Forgot Password?
Return to Course Listing

CME: Therapeutic options and present gaps in the management of refractory and metastatic differentiated thyroid cancer

Activity Description / Statement of Need:

In this online, self-learning activity:

The incidence of differentiated thyroid cancer (DTC) has risen over the last decade, and there are over 43,000 new cases and 2,200 deaths each year. DTC accounts for 95% of all thyroid cancers and can be categorized as papillary or follicular cancer. Thyroid cancer diagnosed and treated at an early stage has a favorable prognosis, with a 5-year survival rate of 99.9%. However, 5-year survival decreases to 53.3% for those patients with advanced or metastatic disease. Patients with disease that has progressed despite TSH-suppressive therapy or radioiodine may be considered for systemic therapy. Patients without a specific targetable marker may receive a multitargeted kinase inhibitor, while those with one may preferentially receive another agent such as a RET inhibitor, NTRK inhibitor, or BRAF inhibitor. DTC may present with actionable mutations, so patients with radioiodine-refractory (RAI-R) or metastatic disease should undergo genomic testing to assess mutation status, deficient mismatch repair (dMMR), microsatellite instability (MSI), and tumor mutational burden (TMB) to identify therapeutic targets.

Target Audience:

HCPs including: Medical oncologists and endocrinologists; physician assistants, nurse practitioners, nurses, and pharmacists who practice in oncology; and any other healthcare professionals with an interest in or who clinically encounter patients with RAI-R or metastatic DTC.


Commercial Support Disclosure: This program is supported by an educational grant from Exelixis.

This activity is free of charge.


Release Date: May 11, 2023 -- Expiration Date: May 11, 2024

Faculty: Gregory Daniels, MD, PhD

Agenda

Faculty introduction, disclosures

Introductory content: defining the context and challenge of RAI-R and metastatic DTC

  • Epidemiology
  • Disease and treatment course prior to consideration of systemic therapy
  • Genomic testing for mutation status, dMMR, MSI, TMB

Treatment of DTC 

  • Goals of therapy
  • Selecting candidates for systemic therapy: tumor size, presence of symptomology
  • Targetable biomarkers not present
    • Multitargeted kinase inhibitor
    • Cases with multitargeted kinase inhibitor contraindication
  • Approaches to targetable biomarkers, including the roles of: TRK inhibition, RET inhibition, BRAF inhibition, andPI3K inhibition
  • Challenges in RAI-R / metastatic DTC
    • Approaches to kinase intolerance
    • Monitoring for, preventing, and managing toxicities
  • Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Recall present and emerging treatment options for RAI-R or metastatic DTC and monitoring parameters for safety and efficacy of treatment.
  • Develop a safe and effective treatment plan for patients with RAI-R or metastatic DTC.
  • Discuss present challenges in the management of RAI-R or metastatic DTC.

Accreditation

ACCME Activity #202515817

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

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

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-23-018-H01-P. This is an Knowledge (K)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosure of Faculty: Gregory A. Daniels, MD, PhD, Professor of Medicine, University of California San Diego, has no relevant financial disclosures.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty WILL discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Exelixis.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


Additional Courses That Are Related To This Activity

Contemporary treatment approaches in the management of graft-versus-host disease (GVHD)

Myeloma bone disease: Monitoring and management

Preventing and mitigating skeletal-related events in breast cancer

Prediction and management of bone complications in prostate cancer