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This content is for healthcare professionals outside of the UK only.

This activity is funded by an independent medical education grant from Daiichi Sankyo Europe GmbH and AstraZeneca.

This activity is provided by touchIME. touchIME is an EBAC® accredited provider.

Faculty & Disclosures

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    Faculty & Disclosures
    Ms Nikolina Dodlek

    University Hospital Centre Osijek, Osijek, Croatia

    Nikolina Dodlek has been an oncology nurse since 2010, and the unit manager of the Department for Oncology at the University Hospital Centre Osijek in Croatia since 2012. Since 2015, Ms Dodlek has been a teaching assistant at the Josip Juraj Strossmayer University of Osijek and she mentors nursing students at Cathedra for Nursing and Palliative Care. read more

    Ms Dodlek earned a master’s diploma in nursing science in 2017 and is currently in the second year of a PhD programme at Cyprus University of Technology, where she also lectures to nursing students. She is passionate about advocating, research, evidence-based practice, equity, teamwork, education, mentoring and bedside care.

    In 2020 Ms Dodlek established a Young Cancer Nurses Network in Croatia in collaboration with the Croatian Oncology Nursing Society and she started an education programme for early career cancer nurses that is approved by the Croatian Nursing Council. Ms Dodlek is co-founder, a board member and secretary of the Croatian Oncology Nursing Society, actively collaborating with the Croatian Nursing Council, universities, the Ministry of Health, the Ministry of Education and the National Society on Cancer Nursing in Croatia.

    Since December 2020, Ms Dodlek has been the chair of the European Oncology Nursing Society (EONS) Young Cancer Nurses Network, and in May 2021 she was elected as an EONS executive board member, also representing EONS at the European Cancer Organization (ECCO) Quality Cancer Care FTN and serving as a member of the ECCO Young Cancer Professionals steering committee. Ms Dodlek is an ECCO board member, she is a lead for the EONS NURTURE project and she is also involved in several research and policy projects.

    In 2022, Ms Dodlek received the EONS RECaN award for outstanding contributions in the field of cancer care. She has co-authored ESMO patient guides and a guide for breast cancer patients in Croatia. Ms Dodlek is an editorial board member for the journal Seminars in Oncology Nursing.

    Ms Nikolina Dodlek has no financial interests/relationships or affiliations in relation to this activity.
    Prof. Sherko Kümmel

    Kliniken Essen-Mitte gGmbH, Essen, Germany

    Sherko Kümmel qualified as an extraordinary professor at the medical school of Humboldt University Berlin, Germany and is the clinical director and chairman of the Interdisciplinary Breast Unit clinics of Essen-Mitte, where he is also the lead of the Breast Cancer Research Programme. read more

    Prof. Kümmel is a global principal investigator and head of clinical investigations and trials at the Essen-Mitte clinics. He has been the chief investigator for 33 national and international phase I to III clinical studies, principal investigator for 94 phase Ib to III clinical studies and sub-investigator for 47 phase II to III clinical studies.

    In addition to his work at the Essen-Mitte clinics, Prof. Kümmel is an executive board member of the German Gynecological Oncology Group (AGO) and a scientific director of the West German Study Group (WSG), an academic study group for breast cancer. He is also a speaker for the AGO Commission for Integrative Medicine (AGIMed) and a member of the organ commission (AGO Mamma).

    Prof. Kümmel is a faculty member of ESMO for breast cancer and a member of the ESMO Scientific Committee. Reflecting his commitment to breast cancer surgery, Prof. Kümmel is a member of both the scientific board of the Oncoplastic Breast Consortium (OPBC) and a scientific committee member for national and international symposia in breast cancer and surgical oncology.

    Prof. Kümmel is a member of the scientific committee of the Northeast German Society of Gynaecological Oncology (NOGGO), a breast cancer group. As a member of the Independent Data Monitoring Committee (IDMC), Prof. Kümmel is a participant of several national and international steering committees. Prof. Kümmel has published over 276 publications and 68 books and chapters.

