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Minimizing the Impact of imAEs and Maximizing Efficacy: Pulmonary Toxicity

  • Authors: Jared Weiss, MD
  • CME / ABIM MOC / CE Released: 3/25/2019
  • Valid for credit through: 3/25/2020, 11:59 PM EST
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Target Audience and Goal Statement

This activity is intended for pulmonologists, hematology/oncology specialists, emergency medicine physicians and nurses.

The goal of this activity is to educate members of the multidisciplinary and interprofessional cancer care team on recognizing and understanding how to manage immune-mediated adverse events (imAEs) related to the use of immune checkpoint inhibitors in the management of multiple cancers.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Clinical trial data on imAEs due to treatment with immune checkpoint inhibitors
    • Real-world evidence on the impact of steroids on the efficacy of immune checkpoint inhibitors in patients with cancer
  • Have greater competence related to
    • Identifying strategies to maximize clinical outcomes in patients receiving immune checkpoint inhibitors
    • Managing across the spectrum of severity of imAEs associated with immune checkpoint inhibitors
    • Counseling patients on how to communicate with clinicians if they suspect an imAE


As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


  • Jared Weiss, MD

    Associate Professor of Medicine
    Lineberger Comprehensive Cancer Center
    University of North Carolina at Chapel Hill


    Disclosure: Jared Weiss, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: AstraZeneca Pharmaceuticals LP; Celgene Corporation; EMD Serono, Inc.; G1 Therapeutics; Immunicum; Nanobiotix; Pfizer Inc.
    Received grants for clinical research from: Celgene Corporation; Merck & Co., Inc.; Pfizer Inc.


  • Davecia R. Cameron, MS

    Medical Education Director, Medscape, LLC


    Disclosure: Davecia R. Cameron, MS, has disclosed no relevant financial relationships.

  • Christin Melton

    Medical Writer


    Disclosure: Christin Melton, has disclosed no relevant financial relationships.

CME Reviewer/Nurse Planner

  • Amy Bernard, MS, BSN, RN-BC, CHCP

    Lead Nurse Planner, Medscape, LLC


    Disclosure: Amy Bernard, MS, BSN, RN-BC, CHCP, has disclosed no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.

Accreditation Statements


Interprofessional Continuing Education

In support of improving patient care, Medscape, LLC 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.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Medscape, LLC staff have disclosed that they have no relevant financial relationships.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.25 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

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    For Nurses

  • Awarded 1.25 contact hour(s) of continuing nursing education for RNs and APNs; 1.25 contact hours are in the area of pharmacology.

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This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 75% on the post-test.

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  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

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Minimizing the Impact of imAEs and Maximizing Efficacy: Pulmonary Toxicity

Authors: Jared Weiss, MDFaculty and Disclosures

CME / ABIM MOC / CE Released: 3/25/2019

Valid for credit through: 3/25/2020, 11:59 PM EST


The following cases are modeled on the interactive grand rounds approach. The questions within the activity are designed to test your current knowledge. After each question, you will be able to see whether you answered correctly and read evidence-based information that supports the most appropriate answer choice. The questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the activity, there will be a short post-test assessment based on the material presented.

Case 1: Patient History

Patient Image

Ken is a 55-year-old man who presents to the emergency department (ED) one Sunday with a new nonproductive cough, dyspnea, and shortness of breath. He says he is having difficulty with his daily activities. Ken has a history of hypertension and type 2 diabetes mellitus, for which he is taking metformin and lisinopril. He is a former smoker with a 30-pack year history. Seven months earlier, he received a diagnosis of unresectable stage III squamous cell carcinoma (SCC) of the lung, which had mediastinal node involvement but no distant metastases. His programmed death-ligand 1 (PD-L1) tumor proportion score (TPS) was 2%. He was treated with concurrent platinum-based chemotherapy and radiotherapy. Computed tomography (CT) imaging 2 weeks after completing therapy was without evidence for progression. Ken then received consolidation therapy with durvalumab, a PD-L1 antibody. He has received 9 14-day cycles of intravenous (IV) durvalumab 10 mg/kg, during which he had no progression. A physical examination shows oxygen saturation of 98% on room air, blood pressure of 120/70 mm Hg, a respiratory rate of 24 bpm, and a temperature of 99.9°F. Nothing specific is heard during lung auscultation. Results of a complete blood count (CBC) and other laboratory tests are unremarkable. The ED physician suspects Ken may have checkpoint inhibitor–related pneumonitis (CIP).

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