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A Call-to-Action Workshop!
Nurse-Centric Case Discussions on the Management of Advanced NSCLC

This program was originally presented as an educational symposium during the ONS 8th Annual Institutes of Learning.

Saturday, November 10, 2007
7:00 pm – 9:00 pm (CST)

Regency Ballroom A
Hyatt Regency Chicago
Chicago, Illinois

Release Date: February 2008
Expiration Date: February 2009
Estimated Time to Complete Activity: 2 hour 1 minutes (Adobe Flash Player and Adobe Acrobat Reader required)

Posttest

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Accreditation Information

Target Audience

This activity has been designed to meet the educational needs of patient care oncology nurses.

Purpose

To educate oncology nurses about the latest practice patterns, research advances, and nursing management strategies for patients with non-small cell lung cancer (NSCLC).

Program Overview

Targeted therapy is quickly changing the treatment paradigm of NSCLC. In this educational symposium, a physician key opinion leader will describe the current treatment landscape and the mechanisms of action of targeted therapies via a 3-D video animated presentation. The remainder of the program will focus on the treatment of four patients with NSCLC, all receiving different therapeutic regimens. Video vignettes of patients with NSCLC and their interactions with oncology nurses will highlight common treatment experiences and effective nursing management strategies to ensure optimal patient outcomes. Audience response technology will be used to elicit experiences of program attendees and stimulate practice-change discussions. Program attendees will receive several clinical tools for side-effect assessment and management as well as sample patient education tools to utilize in their clinical practices.

Learning Objectives

Upon completion of this program, participants should be better able to:

  • Explain the mechanism of action of targeted therapies commonly used for NSCLC
  • Identify current treatment approaches to metastatic NSCLC
  • Describe protocols used to assess side effects of targeted therapies commonly used for NSCLC
  • Discuss management strategies for the most common side effects of targeted therapies used for NSCLC

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the U.S. Food and Drug Administration. IMER, Genentech BioOncology, and OSI Oncology do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of IMER, Genentech BioOncology, or OSI Oncology. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclosure of Conflicts of Interest

IMER requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by IMER for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Please refer to the individual Faculty Bio’s for statements.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Madelyn T. Herzfeld, RN, BSN, OCN®, reported no areas of conflict.

Dorothy Dulko, PhD, RN, AOCNP-C, reported no areas of conflict.

Davecia Ragoonath, MS, reported no areas of conflict.

 

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison to recommendations of other authorities.

Sponsored by:

IMER
  

 

 

 

 

Supported by an independent educational grant from Genentech BioOncology and OSI Oncology.
 

Faculty

Lee M. Krug, MD
Memorial Sloan-Kettering Cancer Center
  • Bio
  • Abstract

Dr. Krug is an assistant attending physician in the Division of Thoracic Oncology at Memorial Sloan- Kettering Cancer Center in New York City. He received his doctor of medicine from Washington University in St. Louis, Missouri. Dr. Krug’s research is focused on clinical trials in NSCLC, small cell lung cancer, and mesothelioma. He lectures frequently on lung cancer topics and his research has been published extensively in journals such as Clinical Cancer Research, Annals of Oncology, and the Journal of Clinical Oncology.

Lee M. Krug, MD, reported a financial interest/relationship or affiliation in the form of: Consultant, GlaxoSmithKline plc., Amgen Inc., & Nektar; Speakers’ Bureau, Eli Lilly and Company, Allos Therapeutics, Inc., Innovive Pharmaceuticals Corporation, Merck & Co. Inc., & Sunesis Pharmaceuticals, Inc.

Treatment of Advanced NSCLC: A Focus on Targeted Therapies

Lung cancer accounts for more deaths (more than 160,000 annually in the United States) than breast, colon, and prostate cancer combined. Most patients present with advanced metastatic disease, for which the primary treatment is palliative chemotherapy. Standard therapy with a platinum-based doublet yields median survival times of approximately 10 months and 1-year survival rates of approximately 35%.

During the past several years, inhibitors of the epidermal growth factor receptor (EGFR) and inhibitors of angiogenesis have been added to the armamentarium of treatments for non-small cell lung cancer (NSCLC). Erlotinib, an oral EGFR tyrosine kinase inhibitor, is now routinely used for second- or third-line therapy. In a randomized, placebo-controlled, phase III trial, erlotinib improved survival in patients previously treated with a platinumbased regimen. Certain clinical characteristics (e.g., never smoking status) and molecular features (e.g., EGFR overexpression, absence of K-ras mutations) may help clinicians select patients who are more likely to benefit from treatment with EGFR tyrosine kinase inhibitors. In addition, bevacizumab, the monoclonal antibody against vascular endothelial growth factor, is available for administration with first-line chemotherapy for patients with nonsquamous NSCLC. The combination of paclitaxel, carboplatin, and bevacizumab has been shown to improve response rates, progression-free survival, and overall survival compared to treatment with paclitaxel and carboplatin alone. This presentation will review the rationale for the use of these new agents, including clinical trial data, toxicity information, and practice recommendations.


