Practical Issues for Clinicians - Session I

Originally presented at HOPA's 13th Annual Conference, March 2017.

Matters Close to the Heart: Cardio-Oncology in Breast Cancer

Therapeutic advancements over recent decades have led to a growing number of breast cancer survivors. However, these successes have been overshadowed by the unintended, and often devastating, cardiac outcomes affecting survivors of breast cancer. Anthracyclines and trastuzumab represent the agents responsible for left ventricular dysfunction and heart failure. In general, healthcare providers are operating in a reactive rather than a proactive manner when monitoring for cardiotoxicity. Ideally, detecting cardiac damage before it results in decline in ejection fraction may lead to better cardiac outcomes. Emerging strategies in prevention and monitoring will be highlighted.

Learning Objectives

  • Review the epidemiology of cardiotoxicity in breast cancer patients.
  • Discuss emerging prevention and monitoring strategies for breast cancer patients receiving cardiotoxic agents.


Sandra Cuellar, PharmD BCOP

Sandra Cuellar is a clinical assistant professor in the Department of Pharmacy Practice at the University of Illinois at Chicago (UIC) College of Pharmacy. She is the clinical pharmacist in the cancer center and director of the oncology specialty residency program. She is also an editor at large for Journal of Hematology Oncology Pharmacy and is involved in research, consulting, and publications in the field of hematology/oncology. She is a member of the American Society of Health-System Pharmacists educational steering committee and chair of the 2016–2017 HOPA BCOP Recertification Committee.

Activity type

Patient Management & Therapeutics

Secondary Acute Myeloid Leukemia Following Myelodysplastic Syndrome: Induction Strategies Beyond 7+3

AML arising from prior myelodysplastic syndrome (MDS) carries a poor prognosis and is less responsive to conventional anthracycline/cytarabine induction regimens. Treatment-naive patients may be candidates for hypomethylators (HMAs); however, no standard of care exists for patients previously treated with HMAs or those with progressive leukocytosis where initial therapy with HMAs may be inadequate. This presentation will discuss alternative induction strategies for MDS to AML transformation and draw comparisons to 7+3-like inductions when applicable. Treatment options to be discussed include liposomal cytarabine/daunorubicin (CPX-351), high-dose cytarabine/anthracycline combinations, and purine antagonist/high-dose cytarabine combinations.

Learning Objectives

  • Recognize differences in response to conventional cytarabine and anthracycline induction regimens for patients with secondary versus de novo acute myeloid leukemia(AML).
  • Analyze induction outcomes for high-risk secondary AML patients receiving CPX-351 versus 7+3.
  • Appraise data supporting the use of high-dose cytarabine-based induction regimens with or without purine antagonists for patients with secondary AML.


Craig Freyer, PharmD BCOP

Craig Freyer is an inpatient clinical pharmacy specialist in hematology/oncology at the Hospital of the University of Pennsylvania in Philadelphia, PA. His focus is the management of hematologic malignancies and allogeneic stem cell transplant, with a specific interest in the management of acute leukemias. From 2012 to 2015 he was clinical pharmacy specialist in the leukemia section of the Roswell Park Cancer Institute in Buffalo, NY. He completed his PGY-2 hematology/oncology specialty residency at the H. Lee Moffitt Cancer Center in Tampa, FL.

Activity type

Patient Management & Therapeutics

Accreditation Statement

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The Hematology/Oncology Pharmacy Association (HOPA) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. An ACPE statement of credit will be issued only upon completion of the pre/post- assessment and a post-activity evaluation form. ACPE credit must be claimed by March 29, 2020.

This activity has been approved for .1 CEU

This course is also included as part of the Best of AC2017 Bundle product.

Release Date: August 31, 2017

Expiration Date: March 29, 2020

Member: $25

Non-Member: $35

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