Chimeric Antigen Receptor Therapies (CAR-Ts) and their Potential Impact on Hematologic Cancer Care


Provided by the Johns Hopkins University School of Medicine and 
the Institute for Johns Hopkins Nursing.


Supported by an educational grant from Kite Pharma.

Overview

Chimeric antigen receptor T-cell (CAR-T) therapy has recently emerged as a new treatment strategy for patients with relapsed and refractory leukemia and lymphoma, a patient population that usually has few good treatment options and poor long-term survival. CAR-T therapy is a type of immunotherapy in which autologous T lymphocytes from a patient with cancer are genetically engineered to express a specific synthetic transmembrane protein, known as a chimeric antigen receptor (CAR), on the T-cell surface. This chimeric protein recognizes tumor-related antigens and also stimulates T-cell responses upon antigen recognition. These therapies redirect the patient’s own immune response to target cancer cells resulting in long-lasting antitumor responses. The US Food and Drug Administration recently approved 2 CAR-T therapies, axicabtagene ciloleucel and tisagenlecleucel, for the treatment of patients with B-cell acute lymphoblastic leukemia (B-ALL) and diffuse large B-cell lymphoma (DLBCL). In clinical trials of patients with multiple relapsed ALL and DLBCL, these agents have produced much higher response rates than historical treatments, with favorable safety and tolerability profiles. However, treatment resistance remains a significant problem, and a number of options are being examined in order to overcome resistance. The use of CAR-T therapies also requires a high degree of vigilance for common immune-mediated adverse events, such as cytokine release syndrome and neurological toxicities, as well as effective approaches to manage them when they occur. CAR-T therapy represents a significant new advance in the treatment of patients with hematologic malignancies.

Target Audience

This activity is intended for hematology/oncology physicians, nurse practitioners, physician assistants, transplant physicians, and nurses who treat patients with hematologic cancers. No prerequisites required.

Learning Objectives

After participating in this activity, the participant will demonstrate the ability to:

  • IDENTIFY the mechanism of action of CAR-Ts and their role in hematologic cancer treatment regimens.
  • REVIEW the CAR-Ts recently-approved and in-development for hematology/oncology care.
  • OUTLINE possible CAR-T-related AEs and their implications for hematology/oncology HCPs.
     

The Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing take responsibility for the content, quality, and scientific integrity of this CME/CNE activity.

Additional information
Goal: 

The goal of this activity is to increase the knowledge of oncologists and other members of the oncology treatment team about the emerging role of CAR-T inhibitors in patients with hematologic malignancies. Learners will gain a better understanding of the mechanism of action of CAR-T therapy, the manufacture and administration of CAR-T cells, indications for use of CAR-T in patients with leukemia and lymphoma, and recognition and management of patients experiencing immune-related adverse events.

Accreditation Statement: 

CE INFORMATION
Accreditation Statements — This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The Institute for Johns Hopkins Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Credit Designation Statement: 

The Johns Hopkins University School of Medicine designates this enduring material for a maximum of .5 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This .5 contact hours of educational activity is provided by the Institute for Johns Hopkins Nursing. Claim only those contact hours actually spent in the activity. Statements will be awarded for this educational activity until July 30, 2020.

The estimated time to complete this activity: 30 minutes.

THE INSTITUTE FOR JOHNS HOPKINS NURSING MISSION STATEMENT
The mission of the Institute for Johns Hopkins Nursing is to share the innovations of Johns Hopkins Nursing in practice, education, and research—locally, nationally, and globally. Our goal in continuing nursing education is to bring you activities that reflect the expertise and creativity of Johns Hopkins Nursing. Our service values are quality, integrity, flexibility, and personal attentiveness. We appreciate your thoughts and welcome your concerns—please feel free to e-mail us: IJHN@.jhmi.edu.

Confidentiality Disclaimer for CME Activity Participant: 

I certify that I am participating in this Johns Hopkins University School of Medicine activity for CME-accredited training and/or educational purposes.

