American Cancer Society. Triple-negative breast cancer. Revised September 20, 2019. Accessed November 16, 2020. https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/types-of-breast-cancer/triple-negative.html
Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2018;36:1714-1768.
BreastCancer.org. Triple negative breast cancer. Accessed November 16, 2020. https://www.breastcancer.org/symptoms/diagnosis/trip_neg
ClinicalTrials.gov. Testing MK-3475 (pembrolizumab) as adjuvant therapy for triple receptor-negative breast cancer. Updated November 16, 2020. Accessed November 16, 2020. https://www.clinicaltrials.gov/ct2/show/NCT02954874?term=SWOG+s1418&draw=2&rank=1
ClinicalTrials.gov. Study of Pembrolizumab (MK-3475) Plus Chemotherapy vs. Placebo Plus Chemotherapy for Previously Untreated Locally Recurrent Inoperable or Metastatic Triple Negative Breast Cancer (MK-3475-355/KEYNOTE-355). Updated October 28, 2019. Accessed November 19, 2020. https://clinicaltrials.gov/ct2/show/NCT02819518
Cortés J, André F, Gonçalves A, et al. IMpassion132 Phase III trial: atezolizumab and chemotherapy in early relapsing metastatic triple-negative breast cancer. Future Oncol. 2019;15:1951-1961.
Cortes J, Cescon DW, Rugo HS, et al. KEYNOTE-355: Randomized, double-blind, phase III study of pembrolizumab + chemotherapy versus placebo + chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer. J Clin Oncol. 2020;38(15 suppl): Abstract 1000.
Cottrell TR, Taube JM. PD-L1 and Emerging biomarkers in immune checkpoint blockade therapy. Cancer J. 2018;24:41-46.
Diéras V, Han HS, Kaufman B, et al. Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2020;21:1269-1282.
FDA. List of cleared or approved companion diagnostic devices (in vitro and imaging tools). Updated October 29, 2020. Accessed November 16, 2020. https://www.fda.gov/medical-devices/vitro-diagnostics/list-cleared-or-approved-companion-diagnostic-devices-vitro-and-imaging-tools
FDA. FDA grants accelerated approval to pembrolizumab for locally recurrent unresectable or metastatic triple negative breast cancer. Published November 13, 2020. Accessed November 20, 2020. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-grants-accelerated-approval-pembrolizumab-locally-recurrent-unresectable-or-metastatic-triple#:~:text=On%20November%2013%2C%202020%2C%20the,L1%20(CPS%20%E2%89%A510)%20as
Garrido-Castro AC, Lin NU, Polyak K. Insights into molecular classifications of triple-negative breast cancer: improving patient selection for treatment. Cancer Discov. 2019;9:176-198.
Gupta GK, Collier AL, Lee D, et al. Perspectives on triple-negative breast cancer: current treatment strategies, unmet needs, and potential targets for future therapies. Cancers (Basel). 2020;12:E2392.
Keung MYT, Wu Y, Vadgama JV. PARP inhibitors as a therapeutic agent for homologous recombination deficiency in breast cancers. J Clin Med. 2019;8:435.
KEYTRUDA® (pembrolizumab) [prescribing information]. Whitehouse Station, NJ: Merck & Co., Inc. Approved 2014. Revised October 2020.
Litton JK, Rugo HS, Ettl J, et al. Talazoparib in patients with advanced breast cancer and a germline BRCA mutation. N Engl J Med. 2018;379:753-763.
LYNPARZA^â (olaparib) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP. Approved 2014. Revised November 2020.
McArthur HL, Ignatiadis M, Guillaume S, et al. ALEXANDRA/IMpassion030: A phase III study of standard adjuvant chemotherapy with or without atezolizumab in early stage triple-negative breast cancer. J Clin Oncol. 2019;37(15 suppl): Abstract TPS598.
Miles DW, Gligorov J, André F, et al. LBA15: Primary results from IMpassion131, a double-blind placebo controlled randomised phase III trial of first-line paclitaxel (PAC) ± atezolizumab (atezo) for unresectable locally advanced/metastatic triple-negative breast cancer (mTNBC). Ann Oncol. 2020;31 (suppl 4): Abstract LBA15.
Mittendorf EA, Zhang H, Barrios CH, et al. Neoadjuvant atezolizumab in combination with sequential nab-paclitaxel and anthracycline-based chemotherapy versus placebo and chemotherapy in patients with early-stage triple-negative breast cancer (IMpassion031): a randomised, double-blind, phase 3 trial. Lancet. 2020;396:1090-1100.
National Cancer Institute. Immune checkpoint inhibitor. Accessed November 16, 2020. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immune-checkpoint-inhibitor
National Comprehensive Cancer Network clinical practice guidelines in oncology (NCCN Guidelines®). Management of immunotherapy-related toxicities. Version 1.2020.
Robson M, Im SA, Senkus E, et al. Olaparib for metastatic breast cancer in patients with a germline BRCA mutation. N Engl J Med. 2017;377:523-533.
Rugo HS, Loi S, Adams S, et al. Performance of PD-L1 immunohistochemistry assays in unresectable locally advanced or metastatic triple negative breast cancer: Post hoc analysis of IMpassion130. Presented at: European Society for Medical Oncology (ESMO) 2019 Annual Meeting; September 27-October 1, 2019; Barcelona, Spain. Abstract LBA20.
Schmid P, Adams S, Rugo HS, et al. Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer. N Engl J Med. 2018;379:2108-2121.
Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for early triple-negative breast cancer. N Engl J Med. 2020;382:810-821.
Schmid P, Rugo HS, Adams S, et al. Atezolizumab plus nab-paclitaxel as first-line treatment for unresectable, locally advanced or metastatic triple-negative breast cancer (IMpassion130): updated efficacy results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2020;21:44-59.
TALZENNA® (talazoparib) [prescribing information]. New York, NY: Pfizer Inc. Approved 2018. Revised October 2020.
TECENTRIQ® (atezolizumab) [prescribing information]. South San Francisco, CA: Genentech, Inc.; Approved 2016. Revised July 2020.

