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This activity is funded by an independent medical education grant from MSD. This activity is jointly provided by USF Health and touchIME.

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    Faculty & Disclosures
    Dr Sandra Cuellar

    University of Illinois, Chicago, IL, USA

    Sandra Cuellar is a clinical associate professor in the Department of Pharmacy at the University of Illinois at Chicago (UIC) College of Pharmacy and a clinical oncology pharmacist at the University of Illinois (UI) Health. read more

    Dr Cuellar is the director of the oncology residency programme, member of the Data and Safety Monitoring Committee and co-chair of the Institutional Review Board at UI Health. She is an editor-at-large for the Journal of Hematology Oncology Pharmacy and an invited lecturer to national organizations, including the Hematology/Oncology Pharmacy Association (HOPA), American Society of Health-System Pharmacists (ASHP), American College of Clinical Pharmacy, Association of Community Cancer Centers and Academy of Managed Care Pharmacy. Dr Cuellar was recently appointed a member of the ASHP Commission on Credentialing and she is the past chair of the Industry Relation Council for HOPA.  

    Dr Sandra Cuellar discloses: Advisory board or panel fees from Pharmacosmos (relationship terminated). Speakers’ bureau fees from Genentech and Seagen.
    Dr Sonia Amin Thomas

    Wellstar North Fulton Hospital and Northwest Georgia Oncology Center, Roswell, GA, USA

    Sonia Amin Thomas is a clinical oncology specialist at Wellstar North Fulton Hospital, Roswell, GA, USA, and an associate professor of pharmacy practice at the School of Pharmacy at the Philadelphia College of Osteopathic Medicine (PCOM), Georgia. read more

    Dr Amin Thomas teaches the oncology therapeutics, clinical reasoning and pharmacogenomics modules at PCOM – Georgia. At Wellstar North Fulton Hospital, she precepts fourth year advanced pharmacy practice experience students and postgraduate year 1 residents on an outpatient/inpatient oncology rotation. She attends a clinic at Northwest Georgia Oncology Centers. She is also a graduate of the Institute for Integrative Nutrition and a health and wellness nutrition coach for cancer survivors.

    Dr Sonia Amin Thomas has no interests/relationships or affiliations to disclose in relation to this activity.
    Ms Meera Desai

    University College London Hospitals NHS Foundation Trust, London, UK

    Meera Desai is a senior oncology pharmacist at University College London Hospitals NHS Foundation Trust with 10 years’ experience in cancer services. read more

    Ms Desai has a specific interest in gastrointestinal oncology, with a background across oncology, haematology, bone marrow transplant, advanced therapy medicinal products and clinical trials. She has previously been involved with and led local projects, including systemic anti-cancer therapies treatment pathways, nurse preparation of monoclonal antibodies, adoption of DPYD gene testing prior to national commissioning, and defining the daycare pharmacist role.

    Ms Desai has more recently joined an in-house steering group to promote the involvement of the pharmacy and multidisciplinary team in the trust’s immunotherapy service.

    Ms Meera Desai has no interests/relationships or affiliations to disclose in relation to this activity.
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    touchONCOLOGY touchONCOLOGY
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    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

    Improving outcomes of immune-related adverse events: The crucial role of the pharmacist

    Faculty Podcast Featured
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    • Downloads including slides are available for this activity in the Toolkit
    Learning Objectives

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

    • Recognize the importance of the community, outpatient or ambulatory care pharmacist in improving outcomes related to irAEs
    • Summarize the challenges associated with the recognition and management of irAEs
    • Formulate a strategy for monitoring and managing irAEs alongside other members of the multidisciplinary team
    Overview

    In this activity, three oncology pharmacists discuss the important role that pharmacists hold in the recognition and management of immune-related adverse events (irAEs) in patients receiving immune-checkpoint inhibitors (ICIs). The discussion is guided by pre-canvassed questions provided by community, outpatient and ambulatory care pharmacists.

    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 community, outpatient and ambulatory care pharmacists involved in the management of patients receiving ICIs for cancer treatment.

    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 Sandra Cuellar discloses: Advisory board or panel fees from Pharmacosmos (relationship terminated). Speakers’ bureau fees from Genentech and Seagen.

    Dr Sonia Amin Thomas has no interests/relationships or affiliations to disclose in relation to this activity.

    Ms Meera Desai has no interests/relationships or affiliations to disclose in relation to this activity.

    Content reviewer

    Kevin Cowart, PharmD, MPH, BCACP, CDCES has no financial interests/relationships or affiliations in relation to this activity.

