AUA Annual Meeting Highlights (2019): Genitourinary Cancer
To better meet the educational needs of urologists and advanced practice providers (APPs), in 2017 the AUA gathered data from a variety of sources, including a comprehensive literature search, as well as membership surveys to determine where gaps exist in knowledge, proficiency, and practice in regards to genitourinary (GU) cancer. The needs assessment findings for urologists and APP’s with regard to managing bladder cancer patients center on immunotherapy and use of checkpoint inhibitor treatments, sequencing of agents/therapies, managing side effects of treatments/therapies and management of comorbid conditions. Additionally, urologists indicated an educational need in the areas of identifying potential interactions between immunosuppressive agents and other medications, appropriate use of biomarker testing to risk stratify patients and a thorough review course of the AUA Clinical Guidelines on Bladder Cancer. In November 2018, the AUA administered a survey to assess the educational needs of U.S. based urologists managing patients with renal cell carcinoma (RCC). Of 1,001 surveys were completed, 74% of respondents indicated they manage RCC patients. Based on the results of the needs assessment, the top three greatest educational needs of urologists in the areas of managing RCC patients include the sequencing of agents, use of emerging treatment options and management of immune-related adverse events.
Target Audience
- Urologists
- Urologists in training
- Non-physician providers involved in urology
Learning Objectives
Course 010IC: Renal Cell Carcinoma: Surgical & Medical Management of High-Risk Renal Cell Carcinoma: New Paradigms for Treatment
At the conclusion of this CME activity, participants should be able to:
• Manage complications of robotic partial nephrectomy to optimize outcomes through video tape analysis.
• Manage the advanced renal cell carcinoma patient with new FDA approved treatment options.
• Utilize transperitoneal and/or retroperitoneal robotic partial nephrectomy approaches to minimize ischemia time and optimize renal function.
Course 023IC - Chemotherapy and Immunotherapy Options for Genitourinary Malignancies: A Primer for Urologists and Advanced Practice Providers
At the conclusion of this CME activity, participants should be able to:
• Describe the standard of care chemotherapy regimens for genitourinary malignancies.
• Recall both historic and newer immunotherapy options in the treatment of genitourinary malignancies, including recently approved checkpoint inhibitors and antibody-drug conjugates.
• Outline the mechanism of action of common chemotherapy and immunotherapy regimens for genitourinary malignancies.
• Recognize and manage the adverse events related to these agents.
• Identify the survivorship issues surrounding patients on systemic treatments for genitourinary malignancies.
• List both completed and accruing clinical trials that are defining the paradigms of chemotherapy and immunotherapy use in genitourinary malignancies.
Course 038IC: Case-Based Discussion of AUA Non-muscle Invasive Bladder Cancer Guidelines
At the conclusion of this CME activity, participants should be able to:
• Analyze the latest evidence on the management of non-muscle invasive bladder cancer as outlined in the AUA guidelines.
• Apply the guidelines in urological practice to improve the therapeutic decision making processes.
• Summarize the process by which evidence is used to develop scientifically rigorous, yet actionable, guidelines.
Course 077IC: Integrating Care for Oncology Patients: Establishing a Multidisciplinary Oncology Clinic with Advanced Therapeutics
At the conclusion of this CME activity, participants should be able to:
• Describe the components of a multidisciplinary urologic cancer and identify the best structure for the practice.
• Utilize advanced therapeutics based on current and emerging best evidence including immunotherapy in urologic oncology patients.
• Identify opportunities for shared care and team-based approaches of patients with urologic cancers including advanced prostate, bladder, and kidney cancer.
• Explain advances in genomic testing and personalized medicine for urologic cancers.
• Differentiate between new therapeutics that expand the treatment options for patients with urologic cancers and alter the definitions of cancer treatment.
