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This activity is funded by an independent medical education grant from AstraZeneca.

This activity is jointly provided by USF Health and touchIME.

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    Faculty & Disclosures
    Dr Razelle Kurzrock

    Medical College of Wisconsin, Milwaukee, WI, USA

    Dr Razelle Kurzrock is a professor of medicine, associate director of clinical research and the Linda T and John A Mellowes Endowed Chair of Precision Oncology at the Medical College of Wisconsin, Milwaukee, WI, USA. She is a world-renowned physician-scientist leader in precision medicine and in the development of novel therapeutics in the field of oncology. read more

    Dr Kurzrock is recognized for founding, developing and chairing one of the largest phase I clinical trial departments globally while at the University of Texas MD Anderson Cancer Center. She is also one of the pioneering trialists of the WINTHER precision medicine international trial, which focused on transcriptomics in addition to genomics for the first time. During her time at the University of California San Diego Health, Dr Kurzrock’s charge was founding and leading the Center for Personalized Cancer Therapy as well as the experimental therapeutics programme. She also founded a rare tumour clinic focused on precision medicine. The signature study of the centre was the I-PREDICT study that gave, for the first time, individualized N-of-1 matched combination therapies to patients with lethal malignancies, hence resulting in improved outcomes. This work was presented at the Nobel Symposium, Karolinska Institute, Stockholm, Sweden in September 2023.

    Dr Kurzrock has performed key early-phase studies of eight drugs that have gone on to receive FDA approval. She is the author of almost 1,000 peer-reviewed articles, with an h-index score of 147 and over 90,000 citations. Since 2019, she has been selected each year on the Clarivate Web of Science list of most cited scientists worldwide.

    Dr Razelle Kurzrock discloses: Grant/research support from Boehringer Ingelheim, Debiopharm, Foundation Medicine, Genentech, Grifols, Guardant, Incyte, Konica Minolta, Medimmune, Merck Serono, Omniseq, Pfizer, Sequenom, Takeda and TopAlliance. Advisory board/panel, consultant and speaker’s bureau fees from Actuate Therapeutics, AstraZeneca, Bicara Therapeutics, Inc., Biological Dynamics, Caris, CureMetrix, Daiichi, Datar Cancer Genetics, Eisai, EOM Pharmaceuticals, Iylon, LabCorp, Lanuaria, Merck, NeoGenomics, Neomed, Pfizer, Precirix, Prosperdtx, Regeneron, Roche, Turning Point Therapeutics, Volastra and X-Biotech. Support (royalties, patent, etc.) Dr Kurzrock is the co-founder and serves on the board of CureMatch.
    Dr Lyudmila Bazhenova

    UC San Diego Moores Cancer Center, San Diego, CA, USA

    Dr Lyudmila Bazhenova is a board-certified medical oncologist and a professor of medicine at UC San Diego Moores Cancer Center, San Diego, CA, USA. Dr Bazhenova’s clinical practice is devoted to patients with all types of lung cancer and she has particular expertise in patients with driver mutations, female patients and nonsmokers. read more

    Dr Bazhenova currently leads the lung cancer group at UC San Diego and has over 18 years of experience in managing patients with lung cancer. She believes in a multidisciplinary approach to lung cancer and works closely with surgical oncologists and radiation oncologists to provide the best patient experience. Dr Bazhenova leads a weekly lung tumour board, where expert physicians and scientists from several specialties review cases to develop the best possible individualized treatment plan.

    Dr Bazhenova is also an active participant in clinical research, including designing and implementing clinical investigations at Moores Cancer Center. She is a recipient of the National Cancer Institute Clinical Trial Leadership Award. Dr Bazhenova is a member of the respiratory committee of the Alliance Cooperative Group and has published research findings in New England Journal of Medicine, Journal of Clinical Oncology, Journal of Thoracic Oncology, Annals of Oncology and other journals. She believes in offering her patients the opportunity to participate in a clinical trial if this fits with their goals. 

    Dr Bazhenova is passionate about teaching junior physicians and is a program director for the haematology–oncology fellowship training programme.

