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Immune Checkpoint Inhibitor Cardiotoxicity: Contributing Factors, Appropriate Treatments, and Retreatment Options

Premiere Date: Wednesday, December 28, 2022

This activity offers CE credit for:

1. ABIM (MOC)
2. Medicine (accme)
3. Nursing (ANCC)
4. Pharmacy (acpe)
5. PA (aapa)
6. Other

All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Credit™

Credit Expiration Date:
Thursday, December 28, 2023
Note: Credit Is No Longer Available

Faculty

Kerry L. Reynolds, MD (Moderator) Assistant Professor of Medicine Harvard Medical School Director, Severe Immunotherapy Complications (SIC) Service Clinical Director, Inpatient Cancer Services Massachusetts General Hospital Cancer Center Boston, MA

Tomas G. Neilan, MD, MPH  Associate Professor of Medicine Harvard Medical School Director, Cardio-Oncology Program Co-Director, Cardiovascular Imaging Research Program Massachusetts General Hospital Boston, MA

Statement of Need

Immune checkpoint inhibitors (ICIs) have permanently changed the landscape of cancer therapy. However, up to half of patients who receive ICIs experience immune-related adverse events (irAEs), and some portion (1-2%, perhaps more) experience cardiotoxicity, such as myocarditis or other cardiovascular events. Recognizing ICI-related cardiotoxicity and initiating prompt treatment is critical. Whether to restart these patients on ICIs is controversial. ICI-related cardiotoxicity is rare, but clear guidelines to screen and treat CV toxicity are lacking, and clinicians need education on cardiotoxic effects of ICI therapy and guidance on rechallenging with ICI therapy.

This initiative seeks to fill those knowledge gaps among cardiologists and clinicians caring for patients with cancer who receive ICI therapy. Clinicians will receive education on the available clinical evidence to make informed decisions regarding resumption of therapy.

Learning Objectives

At the end of this CE activity, participants should be able to:

• Summarize factors contributing to cardiotoxicity associated with ICI use.
• Differentiate risk of outcome severity in patients after experiencing ICI-related cardiotoxicity.
• Select appropriate treatment approaches for ICI-related cardiotoxicity.
• Appraise current clinical evidence for and against ICI rechallenge in patients experiencing CV AEs after ICI therapy.

Financial Support

Supported by educational grant from Bristol Myers Squibb.

Target Audience

Cardiologists, oncologists, PCPs, PAs, NPs, nurses, and pharmacists.

Credit Information

ABIM MOC Credit:
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 medical knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Learning Formats
Enduring material

Royal College MOC:
Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

MIPS Improvement Activity:
This activity counts towards MIPS Improvement Activity requirements under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and mitigated any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Reynolds reports the following financial relationships:

Research Support: Project Data Sphere (a non-profit company)

Stock Shareholder (ownership interest): Biogen

Other Financial or Material Support: (ownership interest): Teledoc Health, Inc.

Dr. Neilan reports the following financial relationships:

Consultant: AbbVie Inc.; Bristol Myers Squibb; CRO Oncology; C4-Therapeutics, Inc.; Genentech, Inc.; Roche; and Sanofi

Grants: AstraZeneca and Bristol Myers Squibb

The following peer reviewer and CME Outfitters staff have no financial relationships:

Michael Franks, APRN, AGACNP-BC, FNP-BC (peer reviewer)

Thomas Mitchell (planning committee)

David Modrak, PhD (planning committee)

Susan H. Yarbrough, CHCP (planning committee)

Sandra Caballero, PharmD (planning committee)

Sharon Tordoff (planning committee)

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).