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COLORECTAL
CANCER
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Colorectal Cancer 2008: Progress and Prospects
As we enter 2008, oncology nurses have witnessed remarkable progress in the treatment of CRC. In this 2-hour symposium, a physician CRC thought leader will reflect on recent progress and discuss the clinical implications of emerging research data in the neoadjuvant, adjuvant, and metastatic settings. A similar presentation, led by an oncology nurse expert, will highlight developments in symptom management and supportive care strategies.
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CME Activity for Oncologists
Colorectal Cancer 2008:
Aligning Clinical Practice With Patient Treatment Goals
Amid remarkable progress in the treatment of CRC, clinical questions abound. Fluoropyrimidine-based chemotherapy has been the mainstay of CRC care since the 1950s. Today, the efficacy of several new therapies has clearly been validated; however, it remains unclear how they work together optimally across the treatment trajectory. As such, how do we make appropriate clinical decisions in light of new research questions, current uncertainties, and diverse treatment options? Are clinical recommendations aligned with patients’ treatment goals? In this first-of-its-kind symposium, leading CRC investigators will moderate discussions regarding optimal treatment decisions in the context of new research and clinical questions raised at this year’s ASCO GI Cancers Symposium. Each investigator will review a disease stage of CRC. Recent progress and new clinical questions for each stage will be highlighted. Following each presentation, audience polling devices will be used to elucidate participants’ treatment recommendations for the relevant disease stage. Panelists will discuss CRC medical oncology practice patterns, and provide their own perspectives on optimal patient management in an ever-changing environment. In preparation for this program, the Institute for Medical Education & Research queried hundreds of patients with CRC regarding topics such as treatment goals and the impact of treatment side effects. Throughout the meeting, patient responses to this survey will be compared with those of participating medical oncologists to determine whether we are effectively aligning clinical decisions with patient goals.
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Fluoropyrimidines in Colorectal Cancer: Past, Present, and Future
Since their introduction in the 1950s, fluoropyrimidines have been an integral part of chemotherapy-based regimens for CRC. In recent years, the use of fluoropyrimidines has become increasingly widespread as data have matured. In this educational activity, a gastrointestinal oncologist will present an overview of how fluoropyrimidines have impacted the treatment of CRC. The role of the oncology nurse in managing patients with CRC will also be explored. To this end, the program will include video vignettes of patients with CRC, who are receiving treatment with oral and intravenous fluoropyrimidines, describing their common experiences. An interactive questionand- answer activity will lead participants through management strategies for common side effects, including diarrhea, mucositis, and cutaneous toxicities. Issues regarding patient adherence to oral regimens will also be discussed. Nurse attendees will receive several clinical tools for side-effect assessment and management, as well as sample patient education materials, to utilize in their clinical practices.
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Correction
In the July 2008 newsletter titled "Colorectal Cancer: An Oncology Nursing Roundtable Discussion," question 1 of the posttest asks about the results of the EORTC-40983 study.
Question (true/false): The EORTC-40983 study demonstrated that perioperative therapy with FOLFOX4 improves disease-free survival in patients with resectable liver metastases.
Answer: True
While discussed at the symposium on which the newsletter was based, information on EORTCC-40983 was missing from the body of the newsletter. The study in question was an abstract by Nordlinger and colleagues titled "Final Results of the EORTC Intergroup Randomized Phase III Study 40983 [EPOC] Evaluating the Benefit of Perioperative FOLFOX4 Chemotherapy for Patients With Potentially Resectable Colorectal Cancer Liver Metastases," and was presented at the American Society of Clinical Oncology's 2007 annual meeting. Results from the study showed that perioperative FOLFOX4 chemotherapy improved progression-free survival over surgery alone in patients whose metastases were resected.
Click here to launch the abstract
We apologize for any inconvenience this may have caused.
In treating patients with advanced CRC, clinicians are looking toward
an individualized continuum of care that merges the use of all active
treatment regimens, applies knowledge gathered from ongoing clinical
trials, and gives considerable weight to the patient’s unique circumstances.