    Dr Lyudmila Bazhenova discloses: Advisory board or panel fees from Abbvie, Anheart, AstraZeneca, Bayer, Bioatla, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Gilead, Janssen, Merck, Neuvogen, Novocure, Pfizer, Regeneron, Sanofi, Summit and Teligene (All Relationships Terminated). Consulting fees from Daichi and Pfizer (All Relationships Terminated).
    Dr Ignacio Wistuba

    MD Anderson Cancer Center, Houston, TX, USA

    Dr Ignacio Wistuba is chair of the Department of Translational Molecular Pathology with joint appointment in the Department of Thoracic/Head and Neck Medical Oncology, and co-director of the Khalifa Institute of Personalized Cancer Therapy at the University of Texas MD Anderson Cancer Center, Houston, TX, USA. read more

    Dr Wistuba is also the director of the Thoracic Molecular Pathology Laboratory, director of the University of Texas Lung Specialized Programs of Research Excellence (SPORE) Tissue Bank, director of the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) Central Biorepository and Pathology Facility, pathologist for the Southwest Oncology Group (SWOG) Lung Cancer Committee and the Lung Cancer Mutation Consortium and co-director of the pre-Clinical Laboratory Improvement Amendments (CLIA) Genomic Testing Developmental Laboratory. 

    Dr Wistuba’s major research interest is the elucidation of the molecular abnormalities involved in the pathogenesis and progression of lung cancer and other solid tumours. He has co-authored over 700 papers in peer-reviewed journals and several book chapters. His research interests also include identifying new molecular targets, validating biomarkers for targeted therapy and immunotherapy, and identifying molecular markers associated with the development of lung cancer and other solid tumours, progression and metastasis using annotated human specimens. Dr Wistuna is principal investigator (PI) and co-PI on several molecular pathology and biomarker projects.

    Dr Ignacio Wistuba discloses: Advisory board or panel fees from Abbvie, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Catalyst Therapeutics, Daiichi Sankyo, Flame, Genentech/Roche, Gl Therapeutics, Guardant Health, Janssen, Johnson & Johnson, Merck, Merus, Novartis, Oncocyte, Pfizer, Regeneron and Sanofi. Grants/research support from 4D, Adaptimmune, Adaptive, Akoya, Amgen, Bayer, Bristol Myers Squibb, EMD Serono, Genentech, Iovance, Johnson & Johnson, Karus, Medimmune, Merck, Novartis, Pfizer and Takeda. Speaker’s bureau fees from AstraZeneca, Genentech/Roche, Medscape, Merus, Merck, Pfizer and Platform Health.
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    touchONCOLOGY touchONCOLOGY
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    Tutorial

    This icon indicates there is a poll question. Click it when you see it to interact with your peers.

    Poll

    What method do you use to test for HER2 mutations in patients with advanced NSCLC?

    Submit your answer to see the results

    Next-generation sequencing
       
    Sanger sequencing
       
    Polymerase chain reaction
       
    Other/do not test for HER2 mutations
       

    Tutorial

    This icon indicates there is a poll question. Click it when you see it to interact with your peers.

    Poll

    In which patients with advanced NSCLC do you consider using trastuzumab deruxtecan?

    Submit your answer to see the results

    Any HER2 alteration
       
    HER2 mutations or HER2 overexpression
       
    HER2 mutations only
       
    Other/do not prescribe trastuzumab deruxtecan
       

    Tutorial

    This icon indicates there is a poll question. Click it when you see it to interact with your peers.

    Poll

    Which of these best describes your approach to HER2 testing in advanced solid tumours?

    Submit your answer to see the results

    I test all patients
       
    I test when no other tx options available
       
    I never test
       
    Other
       
     
    Video Take CE/CME Test
    Lung Cancer CE/CME accredited

    touchPANEL DISCUSSION
    A visually engaging discussion designed to emulate a ‘live’ panel experience and provide clinicians with practical expert insights to address their clinical challenges. Useful tips below will show how to navigate the activity. Close

    Expanding HER2 horizons: Implications for NSCLC and beyond

    Faculty Podcast Featured
    Useful tips
    • Select in the video player controls bar to choose subtitle language. Subtitles available in English, Spanish.
    • A practice aid is available for this activity in the Toolkit
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    Learning Objectives

    After watching this activity, participants should be better able to:

    • Evaluate the clinical implications for tissue-agnostic HER2-targeted treatments for patients with advanced cancer
    • Discuss the latest data for HER2 targeting therapies in patients with advanced NSCLC and HER2 alterations
    • Outline best practices and guidelines for biomarker testing to establish HER2 status in patients with advanced NSCLC
    Overview

    In this activity, two medical oncologists and a pathologist discuss key considerations on tissue-agnostic HER2 targeting in solid tumours, the latest clinical trial data for approved and emerging HER2-targeted therapies in NSCLC, and best practices for testing for HER2 alterations in NSCLC.

