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CPD

Best Practice Treatment of Advanced/Metastatic Cholangiocarcinoma: Case Studies and Expert Perspectives

  • Authors: Angela Lamarca, MD, PhD, MSc
  • CPD Released: 11/1/2021
  • THIS ACTIVITY HAS EXPIRED
  • Valid for credit through: 11/1/2022
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Target Audience and Goal Statement

This educational activity is intended for an international audience of non-US gastroenterologists, hematology/oncology specialists, and pathologists.

The goal of this activity is to increase clinicians’ knowledge and competence regarding the diagnosis and treatment of advanced cholangiocarcinoma.

Upon completion of this activity, participants will:

  • Have greater competence related to
    • Identification of patients eligible for molecularly targeted therapies
    • Application of molecularly guided therapies in routine practice
  • Demonstrate greater confidence in their ability to
    • Diagnose and manage cholangiocarcinoma


Disclosures

WebMD Global requires each individual who is in a position to control the content of one of its educational activities to disclose any relevant financial relationships occurring within the past 12 months that could create a conflict of interest.


Faculty

  • Angela Lamarca, MD, PhD, MSc

    Consultant, Medical Oncology
    Department of Medical Oncology
    The Christie NHS Foundation Trust
    Manchester, United Kingdom

    Disclosures

    Disclosure: Angela Lamarca, MD, PhD, MSc, has the following relevant financial relationships:
    Advisor or consultant for: Eisai; Nutricia Ipsen; QED; Roche
    Speaker or a member of a speakers bureau for: Incyte; Ipsen; Merck; Pfizer; QED
    Grants for clinical research from: Ipsen; Roche
    Other: Travel and educational support from: Bayer; Delcath; Ipsen; Mylan; Novartis; Pfizer; SirtEx

Editors

  • Keisha Peters, MSc

    Medical Education Director, WebMD Global, LLC

    Disclosures

    Disclosure: Keisha Peters, MSc, has disclosed no relevant financial relationships.

  • Tristin Abair, PhD

    Senior Medical Writer, WebMD Global, LLC

    Disclosures

    Disclosure: Tristin Abair, PhD, has disclosed no relevant financial relationships.

Content Reviewer

  • Esther Nyarko, PharmD

    Associate Director, Accreditation and Compliance

    Disclosures

    Disclosure: Esther Nyarko, PharmD, 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

    For Physicians

  • The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 1.0 continuing professional development credits (CPD).

    Contact WebMD Global

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 about your eligibility to claim credit, 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 participating in the activity. To successfully earn credit, participants must complete the activity online during the credit eligibility period that is noted on the title page.

Follow these steps to claim a credit certificate for completing this activity:

  1. Read the information provided on the title page regarding the target audience, learning objectives, and author disclosures, read and study the activity content and then complete the post-test questions. If you earn a passing score on the post-test and we have determined based on your registration profile that you may be eligible to claim CPD credit for completing this activity, we will issue you a CPD credit certificate.
  2. Once your CPD credit certificate has been issued, you may view and print the certificate from your CME/CE Tracker. CPD 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 by accessing "Edit Your Profile" at the top of the Medscape Education homepage.

We encourage you to complete an 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 by accessing "Edit Your Profile" at the top of your Medscape homepage.

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

CPD

Best Practice Treatment of Advanced/Metastatic Cholangiocarcinoma: Case Studies and Expert Perspectives

Authors: Angela Lamarca, MD, PhD, MScFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED

CPD Released: 11/1/2021

Valid for credit through: 11/1/2022

processing....

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 AND PRESENTATION

Arthur is 71 years old and runs a farm with his 2 sons. He fell while working and presented to his primary care provider 2 days later with mild discomfort in his upper right abdomen. An abdominal ultrasound showed multiple hypoechoic masses in his liver (Table 1). Subsequent computed tomography (CT) scan confirmed multiple liver lesions (largest diameter approximately 5 cm) and no evidence of extrahepatic disease. Blood work shows elevated liver function tests (LFTs). Arthur has no known liver cirrhosis and no history of alcohol or smoking.

Table 1. Arthur’s Initial Workup

Patient information
  • 71 years old
  • Height: 1.8 m; Weight: 88.5 kg
  • BMI: 27.2
Personal and family medical history
  • History of mild hypertension and well-controlled diabetes, no other health issues
  • Current medications include diltiazem, glimepiride, and vitamin D
  • Non-smoker, no alcohol
  • No allergies
  • No family history of cancer
Physical exam
  • Mild tenderness in upper right abdomen
  • ECOG PS: 0
Laboratory evaluations
  • CBC: normal
  • Sodium: 135 mmol/L
  • Potassium: 4.8 mmol/L
  • Urea: 4.7 mmol/L
  • Serum creatinine: 65 µmol/L
  • eGFR: 79 mL/min/1.73m2
  • Calcium: 2.39 mmol/L
  • Phosphate: 1.26 mmol/L
  • Total protein: 64 g/L
  • Albumin: 40 g/L
  • Globulin: 24 g/L
  • Adjusted calcium: 2.51 mmol/L
  • Total bilirubin: 12 µmol/L
  • Alkaline phosphatase: 108 IU/L
  • AST: 48 IU/L
  • LDH: 164 IU/L
  • GGT: 86 IU/L
  • CA 19-9: 116 U/mL
Imaging
  • Ultrasound: multiple hypoechoic liver masses
  • CT: multiple liver lesions with irregular peripheral enhancement; largest lesion has a diameter of 5 cm and showed some capsular retraction; no evidence of liver cirrhosis
AST = aspartate aminotransferase; BMI = body mass index; CA = carbohydrate antigen; CBC = complete blood count; CT = computed tomography; ECOG = Eastern Cooperative Oncology Group; eGFR = estimated glomerular filtration rate; GGT = gamma-glutamyl transferase; LDH = lactate dehydrogenase; PS = performance status.