CAGPO 2018 Conference General Learning Objective
At the completion of this conference, the learning will:
- Be familiar with the national legislation regarding MAID and the issue of “conscious Objection”;
- Develop an approach to the diagnosis and treatment of Cancer Associated Thrombosis (CAT), as well as recent changes in the management of CAT;
- Understand the role of PARP inhibitors in the treatment of metastatic breast and ovarian cancers, as well as management of the major toxicities associated with this class of medication;
- Be familiar with the role of SBRT in the curative and palliative settings, as well as patient selection and toxicity management;
- Become familiar with the diagnosis and treatment options available for neuroendocrine tumors, metastatic lung cancer, multiple myeloma and metastatic prostate cancer;
- Be able to discuss the role of anti-emetics in the management of nausea and vomiting due to systemic therapies;
- Develop and approach to rotating narcotics;
- Become familiar with the management of toxicities associated with bone marrow transplantation;
- Become familiar with the toxicity management of immune-oncology drugs;
- Understand the role of tyrosine kinase inhibitors (TKIs) in the treatment of advanced renal cell cancer, as well as the management of TKI treatment-related toxicities;
- Develop an understanding of the role of CDK 4/6 inhibitors in the management of metastatic breast cancer;
- Be provided with a summary of 3 to 4 practice-changing outcomes from ASCO 2018, as well as three areas of significant change in the standard of care for GI malignancies;
- Develop an understanding of the role of the substitute decision maker, advanced care planning and goals of care conversations;
- Become familiar with the presentation of post-traumatic stress disorder in the oncology population, its management and possible prevention strategies.
CAGPO 2018 Talk Specific Learning Objectives
MAID - Where are we now?
- Give an overview of the national legislation regarding MAID;
- Address "Conscious Objection" to providing the service-what are MDs obligated to due by law;
- Discuss the challenges that have been experienced since MAID was legalized.
PARP Inhibitors - Breast and ovarian cancer
- Using a case-based approach, provide the learners with an overview of the signs and symptoms of CAT, which patients are at highest risk, and what are the typical symptoms to educate patients in regards to;
- Using the case, guide the learner through how to initiate LMWH, when to dose adjust (CrCL, weight-?split dosing, PLTs), how long to treat a patient, how and when to use anti-Xa levels;
- Using materials from the Thrombosis Canada website, educate the learners on what is available for patients and clinicians.
Radiation 101 wrt SBRT
- Provide an overview of what PARP inhibitors are and how they work;
- Discuss their role in the treatment of ovarian and breast cancers (what line of treatment, how to monitor, what toxicities to look for and how they are managed, which patients are eligible).
CAT - What is new and practice changing
- Discuss the role of SBRT in potentially curative settings;
- Discuss the role of palliative SBRT and how it differs from standard XRT, and address whether it has changed symptom control & patient survival;
- Provide and overview of the technical process related to the delivery of SBRT;
- Discuss patient eligibility for SBRT;
- Discuss short and long term toxicities and their management;
- Provide and overview of potential drug interactions with SBRT-which oral and IV systemic treatments can continue and which need to be held.
- Building on the previous discussion of CAT, this presentation will address new and practice changing developments in the treatment of CAT.
Metastatic Lung Cancer
- Review the updated terminology and classification for NET;
- Provide an overview of presentation and diagnostic work up of NET;
- Discuss treatment options and their availability, as well as management of symptoms and complications of NET;
- Review response rates;
- Discuss the most common toxicities from treatment and their management.
Bone Marrow Toxicity
- Briefly review the recommended pathology testing and describe which tests are clinically being used in standard therapy;
- Review the options for first line therapy in the setting of patients who have no treatment altering mutations, as well as patients with EGFR mutations and those with ALK mutations;
- Describe who age, co-morbidities and ECOG status affect treatment choices;
- Discuss which patients will benefit from immune therapies and in which line of treatment are they being used.
Anti-emetics and rotating narcotics
- Review the most common and most serious toxicities from a BMT and how they are managed;
- Review the short and long term risks of BMT.
- Discuss the role of anti-emetics in chemotherapy administrations;
- Review the relevant receptors that are targeted;
- Review relevant guidelines for the use of anti-emetics;
- Discuss the potential for drug-drug interactions: which classes of medications one should be concerned of, what actions can be taken to mitigate toxicities.
Immuno-oncology toxicity management
- Discuss the rationale for the practice of rotating narcotics, when, how and why one would choose to alter treatment in this manner;
- Discuss the most common pitfalls in rotating narcotics;
- Provide practical suggestions on how this is accomplished.
Metastatic Prostate Cancer
- Using cases from various disease sites, discuss the toxicities of I-O treatment;
- Discuss the management of I-O toxicities using a case-based approach;
- Discuss when treatment must be discontinued and when a dose reduction is appropriate;
- Discuss patient selection for I-O drugs.
TKIs and RCC
- Provide an update on the recent advances in the treatment of metastatic prostate cancer, both in the setting of early metastatic disease and castrate-resistant disease;
- Review relevant data from Stampede, Chaarted and Latitude studies;
- Review drug toxicities and how they are managed;
- Discuss the role of bone-modifying agents in the treatment of metastatic disease.
Metastatic breast cancer and the CDK 4/6 inhibitors
- Review new treatment options for patients with advanced renal cell carcinoma, including efficacy & toxicity profiles of various treatment options;
- Apply best practices to proactively manage treatment-related toxicities in patients with TKI treatment;
- Evaluate case-based clinical scenarios to determine optimal treatment strategies & methods to mitigate TKI treatment-related toxicities when managing advanced RCC in multiple lines of care.
ASCO Update 2018
- Discuss the mechanism of action of CDK 4/6 inhibitors;
- Review their role in the treatment of metastatic breast cancer;
- Review their toxicities and how they are managed;
- Discuss patient selection (who is and who isn’t appropriate for this class of drugs).
GI Cancer Update
- Select 3 or 4 practice changing outcomes from ASCO 2018 – present an overview of the data presented at ASCO and how this information will affect patient care in 2018.
Talk on Consent
- Discuss 3 areas of practice in GI malignancies that has experienced significant changes to the standard of care in the last 12 months;
- Review the data that lead to these changes;
- Discuss how this information will (or is) affecting patient care;
- Review the main toxicities of these treatments and how the GPO can manage these toxicities.
- Appreciate the impact health care consent has on the Substitute Decision Maker(s);
- Develop an appreciation for the value of ACP and Goals of Care Conversations in health care decision making and to better understand the role of the health care provider;
- Motivate health care providers to endorse and encourage ACP conversations in an effort to support decision makers (patient or SDM’s);
- Demonstrate what information is used by substitute decision makers when making treatment decisions.
Inspired by an article discussing the diminished recovery of cancer patients because of undiagnosed or untreated PTSD
- Discuss the incidence and presentation of PTSD in cancer dx and management;
- Allow for a mindful consideration of the patients perspective;
- Discuss management options and potential supportive strategies;
- Look at the incidence of chronic PTSD in survivors;
- Explore what we could do differently in prevention strategies.