    This activity is jointly provided by USF Health and touchIME. read more

    Target Audience

    This activity has been designed to meet the educational needs of oncologists, pulmonologists and pathologists involved in the management of patients with solid tumours, including NSCLC.

    USF Accreditation

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Dr Lyudmila Bazhenova discloses: Advisory board or panel fees from Abbvie, Anheart, AstraZeneca, Bayer, Bioatla, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Gilead, Janssen, Merck, Neuvogen, Novocure, Pfizer, Regeneron, Sanofi, Summit and Teligene (All Relationships Terminated). Consulting fees from Daichi and Pfizer (All Relationships Terminated).

    Dr Razelle Kurzrock discloses: Grant/research support from Boehringer Ingelheim, Debiopharm, Foundation Medicine, Genentech, Grifols, Guardant, Incyte, Konica Minolta, Medimmune, Merck Serono, Omniseq, Pfizer, Sequenom, Takeda and TopAlliance. Advisory board/panel, consultant and speaker’s bureau fees from Actuate Therapeutics, AstraZeneca, Bicara Therapeutics, Inc., Biological Dynamics, Caris, CureMetrix, Daiichi, Datar Cancer Genetics, Eisai, EOM Pharmaceuticals, Iylon, LabCorp, Lanuaria, Merck, NeoGenomics, Neomed, Pfizer, Precirix, Prosperdtx, Regeneron, Roche, Turning Point Therapeutics, Volastra and X-Biotech. Support (royalties, patent, etc.) Dr Kurzrock is the co-founder and serves on the board of CureMatch.

    Dr Ignacio Wistuba discloses: Advisory board or panel fees from Abbvie, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Catalyst Therapeutics, Daiichi Sankyo, Flame, Genentech/Roche, Gl Therapeutics, Guardant Health, Janssen, Johnson & Johnson, Merck, Merus, Novartis, Oncocyte, Pfizer, Regeneron and Sanofi. Grants/research support from 4D, Adaptimmune, Adaptive, Akoya, Amgen, Bayer, Bristol Myers Squibb, EMD Serono, Genentech, Iovance, Johnson & Johnson, Karus, Medimmune, Merck, Novartis, Pfizer and Takeda. Speaker’s bureau fees from AstraZeneca, Genentech/Roche, Medscape, Merus, Merck, Pfizer and Platform Health.

    Content reviewer

    Danielle Walker, DNP, APRN, AGNP-C has no financial interests/relationships or affiliations in relation to this activity.

    Touch Medical Contributors

    Hannah Fisher has no financial interests/relationships or affiliations in relation to this activity.

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Date of original release: 25 September 2024. Date credits expire: 25 September 2025.

    If you have any questions regarding credit, please contact cpdsupport@usf.edu

    This activity is CE/CME accredited

    To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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    Topics covered in this activity

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    This Activity Is Funded By:

    An independent medical education grant from AstraZeneca. This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 25 September 2024. Date credits expire: 25 September 2025.

    Claim Credit
    touchPANEL DISCUSSION
    Expanding HER2 horizons: Implications for NSCLC and beyond
    0.75 CE/CME credit
    Question 1/5
    Your patient has advanced biliary tract cancer that has progressed following multiple lines of treatment, including durvalumab + gemcitabine + cisplatin and FOLFOX. You determine that there are limited satisfactory treatment options remaining for this patient. Which of the following would you test to guide the potential use of an agent with a tumour-agnostic approval?

    BRCA1, breast cancer gene 1; FOLFOX, folinic acid, fluorouracil and oxaliplatin; HER, human epidermal growth factor receptor; PD-L1, programmed cell death ligand 1.

    A recent tumour-agnostic indication for trastuzumab deruxtecan was approved by the FDA in adult patients with unresectable or metastatic HER2-positive (IHC 3+) solid tumours who have received prior systemic treatment and have no satisfactory alternative treatment options.1 The DESTINY-PanTumor02 trial reported an ORR of 56.3% in patients with biliary tract cancer with HER2 overexpression (IHC 3+).2 

    Abbreviations

    HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry; ORR, objective response rate.

