The Emerging Role of Immunotherapy in Treating Patients with
Presented by the Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing.
Triple-Negative Breast Cancer
Supported by an educational grant from Merck & Co Inc.
Triple negative breast cancer (TNBC) is a biologically heterogeneous disease that accounts for about 15% of all breast cancers. Unlike luminal breast tumors, which express the estrogen receptor and/or progesterone receptor, and human epidermal growth factor receptor-2-overexpressing (HER-2+) breast cancers, TNBC does not express a prototypical target for therapy that has been clinically validated. Therefore, chemotherapy is the mainstay of systemic therapy for both early and late-stage TNBC. Although TNBC typically has a shorter relapse-free time frame and overall survival than other breast cancer subtypes, patients with newly diagnosed primary TNBCs that contain significant levels of tumor-infiltrating lymphocytes (TILs) have better clinical outcomes than those that do not contain TILs. This suggests the potential for harnessing the immune system as a targeted therapy for patients with TNBC. Monoclonal antibody antagonists specific for programmed death-1 (PD-1) receptor or its ligand programmed death ligand-1 (PD-L1) have now been approved for multiple solid tumors and emerging data suggest that these agents will likely play a role in the clinical management of patients with TNBC as well. This activity will review data describing the clinical activity of inhibitors specific for the PD-1/PD-L1 pathway, discuss the management considerations unique to immunotherapy relative to standard chemotherapy, and highlight future directions to enhance the activity of immunotherapy for patients with TNBC.
The goal of this activityc is to review emerging data supporting the future clinical use of immune checkpoint blockade, antagonists of PD-1 and its ligand PD-L1, in patients with TNBC.
This activity is intended for oncology healthcare providers (oncologists, oncology physician assistants, oncology advanced practice nurses) who care for patients with TNBC. No prerequisites required.
After participating in this activity, the participant will demonstrate the ability to:
- DESCRIBE the rationale for harnessing the immune system to treat TNBC.
- EVALUATE the efficacy and safety of late-stage clinical research immunotherapeutic agents for TNBC.
- REVIEW potential current and future clinical practice implications of immunotherapeutic agents in the treatment of TNBC.
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.
This 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.
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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 13, 2019.
The estimated time to complete this activity: 30 minutes.
Release date: March 12, 2018 Expiration date: March 12, 2019
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Chair and Planner
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.
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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 Emens reports serving as a principal investigator and has received intellectual property rights and/or is a patent holder for Aduro Biotech Inc; serving as a principal investigator for AstraZeneca, Corvus Pharmaceuticals Inc, EMD Serono Inc, F. Hoffmann-La Roche Ltd, Genentech Inc, and MaxCyte Inc; serving as a consultant for Peregrine Pharmaceuticals Inc; serving as a consultant and/or serving on the advisory board for Gritstone Oncology Inc; and serving on the scientific advisory board for Amgen Inc, AstraZeneca, Bayer, Celgene, eTheRNA immunotherapies NV, MolecuVax Inc, Vaccinex Inc, Syndax Pharmaceuticals Inc.
No other planners 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).
David S. Ettinger, MD
Alex Grass Professor of Oncology
Sidney Kimmel Comprehensive Cancer Center
Leisha A. Emens, MD, PhD
Associate Professor of Oncology
Johns Hopkins University School of Medicine
Bloomberg-Kimmel Institute for Cancer Immunotherapy
Rebecca Barshick, RN, MSN
The Institute for Johns Hopkins Nursing
MiKaela Olsen APRN-CNS, MS, AOCNS, FAAN
Oncology and Hematology Clinical Nurse Specialist
Sidney Kimmel Comprehensive Cancer Center
at Johns Hopkins Hospital and Greenspring Oncology
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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.
This activity was developed in collaboration with ASiM.
The Emerging Role of Immunotherapy in Treating Patients with Triple-Negative Breast Cancer
Leisha A. Emens, MD, PhD
Postassessment and Evaluation