OncologyConsults



Addressing Unmet Needs in Mesothelioma:
Evaluating the Role of Angiokinase Inhibitors


Presented by the Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing.

Supported by an educational grant from Boehringer-Ingelheim Pharmaceuticals, Inc.

OVERVIEW
Malignant pleural mesothelioma (MPM) is a relatively rare but serious malignancy that arises from the mesothelial surfaces of the pleural cavity. Most cases of MPM are associated with workplace exposure to high levels of asbestos, with the onset of cancer typically occurring 20 to 50 years after asbestos exposure. The diagnosis of MPM is often challenging, and patients are typically diagnosed with advanced disease. Few patients are candidates for surgery due to advanced age, disease stage at diagnosis, or medical comorbidity. Systemic treatment options for patients with MPM have historically been limited, and the 5-year survival rate is only 10%. More recently, a growing body of research has demonstrated that angiogenesis is an important part of the pathophysiology for many types of cancer, including MPM, and angiogenesis inhibitors have increasingly been used to treat patients with MPM. Although not yet approved by the US Food and Drug Administration (FDA) for the treatment of patients with MPM, evidence-based guidelines recommend the addition of the anti-angiogenesis agent bevacizumab, to pemetrexed and cisplatin for select MPM. Several oral angiogenesis inhibitors (also referred to as angiokinase inhibitors) are being developed for treating patients with MPM. One agent (nintedanib) is being evaluated in phase III clinical trials, and several other oral angiogenesis inhibitors are in earlier phases of development. Clinical research is also examining the efficacy and safety of combining angiogenesis inhibition with immune checkpoint inhibitors and other targeted therapies.

GOAL
The goal of this activity is to increase the knowledge of all members of MPM patient’s oncology care team about the role of oral angiokinase inhibitors in the treatment of patients with MPM. Participants will gain a better understanding of the diagnostic and staging challenges of MPM, the rationale for angiogenesis inhibition in MPM, and emerging clinical trial data supporting the use of novel antiangiogenesis agents.

TARGET AUDIENCE
This activity is intended for oncology physicians, physician assistants, nurse practitioners, and nurses who manage patients with MPM. No prerequisites required.

LEARNING OBJECTIVES
After participating in this activity, the participant will demonstrate the ability to:
  • RECOGNIZE clinical challenges and unmet needs associated with MPM diagnosis and treatment.
  • DESCRIBE the role of and rationale for targeting angiogenesis in MPM.
  • EVALUATE available data and potential clinical implications of investigational angiokinase inhibitors for MPM.
The Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing take responsibility for the content, quality, and scientific integrity of this CME/CNE activity.

CE INFORMATION
Accreditation Statements
accme_logoThis activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The Institute for Johns Hopkins Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Credit Designation Statements — The Johns Hopkins University School of Medicine designates this enduring material for a maximum of .5 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This .5 contact hour educational activity is provided by the Institute for Johns Hopkins Nursing. Claim only those contact hours actually spent in the activity. Statements will be awarded for this educational activity until March 5, 2019.

The estimated time to complete this activity: 30 minutes.

Release date: March 5, 2018    Expiration date: March 5, 2019

Policy On Speaker and Provider Disclosure
It is the policy of the Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing that the speaker and provider globally disclose conflicts of interest. The Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the instructional materials.

Full Disclosure Policy Affecting CME Activities
As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) requires attested and signed global disclosure of the existence of all financial interests or relationships with commercial interest from any individual in a position to control the content of a CME activity sponsored by OCME. The following relationships have been reported for this activity:

Planner Disclosures
Dr. Ettinger reports serving as a principal investigator for Golden Biotechnology Corp; serving as a consultant for AbbVie Inc, BeyondSpring Pharmaceuticals, Inc, Boehringer-Ingelheim GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, EMD Serono Inc, Guardant Health Inc, Genentech Inc, Helsinn Therapeutics Inc, Herron Therapeutics, and Sanofi-aventis, US LLC.

Dr. Forde reports service as principal investigator for Bristol-Myers Squibb; AstraZeneca; Novartis; Kyowa. Uncompensated Advisor for Boehringer Ingelheim; Vetmedica; Celgene; AstraZeneca; Bristol-Myers Squibb; Aventis; Novartis.