    References

    1. FDA. Trastuzumab deruxtecan PI. 2024. Available at: www.accessdata.fda.gov/drugsatfda_docs/label/2024/761139s028lbl.pdf (accessed 16 August 2024).
    2. Meric-Bernstam F, et al. J Clin Oncol. 2024;42:47–58.
    Question 2/5
    In the phase Ib element of the BEAMION-Lung1 trial, what ORR has been reported with zongertinib in patients with advanced HER2-mutated NSCLC?

    HER2, human epidermal growth factor receptor 2; NSCLC, non-small cell lung cancer; ORR, objective response rate.

    The phase I/II BEAMION-Lung1 trial of zongertinib in patients with advanced, unresectable and/or metastatic NSCLC reported an ORR of 74% in an interim futility analysis of the phase Ib element, which included 23 patients either pretreated or therapy naive (dependent on the cohort) with a HER2 mutation.1,2

    Abbreviations

    HER2, human epidermal growth factor receptor 2; NSCLC, non-small cell lung cancer; ORR, objective response rate.

    Reference

    1. Heymach J, et al. Presented at: 2024 ASCO Annual Meeting, Chicago, IL, USA. 30 May– 3 June 2024. Abstr. 8514.
    2. ClinicalTrials.gov. NCT04886804. Available at: https://clinicaltrials.gov/study/NCT04886804 (accessed 28 August 2024).
    Question 3/5
    In the Destiny-Lung01 and Destiny-Lung02 trials investigating trastuzumab deruxtecan in patients with advanced HER2-mutated NSCLC, in what range were the ORRs for this patient cohort?

    HER2, human epidermal growth factor receptor 2; ORR, objective response rate.

    The phase II Destiny-Lung01 trial reported an ORR of 55% in patients with metastatic NSCLC harbouring activating HER2 mutations at a dose of 6.4 mg/kg (n=91),1 while the phase II Destiny-Lung02 reported an ORR of 56% at a dose 6.4 mg/kg (n=50) and 50% at a dose of 5.4 mg/kg (n=102).2

    Abbreviations

    HER2, human epidermal growth factor receptor 2; NSCLC, non-small cell lung cancer; ORR, objective response rate.

    References

    1. Li BT, et al. N Engl J Med. 2022;386:241–51.
    2. Jänne PA, et al. Presented at: 2024 ASCO Annual Meeting, Chicago, IL, USA. 31 May–4 June 2024. Abstr. 8543.
    Question 4/5
    Your patient is newly diagnosed with stage IV metastatic NSCLC. You are aware of the need to test the patient for HER2 alterations to help inform treatment decisions. Based on NCCN guidelines, when would you perform these tests for this patient?

    HER2, human epidermal growth factor receptor 2; ICI, immune checkpoint inhibitor; NCCN, National Comprehensive Cancer Network; NSCLC, non-small cell lung cancer.

    NCCN guidelines recommend molecular testing, including HER2, in patients with advanced or metastatic disease at clinical presentation.

    Abbreviations

    HER2, human epidermal growth factor receptor 2; NCCN, National Comprehensive Cancer Network.

    Reference

    NCCN. NSCLC. V7.2024. Available at: www.nccn.org (accessed 17 August 2024).

    Question 5/5
    You have sent tissue and plasma samples from your patient with newly diagnosed advanced NSCLC for molecular testing. You receive the results of the plasma testing, which is negative for all driver mutations. Assuming all options are feasible for this patient, what should you do next?

    NSCLC, non-small cell lung cancer.

    The NCCN guidelines recommend complete genotyping for EGFR, KRAS, ALK, ROS1, BRAF, NTRK1/2/3, MET, RET and HER2 via biopsy and/or plasma testing. Combinations of tissue and plasma testing, either concurrently or in sequence, are acceptable. However, negative results (meaning the absence of a definitive driver mutation) by one method suggests the use of a complementary method, and therefore in this situation the results of the tissue biopsy are required. 

    Abbreviations

    EGFR, epidermal growth factor receptor; HER2, human epidermal growth factor receptor 2; NCCN, National Comprehensive Cancer Network.

    Reference

    NCCN. NSCLC. V7.2024. Available at: www.nccn.org (accessed 17 August 2024).

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    This Activity Is Funded By:

    An independent medical education grant from AstraZeneca. This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 25 September 2024. Date credits expire: 25 September 2025.

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