    Prof. Sherko Kümmel discloses: All support since the initial planning of this work including advisory role and study material from Amgen, AstraZeneca, Daiichi Sankyo, Gilead Sciences and Novartis. Support to his institution from Agendia, AstraZeneca, Eli Lilly and Company, Hologic, MSD, Pfizer, PINK!, Roche and Stemline Therapeutics. Disclosures in the past 36 months including consulting fees from Eli Lilly and Company, MSD, Stryker. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Agendia, Amgen, AstraZeneca, Daiichi Sankyo, Eli Lilly and Company, Exact Sciences Corp., Gilead Sciences, Hologic, MSD, Novartis, Pfizer, pfm medical, Pinkpharma, Roche, Seagen, SOMATEX® Medical Technologies. Support for attending meetings and/or travel from Daiichi Sankyo, Eli Lilly and Company, MSD, Roche, Stemline Therapeutics. Participation on Data Safety Monitoring Board or Advisory Board from Agendia, Amgen, AstraZeneca, Daiichi Sankyo, Eli Lilly and Company, Exact Sciences Corp., Gilead Sciences, MSD, Novartis, Pfizer, pfm medical, Roche, Seagen, SonoScape.
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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 is your main challenge in supporting patients with BC undergoing treatment with HER2-directed ADCs?

    Submit your answer to see the results

    Knowledge gaps
       
    Not enough time
       
    Inadequate patient resources
       
    Lack of confidence
       

    Tutorial

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    Poll

    How involved are you in side effect monitoring/management for patients with BC treated with HER2-directed ADCs?

    Submit your answer to see the results

    Not involved
       
    A little involved
       
    Somewhat involved
       
    Extremely involved
       

    Tutorial

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

    Poll

    How confident are you in explaining the expected outcomes of treatment with HER2-directed ADCs to patients with BC?

    Submit your answer to see the results

    Not at all
       
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    Moderately
       
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    Individualizing treatment strategies: HER2-directed ADCs in breast cancer
    What to look out for: Side effects associated with HER2-directed ADCs in breast cancer
    Optimal strategies for managing patients with breast cancer treated with HER2-directed ADCs
    Take CE/CME Test
    Breast Cancer CE/CME accredited

    touchIN CONVERSATION
    A relaxed discussion between two faculty focussed on real world clinical issues. Useful tips below will show how to navigate the activity. Join the conversation. Close

    Knowledge for nurses: ADC updates in breast cancer

    Faculty Podcast Featured
    Useful tips
    • Select in the video player controls bar to choose subtitle language. Subtitles available in English, French, German, Italian, Spanish.
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    Learning Objectives

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

    • Explain the rationale and latest evidence for current and upcoming HER2-directed ADCs for the treatment of breast cancer
    • Identify, mitigate and manage side effects related to HER2-directed ADCs in breast cancer
    • Discuss best practices for nurses and nurse practitioners caring for patients with breast cancer receiving HER2-directed ADCs in real-world clinical practice
    Overview

    In this activity, two experts in breast cancer, an oncology nurse and a medical oncologist, respond to questions from the oncology community. The questions cover the rationale and latest evidence for HER2-directed antibody–drug conjugates (ADCs) for the treatment of breast cancer; identifying, mitigating and managing side effects; and best practices for nurses and nurse practitioners caring for patients receiving HER2-directed ADCs.

    This activity is provided by touchIME. touchIME is an EBAC® accredited provider.

    Target Audience

    Oncology nurses, including breast cancer nurse specialists involved in the management of breast cancer.

    Disclosures

    Faculty

    Ms Nikolina Dodlek has no financial interests/relationships or affiliations in relation to this activity.

    Prof. Sherko Kümmel discloses: All support since the initial planning of this work including advisory role and study material from Amgen, AstraZeneca, Daiichi Sankyo, Gilead Sciences and Novartis. Support to his institution from Agendia, AstraZeneca, Eli Lilly and Company, Hologic, MSD, Pfizer, PINK!, Roche and Stemline Therapeutics. Disclosures in the past 36 months including consulting fees from Eli Lilly and Company, MSD, Stryker. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Agendia, Amgen, AstraZeneca, Daiichi Sankyo, Eli Lilly and Company, Exact Sciences Corp., Gilead Sciences, Hologic, MSD, Novartis, Pfizer, pfm medical, Pinkpharma, Roche, Seagen, SOMATEX® Medical Technologies. Support for attending meetings and/or travel from Daiichi Sankyo, Eli Lilly and Company, MSD, Roche, Stemline Therapeutics. Participation on Data Safety Monitoring Board or Advisory Board from Agendia, Amgen, AstraZeneca, Daiichi Sankyo, Eli Lilly and Company, Exact Sciences Corp., Gilead Sciences, MSD, Novartis, Pfizer, pfm medical, Roche, Seagen, SonoScape.