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.

Faculty

Janice Tran, PhD, NP-C, AOCNP, CBCN

Texas Oncology
Houston, Texas

Disclosures

Disclosure: Janice Tran, PhD, NP-C, AOCNP, CBCN, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Biotheranostics; Eisai Pharmaceuticals; GlaxoSmithKline; Novartis; Seattle Genetics
Served as a speaker or a member of a speakers bureau for: Novartis

Sarah Donahue, MPH, NP, AOCNP

UCSF Medical Center
San Francisco, California

Disclosures

Disclosure: Sarah Donahue, MPH, NP, AOCNP, has disclosed the following relevant financial relationships:
Served as a speaker or a member of a speakers bureau for: AstraZeneca; Novartis

Editors

Victoria Phoenix, BS

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Victoria Phoenix has disclosed no relevant financial relationships.

Yoji Yamaguchi, MA

Associate Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Yoji Yamaguchi has disclosed no relevant financial relationships.

CE Reviewer/Nurse Planner

Stephanie Corder, ND, RN, CHCP

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Stephanie Corder, ND, RN, CHCP, has disclosed no relevant financial relationships.

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

CE

Nurse View: Tailoring Treatments in Triple Negative Breast Cancer

Authors: Janice Tran, PhD, NP-C, AOCNP, CBCN; Sarah Donahue, MPH, NP, AOCNP
CE Released: 11/23/2020
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 11/23/2021

Start Activity

Target Audience and Goal Statement

This activity is intended for nurses and nurse practitioners

The goal of this activity is to improve the knowledge and competence of nurses surrounding the use of immunotherapy-based treatments and poly (ADP-ribose) polymerase (PARP) inhibitors in the management of patients with triple-negative breast cancer (TNBC).

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Role of biomarkers in identifying patients with TNBC eligible to receive PARP inhibitors or immune checkpoint inhibitor-based therapy
- Optimal therapy for patients with TNBC based on stage, molecular testing, and comorbidities
Have greater competence related to
- Managing treatment-related adverse events (TRAEs) associated with treatments used in TNBC

Disclosures

Faculty

Janice Tran, PhD, NP-C, AOCNP, CBCN

Texas Oncology
Houston, Texas

Disclosures

Disclosure: Janice Tran, PhD, NP-C, AOCNP, CBCN, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Biotheranostics; Eisai Pharmaceuticals; GlaxoSmithKline; Novartis; Seattle Genetics
Served as a speaker or a member of a speakers bureau for: Novartis

Sarah Donahue, MPH, NP, AOCNP

UCSF Medical Center
San Francisco, California

Disclosures

Disclosure: Sarah Donahue, MPH, NP, AOCNP, has disclosed the following relevant financial relationships:
Served as a speaker or a member of a speakers bureau for: AstraZeneca; Novartis

Editors

Victoria Phoenix, BS

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Victoria Phoenix has disclosed no relevant financial relationships.

Yoji Yamaguchi, MA

Associate Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Yoji Yamaguchi has disclosed no relevant financial relationships.

CE Reviewer/Nurse Planner

Stephanie Corder, ND, RN, CHCP

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Stephanie Corder, ND, RN, CHCP, has disclosed no relevant financial relationships.

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

Accreditation Statements

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 Nurses

Awarded 0.50 contact hour(s) of continuing nursing education for RNs and APNs; 0.50 contact hours are in the area of pharmacology.

Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

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 70% on the post-test.

Follow these steps to earn CME/CE credit*:

Read the target audience, learning objectives, and author disclosures.
Study the educational content online or printed out.
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.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

The Nurse View: A Clinical Resource for Oncology Nurses

From Medscape Education Oncology

Nurse View: Tailoring Treatments in Triple Negative Breast Cancer

Authors: Janice Tran, PhD, NP-C, AOCNP, CBCN; Sarah Donahue, MPH, NP, AOCNPFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CE Released: 11/23/2020

Valid for credit through: 11/23/2021

processing....

Pre-Assessment Questions

Page 1 of 4

CE Information Download Slides

Print
Like Tweet

Disclaimer

The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been approved by the US Food and Drug Administration, off-label uses of approved products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

References

Faculty and Disclosures

Faculty

Janice Tran, PhD, NP-C, AOCNP, CBCN

Sarah Donahue, MPH, NP, AOCNP

Editors

Victoria Phoenix, BS

Yoji Yamaguchi, MA

CE Reviewer/Nurse Planner

Stephanie Corder, ND, RN, CHCP

CE

Nurse View: Tailoring Treatments in Triple Negative Breast Cancer

Target Audience and Goal Statement

Disclosures

Faculty

Janice Tran, PhD, NP-C, AOCNP, CBCN

Sarah Donahue, MPH, NP, AOCNP

Editors

Victoria Phoenix, BS

Yoji Yamaguchi, MA

CE Reviewer/Nurse Planner

Stephanie Corder, ND, RN, CHCP

Accreditation Statements

For Nurses

Instructions for Participation and Credit

Nurse View: Tailoring Treatments in Triple Negative Breast Cancer

Pre-Assessment Questions