Beth A. Eaby MSN, CRNP, OCN®
Abramson Cancer Center of the University of Pennsylvania Outpatient Thoracic Oncology
  • Bio
  • Abstract

Ms. Eaby is a board certified nurse practitioner and a nationally certified oncology nurse. She specializes in the treatment of patients with lung cancer and has written numerous articles on the subject, which have been published in The Oncologist, Journal of Symptom Management, and Cancer Investigation. Ms. Eaby is a member of the Oncology Nursing Society and serves as president of her local chapter.

Beth A. Eaby MSN, CRNP, OCN®, reported a financial interest/relationship or affiliation in the form of: Speakers’ Bureau, Amgen Inc., Genentech BioOncology, Merck & Co. Inc., sanofi-aventis U. S.

Oncology Nursing Focused NSCLC Case Presentations

Lung cancer is the second most common cancer and the leading cause of cancer death in the United States. The prognosis for advanced disease is typically 6 to 9 months, because most lung cancers go undetected until a person becomes symptomatic and presents with locally advanced or metastatic disease. Advanced lung cancer is not curable; thus, the primary goal of treating patients with advanced disease is palliative care, with a focus on maximizing symptom management and minimizing toxicity associated with treatment. This presentation reviews oncology nursing management strategies to optimize patient care in the context of case studies.

Wendye M. DiSalvo, RN, MS, NP-C, AOCN® (Chairperson)
Dartmouth-Hitchcock Medical Center
  • Bio
  • Abstract

Ms. DiSalvo is a nurse practitioner at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. She received her master’s degree in nursing from Syracuse University in Syracuse, New York. She later trained at the University of Massachusetts Medical School in Worcester to become a tobacco treatment specialist and serves in that capacity under the umbrella of the APN Survivorship Clinic. Ms. DiSalvo has delivered numerous presentations on issues related to lung cancer treatment and survival. In addition, she serves on several committees, including the ONS Educational Advisory Panel and the APN Cancer and Related Events Survivorship Committee. She is also a member of the Oncology Nursing News editorial board.

Wendye M. DiSalvo, RN, MS, NP-C, AOCN®, reported a financial interest/relationship or affiliation in the form of: Speakers’ Bureau, Genentech BioOncology, & sanofi-aventis U.S.

Oncology Nursing Focused NSCLC Case Presentations

Targeted therapies are changing the treatment paradigm of non-small cell lung cancer (NSCLC), presenting oncology nurses with new challenges in improving the overall survival and quality of life of their patients. These challenges will be explored using a casestudy format focused on regimens involving such agents as erlotinib, docetaxel, pemetrexed, and gemcitabine. Nurses will learn how to optimally manage paronychial fissuring, hair changes, diarrhea, hypersensitivity reactions, and neurotoxicity, which are common side effects of these therapies. In addition, as oral agents are increasingly being used in the treatment of NSCLC, patient adherence to oral regimens has become a critical issue. Strategies for patient education and promotion of adherence will be reviewed.

 

 

Accreditation Statements

This educational activity for 2.0 contact hours will be provided by the Institute for Medical Education & Research (IMER). IMER is an approved provider of continuing education by the Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

A statement of credit will be issued only upon receipt of a completed activity evaluation form.

Safeguards Against Commercial Bias

IMER affirms that the content and format of its CE activities and related materials promote improvements and quality in healthcare and do not promote a specific proprietary business interest of a commercial entity. To this end, IMER employs several strategies to ensure the absence of commercial bias, including but not limited to review of all planned content for CE activities sponsored by IMER to ensure adherence to the American Nurses Credentialing Center’s criteria and operational requirements and the Accreditation Council for Continuing Medical Education’s content validation statements and resolution of any actual or perceived conflict of interest that exist.We employ three metrics as we review your materials:

1. Fair balance
a. Recommendations or emphasis must fairly represent and be based on a reasonable and valid interpretation of the information available on the subject matter
b. No single product or service is overrepresented when other equal competing products or services are available for inclusion

2. Scientific objectivity of studies mentioned in the materials or used as the basis for content

3. Appropriateness of patient care recommendations made to learners

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There are no fees for participating and receiving nursing contact hours for this activity.

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