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Oncology Investigators Provide Perspectives on the Prevention and Management of Tumor Lysis Syndrome
Released November 2017

Featuring interviews with Drs William G Wierda and Amit Lahoti. (Audio Content)

CE Disclosures and Faculty Information

    Tumor lysis syndrome (TLS) is an oncologic emergency characterized by the rapid onset of hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia and/or acute renal failure. Despite the relatively rare incidence of TLS, the clinical landscape of this syndrome changed dramatically with the April 11, 2016 FDA approval of the Bcl-2 inhibitor venetoclax for relapsed/refractory chronic lymphocytic leukemia (CLL) harboring the del(17p) chromosomal abnormality. Given the availability of venetoclax and emerging evidence of its antitumor activity in non-del(17p) CLL and other cancer types, it is likely that concern over TLS will greatly increase in general oncology practice. To bridge the gap between research and patient care, this program uses one-on-one discussions with leading oncology and nephrology investigators to help overcome clinician uncertainties and alleviate current practice gaps surrounding the prevention and management of this potentially devastating complication of effective cancer treatment.


    • Understand the pathophysiology of TLS, recognize its disease- and treatment-related risk factors and establish an evidence-based approach for the prevention and management of this oncologic emergency.
    • Identify patients at increased risk for TLS or its complications (eg, those with increased baseline uric acid, the elderly, those with renal or cardiac dysfunction), and institute appropriate treatment modifications, including early intervention with rasburicase.
    • Formulate an approach to manage TLS-associated metabolic abnormalities — hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia and concomitant renal insufficiency — including recognition of when nephrology consultation is warranted.
    • Appraise the risk-benefit profiles of chemoimmunotherapy treatments and targeted agents and regimens for CLL, and develop management strategies for the unique toxicities associated with recently approved therapeutics.
    • Recognize the increased risk of TLS in patients with CLL treated with venetoclax, and implement approaches to ensure that appropriate administration protocols are followed to mitigate the risk of this potentially fatal toxicity.
      Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians

      Research To Practice designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

      ACCREDITATION INFORMATION FOR NURSE PRACTITIONERS This activity is approved for 1.75 contact hours of continuing education (which includes 1.75 hours pharmacology) by the American Association of Nurse Practitioners.

      This activity was planned in accordance with AANP Accreditation Standards and Policies.

      AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 1.75 Category 1 Credits for completing this activity.

      Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.75 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

      Please note, this program has been specifically designed for the following ABIM specialty: medical oncology.

      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.

      This CME activity contains an audio component. To receive credit, the participant should review the CME information, listen to the MP3s, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form at ResearchToPractice.com/TumorLysis17/CME. The corresponding video program is available as an alternative at ResearchToPractice.com/TumorLysis17/Video.

      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 CE 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 — Dr Lahoti had no relevant conflicts of interest to disclose. The following faculty (and his spouse/partner) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process: Dr WierdaConsulting Agreement: Sanofi Genzyme; Contracted Research: AbbVie Inc, Acerta Pharma, Genentech BioOncology, Gilead Sciences Inc, GlaxoSmithKline, Juno Therapeutics, Karyopharm Therapeutics, Kite Pharma Inc, miRagen Therapeutics Inc, Novartis, Pharmacyclics LLC, an AbbVie Company, Sunesis Pharmaceuticals Inc.

      EDITOR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CE 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, administered by Janssen Scientific Affairs LLC, 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, Pfizer Inc, 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 grantor.

      This activity is supported by an educational grant from AbbVie 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

      Release date: November 2017
      Expiration date: November 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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Oncology Investigators Provide Perspectives on the Prevention and Management of Tumor Lysis Syndrome
Released November 2017

Featuring interviews with Drs William G Wierda and Amit Lahoti. (Audio Content)

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