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Extending Survival for Patients With TNBC: Are You Up to Date on New Treatment Standards?

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Maximum Credits:


PDF Publication PDF Publication


Maximum Credits:
PDF Publication PDF Publication


Maximum Credits:

Overview: This accredited CME/CE publication reviews current data from late-stage clinical trials on checkpoint-inhibitor use in advanced and metastatic triple negative breast cancer (TNBC). It also identifies immune-related adverse events associated with these treatments, provides strategies to manage such events, and offers patient-monitoring recommendations. These discussions are framed in the context of providing care for those with TNBC within the Veterans Health Administration.

CME Information:

Kevin Kalinsky, MD, MS
Associate Professor of Medicine
Herbert Irving Comprehensive Cancer Center
New York-Presbyterian Hospital/Columbia University
Irving Medical Center
New York, NY

Activity Planners
Erin Mooney, MS
Clinical Content Manager
Baltimore, MD
Lisa R. Rinehart, MS, ELS
Director, Editorial Services
Baltimore, MD
Samantha Gordon
CME Specialist
Baltimore, MD
Kathryn Schaefer, MSN, RN, CPHRM
Senior Manager, Accreditation and Compliance
East Lansing, MI

Jennifer Gregg, PhD
Cranberry Township, PA
Learning Objectives
Upon completion, participants should be able to:

  • Evaluate clinically relevant data on ICIs for early stage and metastatic TNBC
  • Identify patients with TNBC who may benefit from treatment with ICIs and/or be eligible for enrollment in clinical trials
  • Monitor patients receiving ICIs to assess treatment response and manage irAEs

Target Audience
This activity is intended for physicians, nurses, pharmacists, and other providers who manage the health of beneficiaries in the federal healthcare system.
Statement of Need
Healthcare professionals who work within the federal healthcare system manage approximately 50,000 incident cancer diagnoses each year. Of these cases, approximately 0.8% represent women with breast cancer, and an even smaller proportion of these involve the most aggressive breast cancer subtype, triple negative breast cancer (TNBC). Although TNBC is a rarely seen cancer in the federal healthcare system, it is important that clinicians be able to optimally manage it when it does present, especially given the emerging, life-extending treatment advances. In early 2019, the FDA approved the combination of atezolizumab and nab-paclitaxel as first-line therapy for women with recurrent or metastatic TNBC positive for programmed cell death ligand 1 (PD-L1) expression. Shortly thereafter, guideline recommendations for TNBC were updated to include this combination regimen as the preferred regimen in this disease and treatment setting. To apply these treatment advances to practice, providers in the federal healthcare system must be able to assess tumor PD-L1 expression to select patients for immunotherapy as well as be able to support those receiving this treatment. Additionally, providers must understand the monitoring and management practices required to properly assess response and identify and manage potential treatment-emergent, immune-related adverse events.

Providership Statement
Provided by Med-IQ.

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Med-IQ designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Med-IQ is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
This nursing activity has been approved for up to 1.0 contact hour.

ACPEMed-IQ is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.0 contact hour (0.1 CEU) of credit for pharmacists. ACPE # 0476-0000-19-013-H04-P. This application-based activity is designed for all pharmacists.

Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.

Medium/Method of Participation
This CME/CE activity consists of a 1.0-credit publication. To receive credit, read the introductory CME/CE material, read the publication, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.
Initial Release Date: August 2, 2019
Expiration Date: August 1, 2020
Estimated Time to Complete This Activity: 1 hour

Disclosure Policy
Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 12 months, including those of a spouse/life partner, that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.
Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation. 
Kevin Kalinsky, MD, MS
Salary (spouse): Array BioPharma
Consulting fees/advisory boards: Amgen Inc, Biotheranostics, Eisai Inc., Eli Lilly and Corporation, Genentech, Immunomedics, Ipsen Group, Novartis Pharmaceutical Corporation, Pfizer Inc.
Ownership interest (spouse): Array BioPharma
Other (speakers bureau): Eli Lilly and Corporation

The writer, peer reviewers, and activity planners have no financial relationships to disclose.

Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.
Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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Acknowledgment of Commercial Support
This activity is supported by an educational grant from Genentech.

© 2019 Med-IQ, Inc.


Unless otherwise indicated, photographed subjects who appear within the content of this activity or on artwork associated with this activity are models; they are not actual patients or doctors.

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