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What Urologists Want to Know: Addressing Current Questions and Controversies Regarding the Role of Immune Checkpoint Inhibitors in the Management of Bladder Cancer
Released August 2017

Proceedings from a CME symposium held at the 2017 American Urological Association’s Annual Meeting. Featuring perspectives from Drs Sia Daneshmand, Charles G Drake, Elizabeth R Plimack, Jonathan E Rosenberg and Robert S Svatek. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity has been designed to meet the educational needs of urologists and other allied healthcare professionals involved in the treatment of bladder cancer.

    OVERVIEW OF ACTIVITY
    The American Cancer Society estimates that 79,030 new cases of bladder cancer will be diagnosed in 2017 and 16,870 deaths will be attributable to this disease. Bladder cancer incidence and death rates in women have actually seen a slight decline, whereas for men, while incidence rates are also falling, mortality rates have remained relatively stable. The disease remains the fourth most common cancer in the United States and is 3 times as likely to be found in men as in women. Although bladder cancer is a heterogeneous collection of diseases, more than 90% of patients are diagnosed with its most common form, urothelial carcinoma, and the remaining 10% present with less prevalent phenotypes, including squamous, small cell and adenocarcinomas. For those patients with metastatic lesions beyond the bladder, cure is not attainable, and therapeutic options for these individuals have historically been limited to cytotoxic approaches, which confer marginal benefits. However, this trend appears to have shifted due to the success of various immune checkpoint inhibitors in the treatment of advanced or metastatic disease. This success will likely create an environment in which expert perspectives and ongoing discussion are needed to help tease out whether these agents are more similar than they are different or if, in fact, one may be more appropriate for use over the others.

    These video proceedings from a live CME symposium feature discussions with leading investigators in the management of bladder cancer regarding actual patient cases and related clinical research findings. By providing information on important therapeutic developments, this activity will assist medical and radiation oncologists, urologists and other healthcare professionals to address existing management uncertainties for patients with bladder cancer.

    LEARNING OBJECTIVES

    • Develop a basic understanding of the human immune response, and identify the underlying mechanisms by which various tumors evade this process to proliferate and grow.
    • Analyze the biologic basis for the development of immune checkpoint inhibitors designed to boost an individual’s immune response for the treatment of urothelial bladder carcinoma (UBC).
    • Compare and contrast the mechanisms of action, efficacy and safety of approved and investigational immune checkpoint inhibitors for the treatment of advanced UBC to determine the current and/or potential utility of each in clinical practice.
    • Recognize immune-related adverse events and other common side effects associated with approved and developmental checkpoint inhibitors used in the management of UBC, and offer supportive management strategies to minimize and/or manage these side effects.
    • Review ongoing research to assist in the identification of biomarkers, tumor characteristics and other clinical features that are indicative of response to immune checkpoint inhibitors in patients with UBC.
    • Describe ongoing clinical trials evaluating novel applications of immune checkpoint inhibitors alone or in combination with other systemic approaches, and counsel appropriately selected patients with UBC about trial availability and potential participation.

    ACCREDITATION STATEMENT
    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CREDIT DESIGNATION STATEMENT
    Research To Practice designates this enduring material for a maximum of 2.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Personal information and data sharing: Research To Practice aggregates deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of a video component. To receive credit, the participant should watch the video, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/AUABladder17/CME.

    CONTENT VALIDATION AND DISCLOSURES
    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

    FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Sia Daneshmand, MD
    Associate Professor of Urology (Clinical Scholar)
    Director of Urologic Oncology
    Director of Clinical Research
    Urologic Oncology Fellowship Director
    USC/Norris Comprehensive Cancer Center
    Institute of Urology
    Los Angeles, California

    No relevant conflicts of interest to disclose.

    Charles G Drake, MD, PhD
    Professor of Medicine 
    Co-Director, Cancer Immunotherapy Programs
    Columbia University Medical Center
    New York, New York

    Consulting Agreements: Agenus Inc, Dendreon Pharmaceuticals Inc, Genentech BioOncology, ImmuneXcite, Janssen Biotech Inc, Lilly, Merck, NexImmune, Pierre Fabre, Roche Laboratories Inc; Contracted Research: Bristol-Myers Squibb Company; Patents: AstraZeneca Pharmaceuticals LP, Janssen Biotech Inc, MedImmune Inc; Scrip Regulatory Affairs: Aduro Biotech, Bristol-Myers Squibb Company, Janssen Biotech Inc; Stock Ownership: Compugen, NexImmune, Potenza Therapeutics, Tizona Therapeutics Inc.

    Elizabeth R Plimack, MD, MS
    Director, Genitourinary Clinical Research
    Associate Professor, Department of Hematology/Oncology
    Fox Chase Cancer Center, Temple Health
    Philadelphia, Pennsylvania 

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Exelixis Inc, Genentech BioOncology, Horizon Pharma, Inovio Pharmaceuticals Inc, Lilly, Novartis, Pfizer Inc, Roche Laboratories Inc; Contracted Research: Acceleron Pharma, Agensys Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Merck, Peloton Therapeutics Inc, Pfizer Inc.

    Jonathan E Rosenberg, MD
    Associate Attending Physician
    Section Head, Non-Prostate Genitourinary Cancers
    Genitourinary Oncology Service
    Enno Ercklentz Endowed Chair
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Advisory Committee: Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, EMD Serono Inc, Genentech BioOncology, Gritstone Oncology, Inovio Pharmaceuticals Inc, Lilly, Merck, Roche Laboratories Inc, Sanofi Genzyme; Contracted Research: Genentech BioOncology, Incyte Corporation, Novartis.

    Robert S Svatek, MDM
    Associate Professor
    Department of Urology
    UT Health Science Center
    San Antonio, Texas

    Consulting Agreement: Rapamycin Holdings; Contracted Research: FKD Therapies, JBL Drug Laboratories.

    MODERATOR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals Inc.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no relevant conflicts of interest to disclose.

    This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

    This activity is supported by educational grants from AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company and Merck.

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
    Adobe Flash Player 10.2 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: August 2017
    Expiration date: August 2018

    After completing the Post-test, learners may download and review the answers here in order to identify further areas of study.

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