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Minimizing the Impact of imAEs and Maximizing Efficacy of ICIs: AEs Affecting the Skin

  • Authors: Joshua Bauml, MD
  • CME / ABIM MOC / CE Released: 6/21/2019
  • Valid for credit through: 6/21/2020, 11:59 PM EST
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Target Audience and Goal Statement

This activity is intended for dermatologists, hematologists/oncologists, nurses, and emergency medicine physicians.

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 affecting the skin due to treatment with immune checkpoint inhibitors
    • Real-world evidence on the impact of antibiotics and 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 affecting the skin in patients receiving immune checkpoint inhibitors
    • Counseling patients on how to communicate with clinicians if they suspect dermatologic imAEs


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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.


  • Joshua M. Bauml, MD

    Assistant Professor
    Perelman School of Medicine
    University of Pennsylvania
    Philadelphia, Pennsylvania


    Disclosure: Joshua Bauml, MD, has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: AstraZeneca Pharmaceuticals LP; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Celgene Corporation; Clovis Oncology; Genentech, Inc.; Guardant Health; Janssen Pharmaceuticals; Merck & Co., Inc.; Takeda Pharmaceuticals North America, Inc.
    Received grants for clinical research from: AstraZeneca Pharmaceuticals LP; Bayer HealthCare; Carevive Systems; Clovis Oncology; Merck & Co., Inc.; Novartis Pharmaceuticals Corporation; Takeda Pharmaceuticals North America, Inc.


  • Davecia R. Cameron, MS

    Medical Education Director, Medscape, LLC


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

  • Christina Loguidice

    Medical Writer, Crispen Communications


    Disclosure: Christina Loguidice, 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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There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

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.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  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 of ICIs: AEs Affecting the Skin

Authors: Joshua Bauml, MDFaculty and Disclosures

CME / ABIM MOC / CE Released: 6/21/2019

Valid for credit through: 6/21/2020, 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 Study 1: Patient History

Mary is a 56-year-old woman who is being treated with pembrolizumab as a first-line therapy for non-small–cell lung cancer (NSCLC) that has metastasized to her liver. At the appointment for her fourth treatment, she mentions a rash on her arms. Several flat reddish pink patches of skin covered with small confluent bumps are observed on her forearms, with no involvement of her upper arms (Figure 1). She says the rash manifested several days earlier and indicates there was no associated burning, blistering or pain but that she had some mild itching earlier that morning, which subsided after she showered and applied her usual moisturizing lotion. A review of her medical history reveals no autoimmune diseases such as lupus nor immune-related skin condition such as psoriasis or lichen planus. Her only other medication is pravastatin for hyperlipidemia, which she has been taking for the past 4 years with no recent dosing modifications. No other parts of her body are affected and she reports no other symptoms.

Figure 1. Maculopapular Rash
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