances into real-world clinical practice regarding differential diagnosis, hallmark signs/symptoms, recommended management strategies, implications of patient/caregiver education, and the essentials of team-based management to optimize patient outcomes.
Host: Misako Nagasaka, MD, PhD
One area of recent progress in the treatment of non–small cell lung cancer (NSCLC) is the development of HER2 targeted therapies for the rare, emerging genetic variant, ERBB2 (HER2) mutations. In fact, the NCCN lists ERBB2 (HER2) mutations as an emerging biomarker to identify novel therapies for patients with metastatic NSCLC. The HER2-directed antibody-drug conjugates (ADC) ado-trastuzumab emtansine (T-DM1) and fam-trastuzumab deruxtecan-nxki are now listed as available targeted agents with activity against HER2 mutations. ADCs with other targets such as Trop-2 and HER3 are now also under investigation and showing promise in NSCLC. ADCs have the potential to increase treatment choices for patients with mNSCLC.
For practicing clinicians, this evolution of HER2-directed therapy and ADCs will add to the complexity of NSCLC treatment. This activity will review the emerging role and potential application of ADCs in mNSCLC, including HER2 as a target in NSCLC, biomarker testing, HER2-, HER3-, and TROP2-targeted ADCs, available clinical data on safety and efficacy, evidence-based guideline recommendations, and how newer targeted agents may fit into the treatment paradigm for patients with mNSCLC.
Host: Jeffrey S. Weber, MD, PhD
Approximately half of metastatic cutaneous melanomas carry mutations in BRAF, leading to more aggressive disease. For patients with BRAF V600–activating mutations, treatment options now include the use of combination targeted therapy with BRAF and MEK inhibitors, and combination targeted therapy and immunotherapy. However, even with guideline recommendations, the optimal treatment selection and sequencing is unclear, and additional combination strategies continue to be studied in clinical trials.
In this activity, expert faculty will review and evaluate combination strategies for the treatment of BRAF V600–activating mutation–positive metastatic melanoma, including considerations for treatment selection, sequencing, and management of associated toxicities.
Host: Scott Kopetz, MD, PhD
Guest: Rona Yaeger, MD
Advances in the diagnosis and treatment of mCRC enable personalized care based on the molecular profile of the tumor to achieve improved outcomes. About 5% to 15% of mCRC patients have a mutation in the proto-oncogene BRAF. BRAF is part of an essential cell signaling pathway, mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK). The BRAF V600E mutation induces constitutive activation of BRAF, leading to increased cell growth and proliferation downstream. Patients with the V600E mutation have a 2-fold increased risk for mortality compared to patients with wild-type BRAF, suggesting this gene mutation may act not only as a prognostic biomarker but also as a predictive biomarker. Understanding the current research regarding the consequences of the V600E mutation and testing for it can help guide treatment decision-making in patients with BRAF V600E–mutated mCRC.
This web-based, on-demand activity will feature an expert panel discussion on the latest trends and emerging research in the treatment of BRAF-mutated mCRC. Expert faculty will review and provide their interprofessional perspectives on testing patients for BRAF mutations, recent and emerging data for combination therapies, appropriate treatment selection, and side effect management.
Host: Kristi K. Orbaugh, MSN, NP, AOCN®
Guest: Val R. Adams, PharmD, FCCP, BCOP, FHOPA
Guest: Theresa W. Gillespie, PhD, MA, RN, FAAN
Endocrine therapy is currently the cornerstone of treatment for advanced hormone receptor–positive (HR+) breast cancer in both pre- and postmenopausal patients. However, not all advanced HR+ breast cancers respond to first-line endocrine therapy, and those that do respond eventually relapse. Agents that target critical pathways involved in resistance to endocrine therapy, such as cyclin-dependent kinase (CDK) 4/6 inhibitors, have been approved by the US Food & Drug Administration (FDA) for the treatment of HR+/human epidermal growth factor receptor 2–negative (HER2−) advanced/metastatic breast cancer. Now, CDK 4/6 inhibitors are being investigated for the treatment of early stage HR+, HER2- breast cancer.