    Touch Medical Contributor

    Katrina Lester has no financial interests/relationships or affiliations in relation to this activity.

    EBAC® Accreditation

    touchIME is an EBAC® accredited provider since 2023.

    This programme is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) for up to 1.0 hour(s) of CE credit(s). Each participant should claim only time that has been spent in the educational activity.

    The Accreditation Council for Continuing Medical Education (ACCME®), and the Royal College of Physicians and Surgeons of Canada hold an agreement on substantial equivalency of accreditation systems with EBAC®.

    Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals and the American Medical Association (AMA), physicians may convert EBAC® CE credits to AMA PRA Category 1 CreditsTM. Information on the process to convert EBAC® credit to AMA credit can be found on the AMA website. Other healthcare professionals may obtain from the AMA a certificate of having participated in an activity eligible for conversion of credit to AMA PRA Category 1 CreditTM.

    Faculty Disclosure Statement / Conflict of Interest Policy

    In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    Requirements for Successful Completion

    Certificates of Completion may be awarded upon successful completion of the post-test and evaluation form. If you have completed one hour or more of effective education through EBAC® accredited CE activities, please contact us at accreditation@touchime.org to receive your EBAC® CE credit certificate. EBAC® grants 1 CE credit for every hour of education completed.

    Date of original release: 31 July 2024. Date credits expire: 31 July 2025.

    Time to complete: 45 minutes.

    If you have any questions regarding the EBAC® credits, please contact accreditation@touchime.org

    This activity is CE/CME accredited

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

    Claim Credit
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    This activity is funded by:

    An independent medical education grant from Daiichi Sankyo Europe GmbH and AstraZeneca. This activity is provided by touchIME. touchIME is an EBAC® accredited provider.

    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.

    EBAC® 

    touchIME is an EBAC® accredited provider since 2023.

    In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    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 to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME activities. touchIME accepts no responsibility for errors or omissions.

    This content is intended for healthcare professionals outside of the UK only.

    Date of original release: 31 July 2024. Date credits expire: 31 July 2025.

    Claim Credit
    touchIN CONVERSATION
    Knowledge for nurses: ADC updates in breast cancer
    1.0 CE/CME credit
    Question 1/5
    HER2-directed antibody-based therapies have been developed for patients with BC with HER2 overexpression, with more in clinical development. In approximately what percentage of BC cases is the HER2 protein overexpressed?

    BC, breast cancer; HER2, human epidermal growth factor receptor 2.

    The HER2 protein is overexpressed in 20–30% of BC cases and is historically associated with higher cancer recurrence rates and shorter disease-free and overall survival vs patients with HER2-negative BC.

    Abbreviations 

    BC, breast cancer; HER2, human epidermal growth factor receptor 2.

    Reference

    Zimmerman BS, Esteva FJ. Cancers (Basel). 2024;16:800.

    Question 2/5
    The DESTINY-Breast03 clinical trial is comparing the efficacy and safety of T-DXd vs T-DM1 in patients with HER2+ metastatic BC. Based on interim trial data, how would you describe the difference in median PFS observed with T-DXd vs T-DM1?

    BC, breast cancer; HER2, human epidermal growth factor receptor 2; PFS, progression-free survival; T-DM1, trastuzumab emtansine; T-DXd, trastuzumab deruxtecan.

    In the phase III DESTINY-Breast03 clinical trial (NCT03529110), median PFS (primary endpoint) at data cutoff, 20 November 2023, was 29.0 months (95% CI, 23.7–40.0) with T-DXd and 7.2 months (95% CI, 6.8–8.3) with T-DM1 (hazard ratio 0.30; 95% CI, 0.24–0.38).1 A hazard ratio of 0.30 means that the study drug provides 70% risk reduction compared with control treatment.2

    Abbreviations

    CI, confidence interval; PFS, progression-free survival; T-DM1, trastuzumab emtansine; T-DXd, trastuzumab deruxtecan.