Current thought is that exposure to all agents with proven
effectiveness in CRC—namely conventional cytotoxic agents such as
oxaliplatin, capecitabine/5-FU, and irinotecan, as well as the targeted
agents bevacizumab, cetuximab, and panitumumab—is more important
than the sequence in which they are administered. In this program, a
gastrointestinal oncologist will summarize the current treatment landscape
to include the most recently reported research and address outstanding
questions. An expert panel of gastrointestinal oncology nurses,
with representation from diverse practice settings and clinical roles,
will conduct a case-based panel discussion of strategies for managing
therapy-related side effects that emerge throughout the CRC continuum
of care. Major side effects to be discussed include rash, peripheral neuropathy,
hypersensitivity reactions, palmar-plantar erythema, diarrhea,
hypertension, and bleeding. Because management of many of these
toxicities lacks consensus, members of the panel will describe their
own practice experiences and they will elicit experiences of program
attendees via audience response technology.
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Despite the high incidence of cancer in older adults, our
knowledge of specific treatment regimens and nursing
interventions for this population is poor. This program will
address the current treatment landscape for older adults with
lung, prostate, breast, and gastrointestinal (GI) malignancies,
and will highlight ways in which practice may be improved. In
addition to current research on the use of aggressive
therapies and treatment guidelines for the older adult
population, a review of a comprehensive geriatric assessment
and symptom management issues will be covered. National
key opinion leaders will present cases of patients with breast,
lung, prostate, and GI malignancies to illustrate the clinical
applications of chemotherapy regimens studied in older
adults.
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Practice Patterns in Colorectal Cancer: A Panel Discussion
What treatment regimen is most commonly given first-line to
patients with metastatic CRC? What is typically given as
second-line therapy? Salvage therapy? If you take a
chemotherapy holiday, do you continue with targeted
therapies? In what doses are certain chemotherapies and
targeted therapies given and are side effects different when
increased doses are given? How do you treat older patients?
There is no consensus regarding the answers to these
questions and several others related to the current treatment
landscape of CRC. Therefore, let us learn from our
colleagues' experiences and improve survival outcomes for
patients with CRC. During this program, questions such as
those outlined above will be asked to an audience of
approximately 550 oncology nurses. A thought-leader panel
with representation from academic and community-based
settings will address participant responses.
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Optimizing Outcomes for Metastatic Colorectal Cancer Patients: An APN Roundtable Discussion
This case-based discussion program is intended for
oncology nurse practitioners and clinical nurse
specialists. Current research on appropriate systemic
treatment sequencing for metastatic colorectal cancer
(mCRC), treatment of the older adult with mCRC, and
the emerging role of neoadjuvant and adjuvant
chemotherapy for patients with resectable or potentially
resectable liver metastases will be highlighted. The
cases will be presented by national key opinion leaders
in colorectal cancer and audience response questions
will be used to stimulate discussions with APN
attendees regarding optimal patient care. Nurse
participants have submitted their own challenging cases
throughout the past 3 months which will be discussed
with colleagues and expert panelists.
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For Reference Only |
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Optimizing Outcomes for Metastatic Colorectal Cancer Patients: An APN Roundtable Discussion
This case-based discussion program is intended for
oncology nurse practitioners and clinical nurse
specialists. Current research on appropriate systemic
treatment sequencing for metastatic colorectal cancer
(mCRC), treatment of the older adult with mCRC, and
the emerging role of neoadjuvant and adjuvant
chemotherapy for patients with resectable or potentially
resectable liver metastases will be highlighted. The
cases will be presented by national key opinion leaders
in colorectal cancer and audience response questions
will be used to stimulate discussions with APN
attendees regarding optimal patient care. Nurse
participants have submitted their own challenging cases
throughout the past 3 months which will be discussed
with colleagues and expert panelists.
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Case-Based Discussion for the Management of Metastatic Colorectal Cancer
This program will provide participants an overview of the recent progress made in the treatment of primary and metastatic colon cancer, which has ultimately led to significant survival benefits. Inspirational patient stories will be included throughout the presentations to provide messages of hope for our patients. Nursing management strategies for common toxicities will also be covered.
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There Is No Place Like Hope: Chronicles of Colon Cancer Survivors
This program will provide participants an overview of the recent progress made in the treatment of primary and metastatic colon cancer, which has ultimately led to significant survival benefits. Inspirational patient stories will be included throughout the presentations to provide messages of hope for our patients. Nursing management strategies for common toxicities will also be covered.
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