Incorporating Immunotherapy Into Treatment for MSI-H/dMMR Colorectal Cancer: Latest Updates on Testing, Treatment, and irAE Management
 
Release Date: February 27, 2019
Last Reviewed: February 23, 2019
Expiration Date: February 27, 2020
Time to Complete Activity: 1.25 hours

*This activity expired for credit on February 27, 2020 and is no longer available for credit
 

Faculty
Michael J. Overman, MD (Chair)
Professor
Department of Gastrointestinal Medical Oncology
Center Medical Director, Ambulatory Treatment Center
Division of Cancer Medicine
The University of Texas MD Anderson Cancer Center
Houston, TX
 
Richard Kim, MD
Section Chief of GI Medical Oncology
Department of Gastrointestinal Oncology
Moffitt Cancer Center
Associate Professor
Division of Medical Oncology
University of South Florida College of Medicine
Tampa, FL
 
Johanna Bendell, MD
Chief Development Officer
Sarah Cannon Research Institute
Tennessee Oncology
Nashville, TN
This activity is provided by Paradigm Medical Communications, LLC.  

Target Audience
This activity has been designed to address the educational needs of oncologists who treat patients with colorectal cancer (CRC). The activity may also benefit other oncology healthcare professionals involved in the management of patients with CRC.
 
Statement of Need
Although immunotherapy has been available for other solid tumors since 2011, several immunotherapy regimens were recently approved for the treatment of relapsed/refractory CRC with high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR), ushering in a new treatment paradigm. Because these agents are new to CRC, many oncology clinicians are not yet familiar with the latest clinical trial data or how to use these agents in clinical practice. In addition, many oncology clinicians are not familiar with the concept of MSI-H or dMMR, and therefore fail to follow universal testing guidelines. As a result, many patients do not receive testing and therefore may not receive immunotherapy. Furthermore, immunotherapy is associated with immune-related adverse events (irAEs), which are distinct from toxicities frequently observed with chemotherapy or targeted therapy. Many oncology clinicians still have difficulty recognizing and appropriately managing irAEs. Therefore, this activity will feature an expert-led, case-based discussion of biomarker testing, the latest on the use of immunotherapy, and managing potential irAEs in patients with CRC.
 
Learning Objectives
Upon proper completion of this activity, participants should be better able to:
  • Use results of MSI/dMMR testing to determine appropriate management of advanced CRC.
  • Formulate treatment plans for advanced CRC using immune checkpoint inhibition, alone or in combination with other therapies, based on the latest clinical trial data.
  • Apply evidence-based strategies to monitor for, recognize, and effectively manage potential irAEs associated with immune checkpoint inhibition.

Table of Contents
  • Introduction to Microsatellite Instability (MSI) and Mismatch Repair (MMR) in CRC
    Michael J. Overman, MD
  • Case 1: Patient With Metastatic CRC Richard Kim, MD
  • Case 2: Patient With Relapsed/Refractory CRC With MSI-H/dMMR
    Michael J. Overman, MD
  • Case 3: Patient With CRC Receiving Immunotherapy Develops an irAE
    Johanna Bendell, MD
  • Faculty Roundtable Discussion and Conclusion Faculty Panel
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Disclosure of Commercial Support
This activity is supported by an educational grant from Bristol-Myers Squibb.
 
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Disclosures
In accordance with Accreditation Council for Continuing Medical Education requirements on disclosure, faculty and contributors are asked to disclose any relationships with commercial interests associated with the area of medicine featured in the activity. These relationships are described below.
 
Faculty
Michael J. Overman, MD
Grant/Research Support: AstraZeneca; Bristol-Myers Squibb Company; Merck & Co., Inc
Retained Consultant: AstraZeneca; Bristol-Myers Squibb Company; Roche
 
Richard Kim, MD
Grant/Research Support: Bayer HealthCare; Bristol-Myers Squibb Company; Eisai, Inc
Retained Consultant: Bayer HealthCare; Bristol-Myers Squibb Company; Eisai, Inc
Speakers Bureau: Eli Lilly and Company
 
Johanna Bendell, MD
No financial relationships to disclose.
 
Paradigm Medical Communications, LLC staff members have no financial relationships to disclose.

Peer reviewer, Marwan G. Fakih, MD, has the following relationships to disclose:
Retained Consultant: Array BioPharma, Seattle Genetics, Inc
Speakers Bureau: Amgen Inc
 
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