Clinical Investigator and Nursing Perspectives on the Management of Multiple Myeloma

Submitted by web@researchtop... on Fri, 10/12/2012 - 09:29

In these audio proceedings from one-on-one interviews conducted by Dr Neil Love, the invited medical oncologist and registered nurse provide oncology nurses with therapeutic strategies to address the disparate needs of patients with multiple myeloma. This content is available in a number of formats for listening on the go with a mobile device or in the office or at home on a computer.

TOPICS DISCUSSED DURING THE PROGRAM

INTERVIEW WITH DR ANDERSON

Extending progression-free and overall survival in MM during the era of novel agents
Current era of MM treatment with proteasome inhibitors — bortezomib, carfilzomib and MLN9708 — and immunomodulatory drugs (IMiDs) — lenalidomide and pomalidomide
Role of autologous stem cell transplant in the era of novel agents
Maintenance therapy after initial induction treatment for transplant-ineligible patients
Post-transplant maintenance lenalidomide and second primary cancers
Preferred options for pretransplant doublet and triplet induction regimens
Tolerability and side effects of lenalidomide
Bortezomib-related side effects – Subcutaneous administration and weekly dosing to ameliorate neuropathy
Benefits of the irreversible proteasome inhibitor carfilzomib in relapsed, refractory MM and the lack of associated peripheral neuropathy
Side effects of carfilzomib
Incorporation of carfilzomib into up-front induction therapy regimens — Carfilzomib/ lenalidomide/ dexamethasone
Efficacy and side effects of the third-generation IMiD pomalidomide
Etiology and management of renal failure in patients with MM
Prevalence of peripheral neuropathy in MM at initial diagnosis
Prevention of lytic bone disease and fractures with bisphosphonates
Duration of bisphosphonate therapy for patients with active myeloma
Bisphosphonate-associated osteonecrosis of the jaw (ONJ)

INTERVIEW WITH MS SPONG

Case discussion: A 69-year-old man with MM and significant bone pain receives CyBorD
– Use of subcutaneous bortezomib administration
– Post-transplant maintenance lenalidomide therapy
– Prevention of lenalidomide-associated thrombosis
– Side effects of pomalidomide
– Family support and patient coping with myeloma and its treatment
Case discussion: A 54-year-old man with IgG kappa smoldering myeloma for several years develops active, indolent myeloma and receives cyclophosphamide, carfilzomib, thalidomide and dexamethasone on the CYCLONE trial
– Efficacy and side effects of carfilzomib
Case discussion: An 87-year-old man has smoldering myeloma for 2 decades before developing active myeloma with significant renal failure and anemia
– Lenalidomide-associated rash
– Initiation and duration of bone-targeted treatment for MM
– Prophylaxis for ONJ


FACULTY:

	Jacy Spong, RN, BSN, OCN Mayo Clinic Scottsdale Scottsdale, Arizona

	Kenneth C Anderson, MD Kraft Family Professor of Medicine Harvard Medical School Chief, Division of Hematologic Neoplasia Director, Jerome Lipper Multiple Myeloma Center Director, LeBow Institute for Myeloma Therapeutics Dana-Farber Cancer Institute Boston, Massachusetts

	EDITOR:

	Neil Love, MD Research To Practice Miami, Florida

OVERVIEW OF ACTIVITY

Multiple myeloma (MM) is a plasma cell neoplasm that accounts for approximately 10% of all hematologic cancers and carries with it the worst death to new cases ratio (3:4) among all the blood cancer subtypes. Patients with smoldering (asymptomatic) myeloma may be cared for by observation only because the course of disease is often indolent for many years without therapy. However, patients with more advanced, active disease require immediate induction therapy in an effort to prepare eligible candidates for autologous stem cell transplant (ASCT). Optimal initial induction therapy for both ASCT candidates and those not eligible remains an area of clinical controversy, and multiple acceptable treatment options appear to merit consideration. Recent clinical research demonstrates an abundance of treatment options now available to patients with both newly diagnosed and relapsed or refractory MM. To provide oncology nurses with therapeutic strategies to address the disparate needs of patients with MM, the Oncology Nursing Update MM audio series employs one-on-one interviews with medical oncologists and nurses who are expert in caring for patients with MM. Upon completion of this CNE activity, oncology nurses should be able to formulate an up-to-date and more complete approach to the care of patients with MM.

LEARNING OBJECTIVES

Discuss the benefits and risks associated with evidence-based systemic therapies used in the treatment of MM, including chemotherapy, proteasome inhibitors, corticosteroids and immunomodulatory agents, in the pre- and postautologous stem cell transplant (ASCT) settings and for patients who are not candidates for ASCT.
Develop a plan of care to manage the side effects associated with these therapies to support quality of life and continuation of treatment.
Evaluate the preliminary safety profiles and response outcomes observed in studies of next-generation proteasome inhibitors and immunomodulatory agents for patients with relapsed or refractory and previously untreated MM.

ACCREDITATION STATEMENT

Research To Practice is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

CREDIT DESIGNATION STATEMENT

This educational activity for 1.5 contact hours is provided by Research To Practice during the period of October 2012 through October 2013.

HOW TO USE THIS CNE ACTIVITY

This is an audio CNE program. This website contains CNE information, including learning objectives, faculty disclosures, a Post-test and an Educational Assessment and Credit Form, as well as links to relevant abstracts and full-text articles.

To receive credit, participants should read the learning objectives and faculty disclosures, listen to the audio MP3s and complete the Post-test and Educational Assessment and Credit Form located at ResearchToPractice.com/ONUMM112/CNE. A statement of CNE credit will be issued only upon completion of the Post-test, with a score of 75% or better, and the Educational Assessment and Credit Form. Your statement of credit will be mailed to you within 3 weeks or may be printed online.

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 potential conflicts of interest with faculty, planners and managers of CNE activities. Real or apparent 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 reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

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

Jacy Spong, RN, BSN, OCN
Mayo Clinic Scottsdale
Scottsdale, Arizona

No real or apparent conflicts of interest to disclose.

Kenneth C Anderson, MD
Kraft Family Professor of Medicine
Harvard Medical School
Chief, Division of Hematologic Neoplasia
Director, Jerome Lipper Multiple Myeloma Center
Director, LeBow Institute for Myeloma Therapeutics
Dana-Farber Cancer Institute
Boston, Massachusetts

Advisory Committee: Bristol-Myers Squibb Company, Celgene Corporation, Merck and Company Inc, Millennium: The Takeda Oncology Company, Nereus Pharmaceuticals, Onyx Pharmaceuticals Inc; Scientific Founder: Acetylon Pharmaceuticals Inc, OncoPep.

EDITOR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME/CNE activities from the following commercial interests: Abbott Laboratories, Allos Therapeutics, Amgen Inc, ArQule Inc, Astellas, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals/Onyx Pharmaceuticals Inc, Biodesix Inc, Biogen Idec, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, EMD Serono Inc, Foundation Medicine Inc, Genentech BioOncology, Genomic Health Inc, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Incyte Corporation, Lilly USA LLC, Medivation Inc, Millennium: The Takeda Oncology Company, Mundipharma International Limited, Novartis Pharmaceuticals Corporation, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc and Teva.

RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no real or apparent 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 Celgene Corporation, Millennium: The Takeda Oncology Company and Onyx Pharmaceuticals Inc.

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: October 2012
Expiration date: October 2013

There is no implied or real endorsement of any product by RTP or the American Nurses Credentialing Center.