    References

    1. Cortés J, et al. Nat Med. 2024. doi: 10.1038/s41591-024-03021-7.
    2. Brody T. In: Brody T. Clinical Trials. Academic Press, 2012;165–90.
    Question 3/5
    According to clinical trial data, what proportion of patients with BC treated with T-DM1 develop thrombocytopenia?

    BC, breast cancer; T-DM1, trastuzumab emtansine.

    Across multiple clinical trials, thrombocytopenia or decreased platelet counts have been commonly reported with T-DM1 and are the most common adverse reaction leading to treatment discontinuation. Thrombocytopenia or reduced platelet counts were reported in 24.9% of patients with metastatic BC and 28.5% of patients with early BC. Patients should have their platelet counts monitored prior to each T-DM1 dose.

    Abbreviations

    BC, breast cancer; T-DM1, trastuzumab emtansine.

    Reference

    EMA. Trastuzumab emtansine SPC. 2023. Available at: https://bit.ly/4avhuvl (accessed 10 July 2024).

    Question 4/5
    How would you advise patients treated with a HER2-directed ADC to facilitate early identification and effective management of ILD/pneumonitis?

    ADC, antibody–drug conjugate; HER2, human epidermal growth factor receptor 2; HRCT, high-resolution computed tomography; ILD, interstitial lung disease.

    Patients with BC treated with HER2-directed ADCs should be educated about potential signs of ILD/pneumonitis to encourage self-monitoring and reporting of potential symptoms.1–3 Symptoms indicative of ILD/pneumonitis should be described, such as a cough, dyspnea and fever. Patients should be encouraged to immediately report new or worsening respiratory symptom(s) suggestive of ILD/pneumonitis.3 HRCT or radiographic changes potentially consistent with ILD/pneumonitis warrant immediate treatment interruption and further evaluation to confirm the diagnosis.3 T-DXd should be permanently discontinued for grade ≥2 ILD/pneumonitis; T-DM1 should be permanently discontinued for all confirmed cases of ILD/pneumonitis.4,5 

    Abbreviations

    ADC, antibody–drug conjugate; BC, breast cancer; HER2, human epidermal growth factor receptor 2; HRCT, high-resolution computed tomography; ILD, interstitial lung disease; T-DM1, trastuzumab emtansine; T-DXd, trastuzumab deruxtecan.

    References

    1. Chai M, et al. Crit Rev Oncol Hematol. 2024;195:104274.
    2. Swain SM, et al. Cancer Treat Rev. 2022;106:102378.
    3. Rugo HS, et al. JCO Oncol Pract. 2023;19:539–46.
    4. EMA. Trastuzumab deruxtecan SPC. 2024. Available at: https://bit.ly/3URZ2rd (accessed 10 July 2024).
    5. EMA. Trastuzumab emtansine SPC. 2023. Available at: https://bit.ly/4avhuvl (accessed 10 July 2024).
    Question 5/5
    Your patient with metastatic HER2-low BC is taking granisetron and dexamethasone emesis prophylaxis alongside T-DXd, but they inform you that they have recently started to experience some nausea. What would you do next to help reduce their symptoms?

    BC, breast cancer; HER2, human epidermal growth factor receptor 2; T-DXd, trastuzumab deruxtecan.

    Eating frequent small meals will ensure the body receives enough calories, protein and nutrients to tolerate treatment. Small meals may help reduce treatment-related side effects, such as nausea.1 Eating five to eight small meals about every 3 hours is recommended.1,2 Eating food cold or at room temperature may reduce its smell and taste.2

    References

    1. Sarah Cannon Cancer Network. Breast Cancer Nutrition. Available at: https://bit.ly/3wFrlRu (accessed 10 July 2024).
    2. BreastCancer.org. Eating When You Have Nausea and Vomiting. Available at: https://bit.ly/3UNkwFq (accessed 10 July 2024).
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    This activity is funded by:

    An independent medical education grant from Daiichi Sankyo Europe GmbH and AstraZeneca. This activity is provided by touchIME. touchIME is an EBAC® accredited provider.

    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.

    EBAC® 

    touchIME is an EBAC® accredited provider since 2023.

    In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    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 to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME activities. touchIME accepts no responsibility for errors or omissions.

    This content is intended for healthcare professionals outside of the UK only.

    Date of original release: 31 July 2024. Date credits expire: 31 July 2025.

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