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PARP Inhibitors and Their Emerging Role in Cancer Therapy: A Guide for the Oncology Pharmacist

Credits: 1.5 hours are available to earn until June 3, 2019

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Needs Statement

The DNA damage response (DDR) pathway is an essential mechanism used to maintain genomic integrity in all cells. Nearly all cancers have deficiencies in one or two DDR pathways, resulting in increased dependence on alternate, less accurate pathways.1,2 Poly ADP-ribose polymerase (PARP) inhibitors are oral agents developed to inhibit these compensatory pathways, resulting in “synthetic lethality,” or the death of the DDR defective cell. PARP inhibitors have thus far been shown to be effective in BRCA mutation-positive tumors, including ovarian, breast, and other cancers.3 While these oral agents offer patients increased flexibility, there also is the potential for incorrect administration, increased drug interactions, and decreased adherence.4 Oncology pharmacists have extensive knowledge regarding pharmacokinetic, pharmacodynamic, efficacy, and financial aspects of oral chemotherapy and are optimally positioned to play a vital role in the oral cancer therapy management of PARP inhibitors. Thus, it is vital that oncology pharmacists be up-to-date on the latest advances in PARP inhibition, including emerging indications and drug formulations, recognition and management of adverse events, appropriate therapy selection based on genetic testing results, and patient adherence strategies.

The objective of this educational activity is for participants to gain an appreciation of the latest clinical and scientific advances in targeting DDR, including updates on the current and emerging prospects of PARP inhibitors for ovarian, breast, and other cancers. Using a case-based approach, faculty will discuss therapeutic selection, genetic testing and counseling, patient adherence strategies, and the recognition and management of adverse events for patients receiving PARP inhibitors.

1van Gent DC, et al. Mol Biol Cell. 2016. 2O’Connor MJ, et al. Mol Cell. 2015. 3Cerrato A, et al. J Exp Clin Canc Res. 2016. 4Felton MA, et al. J Oncol Pharm Pract. 2016.

Learning Objective

At the conclusion of this application-based activity, participants will be able to:

  • Analyze the main signaling pathways and key mechanisms in DNA damage repair and how deficiencies in these pathways can lead to tumor proliferation and growth.
  • Examine the pharmacology of PARP inhibitors and how these agents induce tumor cell death by exploiting the concept of “synthetic lethality” in cells with BRCA mutations.
  • Explore evolving data regarding the efficacy and adverse event profiles of PARP inhibitors currently approved and in clinical development for patients with ovarian, breast, prostate, and pancreatic cancers.
  • Using a case-based approach, assess challenging questions regarding PARP inhibitors and discuss the ways that the oncology pharmacist can optimize therapy, anticipate adverse effects, and improve adherence.

Faculty

Jason Bergsbaken, PharmD BCOP
Pharmacy Coordinator, Regional Oncology Services
University of Wisconsin Hospital and Clinics
Madison, Wisconsin

Dr. Bergsbaken currently serves as Pharmacy Coordinator, Regional Oncology Services for UW Health in Madison, WI. His responsibilities include the coordination and standardization of pharmaceutical care among UW Carbone Cancer Center partners. Dr. Bergsbaken received his Doctor of Pharmacy degree from the University of Wisconsin-Madison. Following graduation, he completed a PGY1 Pharmacy Practice Residency and PGY2 Oncology Pharmacy Residency at UW Health. In addition to his coordinator responsibilities, Dr. Bergsbaken practices as an Oncology Clinical Pharmacist across UW Health adult care settings, including University Hospital (inpatient hematology/oncology/BMT), UW Carbone Cancer Center (ambulatory/clinic), and UW Oncology Pharmacy (community). Additionally, he has been intimately involved with the implementation of multiple practice advancement initiatives, including pharmacist-led oral chemotherapy management. Current professional affiliations include American Society of Health-System Pharmacists (ASHP), Hematology/Oncology Pharmacy Association (HOPA), and Pharmacy Society of Wisconsin (PSW).

James M. Ford, MD
Professor of Medicine and Genetics
Director, Stanford Program for Clinical Cancer Genomics
Division of Oncology
Stanford University School of Medicine
Stanford, California

Dr. Ford is a Medical Oncologist and Geneticist at Stanford, devoted to studying the genetic basis of breast and GI cancer development, treatment and prevention in families and populations. He graduated in 1984 from Yale University where he later received his MD from the School of Medicine in 1989. He was an Internal Medicine resident and Oncology fellow at Stanford, and joined the faculty in 1998. He is currently Professor of Medicine (Oncology) and Genetics, and Director of the Stanford Cancer Genetics Clinic and the Cancer Genomics Program at the Stanford University Medical Center in Stanford, CA.

Dr. Ford’s clinical interests include the diagnosis and treatment of patients with a hereditary pre-disposition to cancer. He runs the Stanford Cancer Genetics Clinic, that sees patients for genetic counseling and testing of hereditary cancer syndromes for prevention and early diagnosis of cancer in high-risk individuals and populations. He has recently been named the Director of Stanford’s new Cancer Genomics Program, performing next-generation tumor profiling to identify novel genetic targets for personalized targeted therapies, and directs the Molecular Tumor Board.

Dr. Ford is an editor of numerous scientific journals, including Cancer Research, DNA Repair, and PLoS Genetics. He has recently been named the founding Editor-in-Chief of JCO Precision Oncology.

Accreditation Statement

logo ipeIn support of improving patient care, Creative Educational Concepts is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Pharmacy (ACPE)

logo acpeThis application-based activity is approved for 1.50 contact hours (0.150 CEUs) of continuing pharmacy education credit (UAN JA0007101-0000-18-006-H01-P).

Expiration Date

June 3, 2019

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