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Disclaimer: CME certification for these activities has expired. All information is pertinent to the timeframe in which it was released.


Emerging Trends In Cancer Therapy And Supportive Care: Practical Insights For Clinicians


GOAL
To provide oncology nurses and oncology physician assistants with up-to-date information on their role in the treatment and management of patients with cancer-related anemia, neutropenia, and mucositis.

TARGET AUDIENCE
This activity is designed for oncology nurses and oncology physician assistants. No prerequisites required.

LEARNING OBJECTIVES
The Institute for Johns Hopkins Nursing and Johns Hopkins University School of Medicine take responsibility for the content, quality, and scientific integrity of this CE activity. At the conclusion of this activity, the participant should be able to:

  • Illustrate emerging data from the 2006 American Society of Clinical Oncology Annual Meeting and the Oncology Nursing Society 31st Annual Congress.
  • Describe how the new data should affect patient care.

ACCREDITATION STATEMENT
The Institute for Johns Hopkins Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education
for physicians.

CREDIT DESIGNATION STATEMENT
The Institute for Johns Hopkins Nursing designates this activity for a maximum of 0.6 contact hours. Claim only those contact hours actually spent in the activity.(50 minutes of contact = 1 contact hour.)

The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The estimated time to complete this educational activity: 30 minutes.

Release date: September 15, 2006.
Expiration date: September 15, 2008.

DISCLAIMER STATEMENT
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Institute for Johns Hopkins Nursing and the Johns Hopkins University School of Medicine names implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

This program is supported by an educational grant from Amgen Inc.

Full Disclosure Policy Affecting CE Activities:
As a provider accredited by the American Nurses Credentialing Center (ANCC), it is the policy of The Institute for Johns Hopkins Nursing to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The Program Directors and Participating Faculty reported the following:

PROGRAM DIRECTORS

MiKaela Olsen, RN, MS, OCN
Oncology and BMT Clinical Nurse Specialist
Sidney Kimmel Comprehensive Cancer Center
The Johns Hopkins Hospital
Baltimore, Maryland
Ms Olsen reports serving on the speakers' bureaus for Amgen Inc., GlaxoSmithKline, and Merck & Co., Inc.

Scott W. Possley, PA-C, MPAS
Oncology and BMT Physician Assistant
New York Presbyterian Hospital
Weill Cornell Medical Center
New York, New York
Mr Possley reports holding stock in CuraGen Corporation; and receiving honoraria from Amgen Inc.

Jerry L. Spivak, MD
Professor of Medicine and Oncology
Johns Hopkins University School of Medicine
Director, Center for Chronic  Myeloproliferative Disorders
The Johns Hopkins Hospital
Baltimore, Maryland
Dr Spivak reports serving as a consultant for FibroGen, Inc., Novartis, Roche Pharmaceuticals, and Shire Pharmaceuticals.

PARTICIPATING FACULTY

Kathryn G. Keegan,  ARNP
Oncology Nurse Practitioner
Puget Sound Veteran's Administration Medical Center
Cancer Care Clinic
Seattle, Washington
Ms Keegan reports having no financial or advisory relationships with corporate organizations related to this activity.

Notice:
The audience is advised that articles in this CE activity contain reference(s) to unlabeled or unapproved uses of drugs or devices.
Ms Keegan—epoetin alfa dosing.
All other faculty have indicated that they have not referenced unlabeled/unapproved uses of drugs or devices.

Johns Hopkins Advanced Studies in Nursing provides disclosure information from contributing authors, lead presenters, and participating faculty. Johns Hopkins Advanced Studies in Nursing does not provide disclosure information from authors of abstracts and poster presentations. The reader shall be advised that these contributors may or may not maintain financial relationships with pharmaceutical companies.

Emerging Trends In Cancer Therapy And Supportive Care: Practical Insights For Clinicians
Part Four: ASCO and ONS 2006 Review

INTRODUCTION
MiKaela Olsen, RN, MS, OCN, Jerry L. Spivak, MD,  and Scott W. Possley, PA-C, MPASà

Studies have indicated that the presence of chemotherapy-induced complications, including anemia,1,2 mucositis,3 and neutropenia,2,4 may lead to delays in chemotherapy treatment, ultimately having a negative impact on patient outcomes. In response to these data, considerable studies have been undertaken and advances have been made in supportive care for chemotherapy-induced complications, resulting in efficacious management and treatment strategies. In addition, evidence-based guidelines for proactive preventive therapies have been introduced for anemia5 and neutropenia 6,7 that are becoming more widely used in clinical oncology practice. Because of their sustained contact with patients, oncology nurse practitioners (NP) and oncology physician assistants (PA) are in a unique position to implement and integrate these evidence-based guidelines into clinical oncology practice as a standardized approach to supportive care, thereby streamlining and optimizing safe, effective patient care.

This year, a wealth of new information on advances in supportive care was presented at the American Society of Clinical Oncology (ASCO) Annual Meeting, held in Atlanta, and the Oncology Nursing Society (ONS) 31st Annual Congress, held in Boston. In this issue of Johns Hopkins Advanced Studies in Nursing, selected abstracts and poster presentations provide highlights of important new data from these meetings.

Also featured in this issue, Kathryn G. Keegan, ARNP, contributes a clinician interview, in which she discusses the importance of this new information and the ongoing challenges faced by oncology NPs and oncology PAs in implementing and managing supportive care in the clinical setting.
In addition, MiKaela Olsen, RN, MS, OCN, and Ms Keegan each contribute a case study applying new information from the 2006 ASCO Annual Meeting and the ONS 31st Annual Congress and illustrating the impact of supportive care on patient outcomes and adherence to chemotherapy treatment.
We hope this issue of Johns Hopkins Advanced Studies in Nursing provides you with new insights on how to apply the latest scientific data to your clinical practice and how to continually improve the care you provide to your patients with cancer.

REFERENCES

1. Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer. 2001;91:2214-2221.
2. Nirenberg A. Managing hematologic toxicities: novel therapies. Cancer Nurs. 2003;26:32S-37S.
3. Scully C, Sonis S, Diz PD. Oral mucositis. Oral Dis. 2006; 12:229-241.
4. Lyman GH, Kuderer N, Greene J, Balducci L. The economics of febrile neutropenia: implications for the use of colony-stimulating factors. Eur J Cancer. 1998;34:1857-1864.
5. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Cancer- and Treatment-Related Anemia. Version 2.2006. Available at: http://www.nccn. org/professionals/physician_gls/PDF/anemia.pdf. Accessed June 1, 2006.
6. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Fever and Neutropenia. Version 1.2005. Available at: http://www.nccn.org/professionals/physician_gls/PDF/fever.pdf. Accessed July 12, 2006.
7. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Myeloid Growth Factors. Version 1.2006. Available at: http://www.nccn.org/professionals/physician_gls/PDF/myeloid_growth.pdf. Accessed June 1, 2006.

The content in this monograph was developed with the assistance of a staff medical writer. Each author had final approval of his/her article and all its contents.





Johns Hopkins Advanced Studies in Medicine (ISSN-1558-0334), is published by Galen Publishing, LLC, d/b/a ASiM, PO Box 340, Somerville, NJ 08876. (908) 253-9001. Copyright ©2012 by Galen Publishing. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. ASiM is a registered trademark of The Healthcare Media Group, LLC.