I understand that while I am participating in this capacity, I may be exposed to "protected health information," as that term is defined and used in Hopkins policies and in the federal HIPAA privacy regulations (the “Privacy Regulations”). Protected health information is information about a person's health or treatment that identifies the person.

I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential. I agree not to post or discuss this protected health information, including pictures and/or videos, on any social media site (eg, Facebook, Twitter, etc.), in any electronic messaging program or through any portable electronic device.

I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality. The contact information is: Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.

“The Office of Continuing Medical Education at the Johns Hopkins University School of Medicine, as sponsor of this activity, has relayed information with the CME attendees/participants and certify that the visitor is here for training, education and/or observation purposes only.”

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Office of Continuing Medical Education
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Baltimore, Maryland 21205-2195
Reviewed & Approved by: General Counsel, Johns Hopkins Medicine (4/1/03)
(Updated 4/09 and 3/14)

Course summary
Available credit: 
  • 0.50 AMA PRA Category 1 Credit(s)™
  • 0.50 Nursing
Course opens: 
07/30/2018
Course expires: 
07/30/2020
Rating: 
0

Policy on Speaker and Provider Disclosure
It is the policy of the Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing that the speaker and provider globally disclose conflicts of interest. The Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made prior to presentation of the education.

Full Disclosure Policy Affecting CME Activities
As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) requires attested and signed global disclosure of the existence of all financial interests or relationships with commercial interest from any individual in a position to control the content of a CME activity sponsored by OCME. The following relationships have been reported for this activity:

Planner Disclosures
Dr. Ettinger reports serving as a principal investigator for Golden Biotechnology Corp and serving as a consultant for AbbVie Inc, BeyondSpring Pharmaceuticals, Inc, Boehringer Ingelheim Vetmedica, Inc, Bristol-Myers Squibb Company/Sanofi-Aventis US LLC, Eli Lilly and Company, Genentech In, and Guardant Health Inc. 

No other planners have indicated that they have any financial interests or relationships with a commercial entity.

Participating Faculty Disclosures
No faculty members have indicated that they have any financial interests or relationships with a commercial entity.

Note: Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution that receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

FACULTY
Johns Hopkins University School of Medicine Chair and Planner
David S. Ettinger, MD

Alex Grass Professor in Oncology
Sidney Kimmel Comprehensive Cancer
Baltimore, Maryland

Faculty Author
Patrick Brown, MD

Associate Professor of Oncology and Pediatrics
Director, Pediatric Leukemia Program
Sidney Kimmel Comprehensive Cancer Center
Johns Hopkins University School of Medicine
Baltimore, Maryland

Peer Reviewer
Bradley Reames, MD, MS

Oncology Fellowship
Department of Surgery
Johns Hopkins Hospital
Baltimore, Maryland

Nurse Planner
Rebecca Barshick, RN, MSN

Nurse Educator
The Institute for Johns Hopkins Nursing
Baltimore, Maryland

Nurse Reviewer
MiKaela Olsen, APRN-CNS, MS, AOCNS, FAAN

Oncology and Hematology Clinical Nurse Specialists
Ambulatory Oncology
Sidney Kimmel Comprehensive Cancer Center
Johns Hopkins University School of Medicine
Baltimore, Maryland

Off-Label Product Discussion
No faculty member has indicated that their presentation will include information on off-label products.

Non-Endorsement of Products
The Institute for Johns Hopkins Nursing and the American Nurses Credentialing Center do not endorse the use of any commercial products discussed or displayed in conjunction with this educational activity.

Available Credit

  • 0.50 AMA PRA Category 1 Credit(s)™
  • 0.50 Nursing

Accreditation Period

Course opens: 
07/30/2018
Course expires: 
07/30/2020
Please login or register to take this course.

Required Hardware/software

Pentium 800 processor or greater, Windows 98/NT/200/XP or Mac OS 9/X or later, Microsoft Internet Explorer, Safari, Firefox, Windows Media Player 9.0 or later Flash player, 128 MB of RAM Monitor settings: High color at 800 x 600 pixels, Sound card and speakers, Adobe Acrobat Reader.