Sunday, December 3, 2023
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Associate Professor of Medicine
Lineberger Comprehensive Cancer Center
University of North Carolina at Chapel Hill
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
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:
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.
Associate Professor of Medicine
Lineberger Comprehensive Cancer Center
University of North Carolina at Chapel Hill
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
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AMA PRA Category 1 Credit(s)™
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CME / ABIM MOC / CE Released: 3/25/2019
Valid for credit through: 3/25/2020, 11:59 PM EST
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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.
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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).
