Weight Loss in Patients with Lung Cancer:
Current and emerging strategies to manage loss of appetite,
sarcopenia, cachexia, and other problems and manifestations
Overview
  • Dates of Release & Expiration: January 1, 2016 - January 1, 2017
  • Available "24/7" on-demand, to be viewed either as a CME or CE or non-accredited program
  • 6 medical oncologists, an advanced nurse practitioner, and an oncology pharmacist
  • 0.5 Category 1 CME credits available for physicians
  • 0.5 CE credits available for nurses and pharmacists
Course Director
Philip Bonomi, MD
Director of Hematology/Oncology
Rush University Medical Center
Chicago, IL
 
Click here to
view this 30-minute webinar and earn either CME or CE credit. Requires completion of a brief evaluation form, participation in 4 pre- and post-questions, and successfully passing a CME or CE test of 4 questions
 
Click here to
view this 30-minute webinar without CME or CE credit
 
 

Overview

With the knowledge from eight lung cancer experts, this 30-minute Webinar is designed to help the target audience of medical oncologists, oncology nurses/nurse practitioners, pharmacists, nutritionists and other healthcare professionals involved in the management of unintended weight loss in patients with lung cancer improve their quality of life and, hopefully, also their survival.

The content of this Webinar includes both evidenced-based published data and also the vast clinical experience of these eight experts on how to most effectively improve appetite, increase lean muscle mass and ameliorate the related symptoms associated with weight loss and cancer cachexia/anorexia ranging from frailty, inability to exercise, depression and many other consequences of this syndrome.

Target Audience

  1. Medical oncologists
  2. Advanced nurse practitioners
  3. Oncology nurses
  4. Clinical nurse specialists
  5. Palliative care specialists
  6. Oncology pharmacists
  7. Nutritionists
  8. Dietitians
  9. Social workers
  10. Patient Caregivers

Learning Objectives

  1. Recognize the prevalence and significance of unintended weight loss in lung cancer patients.
  2. Understand the problems and clinical manifestations associated with unintended weight loss in patients with lung cancer.
  3. Analyze the endpoints and techniques for measuring and monitoring loss or gain of lean muscle mass in lung cancer patients.
  4. Evaluate the toxicities and limitations associated with the traditional approaches used in lung cancer patients for managing weight loss.
  5. Compare and contrast the emerging strategy using ghrelin agonist therapy with the current approaches for managing weight loss and improving appetite in patients with lung cancer.

Faculty & Disclosures

Course Director
Philip Bonomi, MD
Director of Hematology/Oncology
Rush University Medical Center
Chicago, IL

Consulting Fees (e.g., advisory boards): Helsinn Pharmaceuticals

Faculty
Marianne Davies, DNP, MSN, RN, APRN, CNS-BC, ACNP-BC, AOCNP
Assistant Professor of Nursing,
Yale School of Nursing
Oncology Nurse Practitioner,
Yale Thoracic Oncology Program
Yale Cancer Canter
New Haven, CT

Fees for Non-CME Services Received Directly from Commercial Interest or their Agents: Genentech, Bristol-Myers Squibb, Novartis, Merck

David Ettinger, MD
Alex Grass Professor of Oncology
Sidney Kimmel Comprehensive Cancer Center
Johns Hopkins School of Medicine
Baltimore, MD

Consulting Fees (e.g., advisory boards): ARIAD Pharmaceuticals, Inc., Boehringer-Ingelheim, BMS, Eisai, Inc., Eli Lilly & Co., EMD Serono, Genentech, Golden Biotech, Helsinn Therapeutics (US), Inc., Sandoz
I intend to reference unlabeled/unapproved uses of drugs or products in my presentation.

Richard Gralla, MD
Professor of Medicine
Albert Einstein College of Medicine
New York, NY

Fees for Non-CME/CE Services Received Directly from Commercial Interest or their Agents (e.g., speakers' bureaus): Helsinn
Consulting Fees (e.g., advisory boards): Helsinn
I intend to reference unlabeled/unapproved uses of drugs or products in my presentation.

Edward Kim, MD
Chair of Solid Tumor Oncology
Investigational Therapeutics
Levine Cancer Institute of the
Carolina's Heath Care System

Consulting Fees (e.g., advisory boards): Boehringer Ingelheim, Celgene and Eli Lilly

Jim Koeller, MS
Professor of Pharmacy,
University of Texas at Austin, College of Pharmacy
Professor of Medicine in Oncology
at the Health Sciences Center,
San Antonio, TX

Fees for Non-CME/CE Services Received Directly from Commercial Interest or their Agents (e.g., speakers' bureaus): Lilly, Merck

Corey Langer, MD
Professor of Medicine
Perelman School of Medicine
University of Pennsylvania
Director of Thoracic Oncology
Abramson Cancer Center
Philadelphia, PA

Grant/Research Support: Bristol-Myers Squibb, Pfizer, Lilly, Genentech, OSI (Astellas), Merck, GSK, Nektar, Clovis
Scientific Advisor: Bristol-Myers Squibb, ImClone, Sanofi-Aventis, Pfizer, Lilly, Amgen, AstraZeneca, Novartis, Genentech, Bayor/Onyx, Abbott, Morphobiotek, Biodesix, Clarient, Claris Dx, Vertex, Synta, Celgene, Boehringer-Ingelheim, AbbVie, Clovis, Merck
Speakers Bureau: Lilly, Genentech, OSI, Imclone-BMS (all susoended as of 12/10)
DSMC: Lilly, Amgen, Synta, Agennix, Peregrine, Incyte, SWOG
CME: Imedex, PER, TRM
I intend to reference unlabeled/unapproved uses of drugs or products in my presentation.