    Touch Medical Director

    Adriano Boasso 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

    Pharmacists

    USF Health is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This knowledge-based program has been approved for 0.75 contact hours (0.75 CEUs).  Universal program number is as follows: 0230-9999-23-006-H01-P.

    Date of original release: 11 April 2023. Date credits expire: 11 April 2024.

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

    This activity is CE/CME accredited

    To obtain contact hours from this activity, please complete this post-activity test.

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    This Activity is Funded By:

    An independent medical education grant from MSD.
    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 judgment 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: 11 April 2023. Date credits expire: 11 April 2024.

    Claim Credit
    touchPANEL DISCUSSION
    Improving outcomes of immune-related adverse events: The crucial role of the pharmacist
    0.75 CE/CME credit
    Question 1/5
    Which are the most common irAEs observed in patients with cancer treated with ICIs?

    ICI, immune checkpoint inhibitor; irAE, immune-related adverse event.

    Cutaneous toxicities are the most common irAEs observed during treatment with ICIs, occurring in up to 72% of patients.

    Abbreviations

    ICI, immune checkpoint inhibitor; irAE, immune-related adverse event.

    Reference

    Schneider BJ, et al. J Clin Oncol. 2021;9:4073–126.

    Question 2/5
    Which of the following poses a challenge in identifying irAEs in patients treated with ICIs?

    ICI, immune checkpoint inhibitor; irAE, immune-related adverse event.

    There are several challenges to the early identification of irAEs, including difficulty in distinguishing non-specific early symptoms, such as dyspnoea and fatigue, in patients receiving combination therapies (e.g. ICI plus chemotherapy); a delayed time of onset, up to 1 year after ICI therapy completion or discontinuation; delayed patient monitoring due to poor awareness of symptoms or limited access to emergency care; and limited cost-effective monitoring strategies between treatment cycles.

    Abbreviations

    ICI, immune checkpoint inhibitor; irAE, immune-related adverse event.

    Reference

    Medina P, et al. J Pharm Pract. 2020;33:338–49.

    Question 3/5
    Pharmacist-led education programmes are important for the management of irAEs. Which of the following should be an aim of patient education?

    irAE, immune-related adverse event.

    Pharmacist-led education programmes should enable patients and caregivers to identify signs and symptoms of irAEs, understand the potential consequences of treatment, and know that symptoms should be reported without delay.1,2

    Abbreviation

    irAE, immune-related adverse event.

    References

    1. Medina P, et al. J Pharm Pract. 2020;33:338–49.
    2. Champiat S, et al. Ann Oncol. 2016;27:559–74.
    Question 4/5
    Your 73-year-old patient with NSCLC, who is being treated with pembrolizumab monotherapy, was diagnosed with grade 2 colitis. Their pembrolizumab treatment was paused and they were prescribed 1 mg/kg/day prednisone. Their symptoms recovered to grade 1 after 3 weeks of treatment. What would you do next?

    GI, gastrointestinal; irAE, immune-related adverse event; NSCLC, non-small cell lung cancer.

    SITC guidelines recommend that ICI treatment is temporarily suspended and low-dose corticosteroid (1 mg/kg/day) treatment initiated if patients develop grade 2 colitis.1 The steroid dose should be tapered over at least 4–6 weeks once the colitis symptoms have resolved to grade ≤1.2,3 Resuming ICI treatment may be considered when the steroid taper is completed.2 Frequent monitoring is required during the tapering period due to the increased risk of irAE recurrence.2

    Abbreviations

    ICI, immune checkpoint inhibitor; irAE, immune-related adverse event; SITC, Society for Immunotherapy of Cancer.

    References

    1. Brahmer JR, et al. J Immunother Cancer. 2021;9:e002435.
    2. Medina P, et al. J Pharm Pract. 2020;33:338–49.
    3. Schneider BJ, et al. J Clin Oncol. 2021;9:4073–126.
    Question 5/5
    In what situation would you document new symptoms of headache and fatigue in the medical record of patients treated with nivolumab?

    Recording all new signs and symptoms is important. The consistent assessment and documentation of new signs and symptoms, including those that seem minor, will enable the clinical team to note changes that occur over time, which may indicate the development of an early irAE.

    Abbreviation

    irAE, immune-related adverse event.

    Reference

    Brahmer JR, et al. J Clin Oncol. 2018;36:1714–68.

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    This Activity is Funded By:

    An independent medical education grant from MSD.
    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 judgment 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: 11 April 2023. Date credits expire: 11 April 2024.

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