Optimizing Patient Care in the Era of Novel Therapies for Renal Cell Carcinoma
Release Date: June 30, 2009
Expiration Date: June 30, 2010
Target
Audience
Nurses
Program Purpose
Tremendous progress has been made in managing advanced renal cell carcinoma (RCC), a disease for which historically surgery has been the mainstay and older cytotoxic therapies had limited impact. The initial introduction of novel targeted therapies (i.e., sunitinib, sorafenib) against the VEGF pathway have made a significant clinical impact on disease stabilization and progression-free survival. Both sunitinib and sorafenib have been recommended as first line therapies in recent NCCN guidelines. In addition to blocking the VEGF receptor, another treatment strategy includes blocking the mTOR pathway (i.e., everolimus and temsirolimus). Given the availability of multiple treatment options, several clinical questions emerge: Is there an optimal sequence or combination of therapies? Is there a current role for cytokine therapy in RCC? Most importantly, can cure rates be improved with use of these agents earlier in the disease (neoadjuvant or adjuvant therapy)?
Ongoing and planned clinical trials will provide insights into many of these questions. Although these important novel therapies have changed the clinical progression and landscape of metastatic RCC, they are not without common toxicities (>20%) such as rash, fatigue, hypertension, and diarrhea. However, it is the potentially disabling complications (i.e., hand-foot syndrome) that represent a key area where oncology nurses have an increasingly important role in monitoring, managing symptoms, and counseling patients. In contrast to conventional chemotherapy, treatment with these novel targeted therapies is chronic and continuous, given over a prolonged period of time, sometimes years. If treatment is interrupted or terminated due to side effects, the disease may exacerbate and progress rapidly. Nurses’ knowledge of advancing treatment options, and especially about the optimal management of side effects, is therefore important to help avoid unnecessary dose reductions, treatment interruptions or even early treatment terminations, as well as to reduce patient discomfort during treatment.
Learning
Objectives
Upon completion of this activity, attendees will have received information that
should allow them to:
- Describe the risk, diagnosis, and current treatment options in patients with RCC;
- Identify the key angiogenic pathways involved in the pathophysiology of RCC;
- Critique the results of recently presented trials of novel therapies in RCC;
- Identify symptom management strategies for patients receiving novel therapies;
- Delineate a nursing care plan for the assessment and management of potential toxicities related to RCC treatment.
Accreditation and Credit Designation
The University of North Texas Health Science Center is an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Centers Commission on Accreditation.
The University of North Texas Health Science Center provides 1.5 continuing nursing education contact hours.
Faculty
Laura S. Wood, RN, MSN, OCN
Renal Cancer Research Coordinator
Cleveland Clinic Taussig Cancer Center
Cleveland, OH
Susan Y. Chon, MD
Assistant Professor
Department of Dermatology
UT MD Anderson Cancer Center
Houston, TX
Laurie H. Appleby, NP
Nurse Practitioner
Dana-Farber Cancer Institute
Boston, MA
Disclosure Information
It is the policy of the University of North Texas Health Science Center (UNTHSC) at Fort Worth Office of PACE to ensure balance, independence, objectivity, and scientific rigor in all sponsored educational activities. All faculty participating in sponsored programs are expected to disclose to the program audience any real or perceived conflicts of interest related to the content of their presentations or to their financial and professional relationships. The UNTHSC Office of PACE is committed to stringent enforcement of full disclosure in the planning and execution of all sponsored activities and resolution of any perceived conflicts. Pursuant to regulatory guidelines, the UNTHSC Office of PACE complies with those protocols established by professional, scientific, and governmental oversight, and expects the faculty to adhere to the same, in order to help ensure the integrity of both scientific content and professional conduct.
It is not assumed that these financial interests or affiliations will have an adverse impact on the faculty presentations. They simply are noted here to fully inform course participants. Further, two independent external reviewers have reviewed the presentations and have determined that no commercial bias exists. These external reviewers are:
Victoria W. Loerzel, PhD, RN, OCN, Assistant Professor, University of Central Florida; Clinical Nurse Research Scientist, Orlando Regional Healthcare System, Orlando, FL
Karen Meneses, PhD, RN, Professor and Associate Dean for Research, University of Alabama at Birmingham; Senior Scientist, University of Alabama Comprehensive Cancer Center, Birmingham, AL
The following was received from the course faculty:
Laurie H. Appleby, NP
Speaker's Bureau: Bayer, Pfizer, Wyeth
Susan Y. Chon, MD
Has nothing to disclose.
Laura S. Wood, RN, MSN, OCN
Speaker's Bureau: Bayer/Onyx, Pfizer, Wyeth
The contributing faculty developed the content independently. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the educational sponsor or commercial supporter.
Method of Instruction
To receive continuing education, you must:
- View the activity.
- Successfully complete the post-test (50% or higher).
- You will have 2 opportunities to successfully complete the program.
Your statement of credit will be issued immediately upon successful completion
of the test and submission of the evaluation form.
Fee
There is no charge for this activity.
Commercial Support Statement
This activity is supported by an educational grant from Wyeth Pharmaceuticals.
Software Requirements:
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