Heather A. Wakelee, MD
Assistant Professor
Department of Medicine
Division of Oncology
Stanford Cancer Institute
Stanford Comprehensive Cancer Center
Stanford, CA

Consulting Fees (e.g., advisory boards): Peregrine, Novartis, ACEA
Contracted Research: Novartis, BMS, Clovis, Xcovery, Celgene, Roche/Genentech, Medimmune, Pfizer, Lilly
I intend to reference unlabeled/unapproved uses of drugs or products in my presentation.

LEAD NURSE PLANNER
Diane D. DePew, DSN, RN-BC

I have no real or apparent conflicts of interest to report.

PLANNER & CME/CE REVIEWER
Steve Madison, RPh, MBA (BMLI Manager)

I have no real or apparent conflicts of interest to report.

CME/CE PEER REVIEWER
Danielle Shafer, MD

I have no real or apparent conflicts of interest to report.

Peer Review Process of Conflicts of Interest

This educational activity has been independently peer-reviewed.

Disclosure of Unlabeled Uses

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration (FDA). For additional information about approved uses, including approved indications, contraindications, and warnings, please refer to the prescribing information for each product or consult the Physicians' Desk Reference.

The Biomedical Learning Institute (BMLI) does not recommend the use of any agent outside of the FDA labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the BMLI. Please refer to the official FDA prescribing information for each product for discussion of approved indicated, contraindications, and warnings.

CME/CE Accreditation & Credit Designation

To receive CME/CE credit participation in the entire activity by viewing the 30-minute video and the completion of a brief evaluation form, participation in 4 pre- and post-questions, and successfully passing a CME/CE test of 4 questions.

The Biomedical Learning Institute is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Biomedical Learning Institute designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 Credits™.

Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Biomedical Learning Institute is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

UAN: 0838-0000-16-001-H01-P
Credits: 0.5 hours (0.05 ceus)
Type of Activity: Knowledge

The Biomedical Learning Institute is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's COA.

The Biomedical Learning Institute designates this educational activity for 0.5 contact hours.

Accreditation by the American Nurses Credentialing Center's COA refers to recognition of educational activities and does not imply approval or endorsement of any product.

Participation at the entire activity, a 70% or better score on the post-test and completion of the evaluation form is required to receive CE contact hour credit.

Physician Assistants: AAPA accepts certificates of attendance for educational activities certified for Category 1 credit from AOACCME, Prescribed credit from AAFP, and AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician Assistants may receive a maximum of 0.5 hours of Category 1 credit for attending this symposium.

Fellows will receive a certificate of attendance that they can submit to their accrediting organizations for continuing education credit.

Educational Support

Sincere appreciation is extended to Helsinn for their generous support of this educational activity

Educational Needs

Weight loss due to cancer anorexia-cachexia and sarcopenia is a multifactorial syndrome characterized by involuntary weight loss, muscle atrophy and physiological changes. This leads to progressive functional impairment, a poor quality of life and a decreased survival. This problem has been reported to occur in between 30 and 80% of all lung cancer patients and is related to approximately 20% of all cancer deaths.

In 2011, cancer anorexia-cachexia syndrome (CACS) was officially defined by an international expert consensus group as "a multifactorial syndrome characterized by an ongoing loss of skeletal mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment." CACS has severe consequences, such as reduction of treatment tolerance, reduction of response to therapy, and shortened survival, and, it can adversely affect a person's quality of life.

During the past few decades very few effective therapeutics have been available. Three of the several more traditional agents used are either synthetic marijuana (Delta-9-Tetrahydrocannabinol) or in States where it is legal, medical marijuana, and the use of megestrol acetate. These agents have demonstrated very limited if any success in improving appetite and increasing lean muscle mass and are associated with problems and side effects prohibiting long-term use. Clearly, there is an unmet medical need for improved management of unintended weight loss, loss of appetite, cancer cachexia/anorexia, and other associated problems in lung cancer patients.

During the past few years several clinical trials have evaluated an orally administered agent that is an agonist against the ghrelin receptor agonist. Ghrelin is a hormone that stimulates appetite. This agent is anamorelin which is in late-stage clinical development as of January 2016. Two large, global Phase III trials with anamorelin known as the ROMANA 1 and 2 trials demonstrated that after only one month of anamorelin therapy patients, added an average of one kilogram of lean body mass. And perhaps equally importantly, patients stated that they had an improvement in appetite. The conclusions of the data from these two Phase III studies was that anamorelin was well tolerated, and significantly improved lean body mass and appetite, and was associated with less fatigue than patients taking placebo.

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