No other planners or faculty have indicated that they have any financial interests or relationships with a commercial entity.

Note: Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution that receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

FACULTY
Chair and Planner
David S. Ettinger, MD

Alex Grass Professor of Oncology
Sidney Kimmel Comprehensive Cancer Center
Baltimore, Maryland

Faculty Author
Patrick Forde, MBBCh

Assistant Professor of Oncology
Johns Hopkins University School of Medicine
Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
Baltimore, Maryland

Nurse Planner
Rebecca Barshick, RN, MSN

Nurse Educator
The Institute for Johns Hopkins Nursing
Baltimore, Maryland

Nurse Reviewer
MiKaela Olsen APRN-CNS, MS, AOCNS, FAAN

Oncology and Hematology Clinical Nurse Specialist
Ambulatory Oncology
Sidney Kimmel Comprehensive Cancer Center
  at Green Spring Station
Baltimore, Maryland

Off-Label Product Discussion
The activity chair has disclosed this module will reference the following unlabeled/unapproved uses of drugs or products:

  • Cediranib
  • Nintedanib
Non-Endorsement of Products
The Institute for Johns Hopkins Nursing and the American Nurses Credentialing Center do not endorse the use of any commercial products discussed or displayed in conjunction with this educational activity.

DISCLAIMER
The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This activity is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients.

CONFIDENTIALITY DISCLAIMER FOR CME ACTIVITY PARTICIPANT
I certify that I am participating in this Johns Hopkins University School of Medicine activity for CME-accredited training and/or educational purposes.

I understand that while I am participating in this capacity, I may be exposed to "protected health information," as that term is defined and used in Hopkins policies and in the federal HIPAA privacy regulations (the “Privacy Regulations”). Protected health information is information about a person's health or treatment that identifies the person.

I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential. I agree not to post or discuss this protected health information, including pictures and/or videos, on any social media site (eg, Facebook, Twitter, etc.), in any electronic messaging program or through any portable electronic device.

I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality. The contact information is: Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.

“The Office of Continuing Medical Education at the Johns Hopkins University School of Medicine, as sponsor of this activity, has relayed information with the CME attendees/participants and certify that the visitor is here for training, education and/or observation purposes only.”

For CME questions, please contact the CME Office at 410-955-2959 or e-mail cmenet@jhmi.edu.
Johns Hopkins University School of Medicine
Office of Continuing Medical Education
720 Rutland Avenue/ Turner 20
Baltimore, Maryland 21205-2195
Reviewed & Approved by: General Counsel, Johns Hopkins Medicine (4/1/03) (Updated 4/09 and 3/14)

HARDWARE & SOFTWARE REQUIREMENTS
Pentium 800 processor or greater, Windows 98/NT/200/XP or Mac OS 9/X or later, Microsoft Internet Explorer, Safari, Firefox, Windows Media Player 9.0 or later Flash player, 128 MB of RAM Monitor settings: High color at 800 x 600 pixels, Sound card and speakers, Adobe Acrobat Reader.

THE INSTITUTE FOR JOHNS HOPKINS NURSING MISSION STATEMENT
The mission of the Institute for Johns Hopkins Nursing is to share the innovations of Johns Hopkins Nursing in practice, education, and research—locally, nationally, and globally. Our goal in continuing nursing education is to bring you activities that reflect the expertise and creativity of Johns Hopkins Nursing. Our service values are quality, integrity, flexibility, and personal attentiveness. We appreciate your thoughts and welcome your concerns—please feel free to e-mail us: IJHN@.jhmi.edu.

ACTIVITY INSTRUCTIONS
The following is an interactive case module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, an interactive case study, and a CME/CNE post-test and evaluation. All 3 sections must be completed to receive CME/CNE credit. A certificate of participation will be available online immediately following successful completion of the activity.

Preassessment

Addressing Unmet Needs in Mesothelioma:
Evaluating the Role of Angiokinase Inhibitors

Patrick Forde, MBBCh

Postassessment and Evaluation

This activity was developed in collaboration with ASiM.


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