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CME / ABIM MOC

Assess Your Understanding of Immune Checkpoint Inhibitors in Metastatic Melanoma

  • Authors: Janice M. Mehnert, MD
  • CME / ABIM MOC Released: 1/13/2023
  • Valid for credit through: 1/13/2024
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  • Credits Available

    Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 0.25 ABIM MOC points

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for oncologists, dermatologists, pathologists, surgeons, and other members of the multidisciplinary team.

The goal of this activity is for learners to be better able to understand the spectrum of immune checkpoint inhibitors (ICIs) used in the frontline management of metastatic melanoma.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Therapeutic management strategies involving ICIs for the treatment of patients with metastatic melanoma
  • Self-assess learning needs related to
    • Best practices for integrating ICIs for the treatment of metastatic melanoma


Disclosures

Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


Faculty

  • Janice M. Mehnert, MD

    Professor of Medicine
    NYU Grossman School of Medicine​
    Associate Director for Clinical Research
    Laura and Isaac Perlmutter Cancer Center at NYU​
    Director
    Melanoma and Cutaneous Medical Oncology​
    New York, New York

    Disclosures

    Janice M. Mehnert, MD, has the following relevant financial relationships:
    Consultant or advisor for: Merck
    Speaker or member of speakers bureau for: Bristol Myers Squibb Company; Eisai, Inc.; Novartis; Regeneron Pharmaceuticals, Inc.; Seagen, Inc.
    Research funding from: Bristol Myers Squibb Company; Incyte Corporation; Kinnate; Merck; Novartis
    Stock options from: Pfizer, Inc.
    Owns stock (publicly traded) in: Pfizer, Inc.

Editor

  • Deborah Middleton, MS

    Senior Medical Education Director, WebMD Global, LLC

    Disclosures

    Deborah Middleton, MS, has no relevant financial relationships.

Compliance Reviewer

  • Leigh Schmidt, MSN, RN, CNE, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC

    Disclosures

    Leigh Schmidt, MSN, RN, CNE, CHCP, has no relevant financial relationships.

Peer Reviewer

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


Accreditation Statements



In support of improving patient care, Medscape, LLC is jointly accredited with commendation 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 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.25 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.

    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*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it 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.

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.

CME / ABIM MOC

Assess Your Understanding of Immune Checkpoint Inhibitors in Metastatic Melanoma

Authors: Janice M. Mehnert, MDFaculty and Disclosures

CME / ABIM MOC Released: 1/13/2023

Valid for credit through: 1/13/2024

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References

  1. Alexandrov LB, et al. Signatures of mutational processes in human cancer. Nature. 2013;500:415-521.
  2. Davis EJ, et al. Melanoma: what do all the mutations mean? Cancer. 2018;124:3490-3499.
  3. Yarchoan M, et al. Tumor mutational burden and response rate to PD-1 inhibition. N Engl J Med. 2017;377:2500-2501.
  4. Robert C, et al. Anti-programmed-death-receptor-1 treatment with pembrolizumab in ipilimumab-refractory advanced melanoma: a randomised dose-comparison cohort of a phase 1 trial. Lancet. 2014;384:1109-1117.
  5. Chen L. Co-inhibitory molecules of the B7-CD28 family in the control of T-cell immunity. Nat Rev Immunol. 2004;4:336-347.
  6. Anderson AC, et al. Lag-3, Tim-3, and TIGIT: co-inhibitory receptors with specialized functions in immune regulation. Immunity. 2016;44:989-1004.
  7. Hodi FS, et al. Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med. 2010;363:711-723.
  8. Robert C, et al. Pembrolizumab versus ipilimumab in advanced melanoma. N Engl J Med. 2015;372:2521-2532.
  9. Lythgoe MP, et al. Gene of the month: lymphocyte-activation gene 3 (LAG-3). J Clin Pathol. 2021;74:543-547.
  10. Wherry EJ, et al. Molecular and cellular insights into T cell exhaustion. Nat Rev Immunol. 2015;15:486-499.
  11. Woo S-R, et al. Immune inhibitory molecules LAG-3 and PD-1 synergistically regulate T-cell function to promote tumoral immune escape. Cancer Res. 2012;72:917-927.
  12. Hamid O, et al. Five-year survival outcomes for patients with advanced melanoma treated with pembrolizumab in KEYNOTE-001. Ann Oncol. 2019;30:582-588.
  13. Larkin J, et al. Five-year survival with combined nivolumab and ipilimumab in advanced melanoma. N Engl J Med. 2019;381:1535-1546.
  14. Wolchok JD, et al. Long-term outcomes with nivolumab plus ipilimumab or nivolumab alone versus ipilimumab in patients with advanced melanoma. J Clin Oncol. 2022;40:127-137.
  15. Wolchok JD, et al. Overall survival with combined nivolumab and ipilimumab in advanced melanoma. N Engl J Med. 2017;377:1345-1356.
  16. Tawbi HA, et al. Relatlimab and nivolumab versus nivolumab in untreated advanced melanoma. N Engl J Med. 2022;386:24-34.
  17. Gogishvili M, et al. Cemiplimab plus chemotherapy versus chemotherapy alone in non-small cell lung cancer: a randomized, controlled, double-blind phase 3 trial. Nat Med. 2022;28:2374-2380.
  18. Sezer A, et al. Cemiplimab monotherapy for first-line treatment of advanced non-small-cell lung cancer with PD-L1 of at least 50%: a multicentre, open-label, global, phase 3, randomised, controlled trial. Lancet. 2021;397:592-604.
  19. Hamid O, et al. Clinical activity of fianlimab (REGN3767), a human anti-LAG-3 monoclonal antibody, combined with cemiplimab (anti-PD-1) in patients (pts) with advanced melanoma. J Clin Oncol. 2021;39(suppl 15): abstract 9515.
  20. Hamid O, et al. Phase I study of fianlimab, a human lymphocyte activation gene-3 (LAG-3) monoclonal antibody, in combination with cemiplimab in advanced melanoma (mel). Ann Oncol. 2022;33(suppl 7):S356-S409. Abstract 790MO.
  21. National Comprehensive Cancer Network (NCCN). Melanoma: Cutaneous (Version 3.2022). 2022. Accessed January 11, 2023. https://www.nccn.org
  22. Palmieri M, et al. Real-world application of tumor mutational burden-high (TMB-high) and microsatellite instability (MSI) confirms their utility as immunotherapy biomarkers. ESMO Open. 2022;7:100336.
  23. Mehnert JM, et al. The challenge for development of valuable immune-oncology biomarkers. Clin Cancer Res. 2017;23:4970-4979.
  24. National Comprehensive Cancer Network (NCCN). Management of Immunotherapy-Related Toxicities (Version 1.2022). 2022. Accessed January 11, 2023. https://www.nccn.org
  25. Atkins MB, et al. Combination dabrafenib and trametinib versus combination nivolumab and ipilimumab for patients with advanced BRAF-mutant melanoma: the DREAMseq trial -- ECOG-ACRIN EA6134. J Clin Oncol. 2022. [Epub ahead of print]
  26. Margolin K, et al. Ipilimumab in patients with melanoma and brain metastases: an open-label, phase 2 trial. Lancet Oncol. 2012;13:459-465.
  27. Tawbi HA, et al. Combined nivolumab plus ipilimumab in melanoma metastatic to the brain. N Engl J Med. 2018;379:722-730.
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