Course 010IC: Renal Cell Carcinoma: Surgical & Medical Management of High-Risk Renal Cell Carcinoma: New Paradigms for Treatment
Benjamin R. Lee, MD, Course Director
Professor and Chief of Urology
University of Arizona College of Medicine
Tucson, AZ
Disclosures: Journal of Endourology: Other
A. Oliver Sartor, MD
Medical Director of the Tulane Cancer Center
Laborde Professor for Cancer Research at Tulane Medical School
New Orleans, LA
Disclosures: Johnson & Johnson: Consultant or Advisor, Scientific Study or Trial; Oncogenex: Consultant or Advisor; Bellicum: Consultant or Advisor; Bayer: Consultant or Advisor, Scientific Study or Trial; Bristol-Myers Squibb: Investment Interest; Invitae: Scientific Study or Trial; Myovant: Scientific Study or Trial; Astellas: Consultant or Advisor; Progenics: Consultant or Advisor; NRG: Leadership Position; Pfizer: Consultant or Advisor; Constellation: Consultant or Advisor; Advancel Accelerator Applications (AAA): Consultant or Advisor; Bavarian-Nordic: Consultant or Advisor; Merck: Scientific Study or Trial; AstraZeneca: Consultant or Advisor; Celgene: Consultant or Advisor; Dendreon: Consultant or Advisor; EMD Serono: Consultant or Advisor; Endocyte: Consultant or Advisor, Scientific Study or Trial; Innocrin: Consultant or Advisor, Scientific Study or Trial
Chandru P. Sundaram, MD
Director of Minimally Invasive Surgery
Welch Professor of Urology
Indiana University School of Medicine
Indianapolis, IN
Disclosures: Journal of Endourology and Videourology: Leadership Position
Course 023IC - Chemotherapy and Immunotherapy Options for Genitourinary Malignancies: A Primer for Urologists and Advanced Practice Providers
Costas D. Lallas, MD, Course Director
Professor and Vice Chair of Urology
Sidney Kimmel Medical College of Thomas Jefferson University
Philadelphia, PA
Disclosures: Nothing to disclose.
Anne E. Calvaresi, DNP, CRNP
Urologic Nurse Practitioner
Thomas Jefferson University
Philadelphia, PA
Disclosures: Nothing to disclose.
Edouard J. Trabulsi, MD, FACS
Professor and Vice Chair of Urology
Sidney Kimmel Medical College of Thomas Jefferson University
Philadelphia, PA
Disclosures: Janssen: Consultant or Advisor, Meeting Participant or Lecturer; Pfizer: Consultant or Advisor, Meeting Participant or Lecturer; Astellas: Consultant or Advisor, Meeting Participant or Lecturer
Course 038IC: Case-Based Discussion of AUA Non-muscle Invasive Bladder Cancer Guidelines
Sam S. Chang, MD, Course Director
Patricia and Rodes Hart Endowed Professor of Urologic Surgery and Oncology
Oncology Fellowship Director
Vice-Chair of Urologic Surgery
Vanderbilt University Medical Center
Nashville, TN
Disclosures: astellas: Consultant or Advisor; NIH: Scientific Study or Trial; GLG: Consultant or Advisor; Janssen: Consultant or Advisor; Altor: Consultant or Advisor; BMS: Consultant or Advisor; Pfizer: Consultant or Advisor
James M. McKiernan, MD
John K. Lattimer Professor and Chairman of the Department of Urology
College of Physicians and Surgeons
Urologist-in-Chief
New York-Presbyterian/Columbia
New York, NY
Disclosures: Nothing to disclose.
Chad R. Ritch, MD
Assistant Professor of Urology
University of Miami Miller School of Medicine
Miami, FL
Disclosures: Nothing to disclose.
Course 077IC: Integrating Care for Oncology Patients: Establishing a Multidisciplinary Oncology Clinic with Advanced Therapeutics
Kelly L. Stratton, MD, Course Director
Assistant Professor of Urologic Oncology
Adjunct Assistant Professor of Medical Oncology
University of Oklahoma, Stephenson Cancer Center
Oklahoma City, OK
Disclosures: Ebix: Other; Bayer: Leadership Position, Consultant or Advisor; Oakstone: Other; Genentech: Scientific Study or Trial; Astellas Pharma: Scientific Study or Trial; Roche/Genentech: Scientific Study or Trial, Other; Myovant Sciences: Scientific Study or Trial
Brian M. Shuch, MD
Director of the Kidney Cancer Program
Alvin & Carrie Meinhardt Endowed Chair in Kidney Cancer Research
University of California, Los Angeles
Los Angeles, CA
Disclosures: Pfizer: Consultant or Advisor
Kelvin A. Moses, MD
Assistant Professor of Urology
Vanderbilt University Medical Center
Nashville, TN
Disclosures: Astellas: Meeting Participant or Lecturer; Dendreon: Meeting Participant or Lecturer; Pfizer: Meeting Participant or Lecturer
Alicia Morgans, MD, MPH
Associate Professor of Medicine, Division of Hematology/Oncology
Northwestern University Feinberg School of Medicine
Chicago, IL
Disclosures: Astra Zeneca: Consultant or Advisor; Sanofi: Consultant or Advisor; Genetech: Consultant or Advisor
Planners
Manoj Monga, MD, FACS
Director, Center for Endourology & Stone Disease
Cleveland Clinic
Cleveland, OH
Disclosures: Fortec: Other
Victor W. Nitti, MD
Professor of Urology and Obstetrics and Gynecology
Chair in Urology
Chief of Female Pelvic Medicine and Reconstructive Surgery (FPMRS)
David Geffen School of Medicine at UCLA
Los Angeles, CA
Disclosures: Serenity Pharmeuticals: Investment Interest
Michael Abern, MD
Assistant Professor, Urology
Director, Urologic Oncology
University of Illinois at Chicago
Chicago, IL
Disclosures: Department of Defense Prostate Cancer Research Program: Scientific Study or Trial; American Urological Association Office of Education: Leadership Position
Estimated time to complete this activity: 1.25 hours
Release Date: October 2019
Expiration Date: October 31, 2020
Accreditation Statement
The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit Designation
The American Urological Association designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Other Learners
The AUA is not accredited to offer credit to participants who are not MDs or DOs. However, the AUA will issue documentation of participation that states that the activity was certified for AMA PRA Category 1 Credit™.