This web-based, on-demand, activity will feature interprofessional perspectives and expert insights on the latest emerging evidence for CDK 4/6 inhibitors in the adjuvant setting for early breast cancer. The faculty panel will also provide their perspectives and best practice recommendations for improving adherence and side effect management. Case-based discussion will provide practical approaches for integrating CDK 4/6 inhibitors into real-world clinical practice for the treatment of early stage HR+, HER2- breast cancer.
Since the date of this activity’s recording, an exciting and practice changing advancement has occurred with the Food and Drug Administration’s (FDA) recent approval of abemaciclib with endocrine …
Guest: D. Ross Camidge, MD, PhD
The discovery of predictive biomarkers, such as sensitizing epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) rearrangements, ROS1 rearrangements, and BRAF V600E mutations has led to an improvement in overall survival and progression-free survival in non–small cell lung cancer (NSCLC) by identifying subgroups of patients who benefit from targeted treatment. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines®) note, “For patients with recurrent and metastatic disease, the NCCN Guidelines recommend that histologic subtype should be determined before therapy so that the best treatment can be selected. In addition, biomarker testing for genetic alterations (ie, oncogenic driver events) is recommended in patients with NSCLC, because targeted therapy has been shown to decrease tumor burden, decrease symptoms, and dramatically improve the quality of life for patients with specific genetic alterations. The number of available targeted agents is increasing.” (Ettinger et al, 2020.)
Approximately 5% of patients with NSCLC have ALK gene rearrangements. One of the most noteworthy areas of progress is the development of effective ALK-targeting therapies to treat NSCLC, including crizotinib, ceritinib, alectinib, brigatinib, and lorlatinib. Because of the fast pace of developments in this area, it may be difficult for clinicians to remain up-to-date on …
Guest: Monica L. Baskin, PhD
Guest: Josep M. Llovet, MD, PhD
Hepatocellular carcinoma (HCC) is the most common form of liver cancer. Patients with advanced disease at diagnosis typically are not candidates for potentially curative treatment options, such as resection, liver transplantation, or ablation. Additionally, liver cirrhosis and hepatic dysfunction often complicate treatment. Advances in the understanding of the molecular pathogenesis of HCC have broadened the potential for effective molecular targeted therapies, and advances in immune checkpoint inhibitor therapy are now transforming the way clinicians treat HCC.
Of particular concern, HCC incidence and mortality rates have risen among American Indian/Alaska Native, Hispanic, and black populations in the United States in recent years. Incidence of HCC is also expected to increase in older populations due to hepatitis C, a risk factor for development of HCC, among other comorbid conditions such as cirrhosis, obesity, diabetes, and non-alcoholic steatohepatitis, which are also on the rise. Screening and surveillance of these conditions that contribute to the development of HCC occur less often in many Hispanic and black populations, which can delay diagnosis and leave them ineligible for curative resection or transplantation due to advanced disease, leading to worse prognosis.
In this activity, the expert faculty will review health disparities, inequities, and …
Host: Eric H. Kraut, MD
Hemophilia A is a rare bleeding disorder caused by deficiency of clotting factor VIII. The current standard of care for patients with severe hemophilia A centers on replacement therapy with factor VIII concentrate, either on demand when bleeding occurs or prophylactically (replacement therapy). Potential complications from replacement therapy include the development of inhibitory antibodies that attack the clotting factor in approximately one-fourth of patients, viral infections from human clotting factors, and bleeding in joints and muscles resulting from treatment delays. According to treatment guidelines from the Medical and Scientific Advisory Council (MASAC), “Inhibitor development is the most severe complication of treatment for patients with inherited hemophilia A.” In addition, the high cost and frequency of infusing factor VIII concentrates can increase the potential for side effects, thereby negatively affecting patient quality of life.
Fortunately, several unique agents have been newly approved or are currently under development. These agents promise to reduce morbidity and improve quality of life for patients. Clinicians will be challenged to integrate these new agents into their clinical practices.
AXIS routinely collects and analyzes data gathered from participants in our live grand rounds programs. These questions provide incredible insight regarding the persistent challenges that clinicians face when …