Content
This enduring material credit is valid only for content reformatted from courses 013IC, 027IC, 037IC, 048IC and 065IC.
Statement of Need
To better understand urologists’ educational needs for treating CRPC, the AUA conducted an in-depth educational needs assessment of its domestic membership representing >90% of U.S. Board Certified urologists in 2013 (Phase I). The AUA reassessed its member’s educational needs after releasing the updated CRPC Guideline and targeted CRPC educational activities in 2015 (Phase II) and again in 2017 (Phase III). Areas identified as an educational need with regard to managing CRPC patients center on sequencing of agents, managing side effects of treatments, management of comorbid conditions and identifying potential interactions between immunosuppressive agents and other medications. Urologists continue to indicate a strong educational need for a thorough review of the AUA CRPC Guideline.
Acknowledgements
The AUA Office of Education would like to thank the companies who support continuing education of physicians. The AUA recognizes the following companies for providing educational grant support:
AstraZeneca
Bristol-Myers Squibb
Genentech
Merck
American Urological Association Education & Research, Inc. ensures that all educational activities are developed and implemented independent of the control and/or influence of any commercial interests (ACCME: SCS1).
AUA Disclosure Policy
All persons in a position to control the content of an educational activity (i.e., activity planners, presenters, authors) are required to disclose to the provider any relevant financial relationships with any commercial interest. The AUA must determine if the individual's relationships may influence the educational content and resolve any conflicts of interest prior to the commencement of the educational activity. The intent of this disclosure is not to prevent individuals with relevant financial relationships from participating, but rather to provide learners information with which they can make their own judgments.
Resolution of Identified Conflict of Interest
All disclosures will be reviewed by the program/course directors or editors for identification of conflicts of interest. Peer reviewers, working with the program directors and/or editors, will document the mechanism(s) for management and resolution of the conflict of interest and final approval of the activity will be documented prior to implementation. Any of the mechanisms below can/will be used to resolve conflict of interest:
- Peer review for valid, evidence-based content of all materials associated with an educational activity by the course/program director, editor, and/or Education Conflict of Interest Review Committee or its subgroup.
- Limit content to evidence with no recommendations
- Introduction of a debate format with an unbiased moderator (point-counterpoint)
- Inclusion of moderated panel discussion
- Publication of a parallel or rebuttal article for an article that is felt to be biased
- Limit equipment representatives to providing logistics and operation support only in procedural demonstrations
- Divestiture of the relationship by faculty
Evidence-Based Content
It is the policy of the AUA to ensure that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous and free of commercial bias.
Off-label or Unapproved Use of Drugs or Devices
The audience is advised that this continuing medical education activity may contain reference(s) to off-label or unapproved uses of drugs or devices. Please consult the prescribing information for full disclosure of approved uses.
Disclaimer
The opinions and recommendations expressed by faculty, authors and other experts whose input is included in this program are their own and do not necessarily represent the viewpoint of the AUA.
Reproduction Permission
Reproduction of written materials developed for this AUA course is prohibited without the written permission from individual authors and the American Urological Association.
Available Credit
- 1.25 AMA PRA Category 1 Credit™
- 1.25 Non-Physician Participation