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CBP 104: ICI BREAST CANCER PRECEPTORSHIP

Multidisciplinary management, standards of care, optimal diagnostics, therapies and future perspectives in the care of Breast Cancer patients in sub-Saharan Africa incorporating Biosimilars.

Eldoret, Kenya

Training Dates: 10^th January 2022- 18^th February 2022

Training Duration: 6 weeks

Course Director: Prof. Fredrick Chite Asirwa MD

Consultant Physician. Medical Oncologist & Hematologist

Executive Director/CEO: International Cancer Institute (ICI)

P.O. Box 8088, Code 30100 Eldoret, Kenya

Email: director@intercancer.com Website: www.intercancer.com

Lead Course Faculty:

Dr. Kevin Makori MD, MMED

Clinical & Radiation Oncologist

Deputy Director of Programs

International Cancer Institute (ICI)

P.O. Box 8088, Code 30100 Eldoret, Kenya

Email: kevin.makori@intercancer.com Website: www.intercancer.com

This educational activity is provided independently by International Cancer Institute (ICI)

through the Blueprint Program

Accreditation of this course is by KMPDC, PPB, NCK and COC

Target Audience

The primary target audience for this course comprise the multidisciplinary clinical cancer care team members including, but not limited to medical, surgical, and radiation oncologists; fellows; gastroenterologists; nephrologists; neurologists; pathologists; pulmonologists; radiologists; researchers; oncology nurse practitioners and oncology nurses; Oncology pharmacists; Oncology PharmTechs; Oncology clinical officers; physician assistants; and other allied health care professionals.

Statement of Need

General internists, specialist health care professionals and Primary Care Clinicians must maintain an extensive knowledge base on a wide variety of topics covering all body systems as well as common and uncommon disorders. International Cancer Institute’s Preceptorship Courses aims to leverage the expertise of its Faculty to help clinicians understand best practices in diagnosis and management of conditions encountered in the clinical setting in sub-Saharan Africa.

LEARNING OBJECTIVES

At the end of this educational activity, participants should be able to:

Understand the Epidemiology of Breast cancer in sub-Saharan Africa (SSA)
- Epidemiologic features of breast cancer in Sub Saharan Africa
- Peculiar features of breast cancer in Sub Saharan Africa vis-a-vis globally
Discuss breast cancer screening, risk factors and protective factors associated with breast cancer
- Discuss the modifiable risk factors for breast cancer
- Be familiar with the indications for screening as well as best imaging tools
- Understand the principles of chemoprevention, its indications and side effects
- Understand the indications of referring patients and their relatives for genetic counselling and testing and the implications of BRCA positivity in the management of carriers and patients.
Recognize the role of pathological diagnosis, staging, molecular subtypes, the prognostic and therapeutic significance of tumor estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expressions for breast cancer
- Be familiar with the diagnostic tools in pathology (fine needle aspiration (FNA) and core biopsy)
- Learn the risk assessment work-up of prognostic factors, including staging and biological markers (hormone and HER-2 receptors)
- Familiarize oneself with the implications of the different molecular subtypes of breast cancer in terms of prognosis and selection of appropriate therapies.
Interpret mammograms and appreciate the role of radiology in breast cancer management
- Familiarize oneself with the indications and limitations of the different imaging modalities available for breast cancer including mammography, ultrasound, magnetic resonance imaging (MRI)
- To identify the best staging modalities.
To review the optimal treatment strategies for Breast cancer: chemotherapy, hormonal, targeted agents, monoclonal antibodies etc. Includes Standard of care Treatment protocols
- Knowledge regarding the types of systemic therapies (hormonal therapy), chemotherapy and targeted therapy, different regimens, their indications, main side effects and management for early and advanced disease.
- Discuss fertility preservation.
Describe the current trends in the locoregional and systemic management of operable early-stage breast
- Understand the different goals of treatment and their implications for early breast cancer
- Indications, objectives and limitations of neoadjuvant i.e. preoperative systemic therap
- Criteria; clinical and biological for decisions about adjuvant chemotherapy, including genomic tests, their indications and limitations
To understand the role of multidisciplinary team in Breast cancer management
- Evaluation of response in the neoadjuvant and advanced setting.
- To be aware of the existence of different therapeutic modalities (surgery, radiotherapy, systemic therapy) as well as specialties e.g., Physical therapy to manage lymphedema.
- Understand the indications and limitations of follow-up procedures for patients with breast cancer.
To understand the role of Surgery in the management of Breast cancer
- Indications, value, modalities and limitations of surgery for breast cancer in all stages as well as the different possible sequences
- Understand appropriate surgical procedures at various presentations
To understand the role of radiotherapy in the management of breast cancer
- Basic principles of radiotherapy in cancer management.
- Indications, value, modalities and limitations of radiotherapy as well as the different possible sequences.
To recall the current goals and standard of care in management of metastatic breast
- Understand the different goals of treatment and their implications for metastatic breast cancer.
- Understand how to evaluate response to treatment in the advanced setting.
To recognize the existence of breast cancer in male patients
- To understand the characteristics of breast cancer in male patients and main management procedures including special considerations.
To understand the role of Palliative, supportive and survivorship care in Breast cancer management
- To comprehend the most common long term side effects and other survivorship issues, including psychological that affect patients who had a diagnosis of breast cancer, as well as those living with metastatic disease.
- Understand the complications that derive from disease progression and those that are treatment- associated in the context of being familiar with supportive and palliative care strategies
To discuss the role and integration of Biosimilars in breast cancer management
- Introduce the concept of biosimilars, their comparison with biologics in terms of development, regulatory pathway of approval and pharmacovigilance.
- Discuss the role of biosimilars and their impact on access to treatment, cost utility, and patient outcomes.
- Integrate shared decision-making practices to inform and engage patients on Biosimilars.
- Consider how the availability of Biosimilars will impact clinical practice in SSA.
Appreciate the research priority areas in breast cancer in SSA
- Explore the disparities in Breast cancer management and the outcomes
- Improving survival in breast cancer patients.
- Opportunities and the role of clinical trials in breast cancer management.

Disclosure of Conflicts of Interest

International Cancer Institute (ICI) requires instructors, planners, managers and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by ICI for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty must report any financial relationships or contractual relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Method of Participation and Request for Credit

To receive credit for this activity, participants must review the activity information including learning objectives and faculty/planner disclosures and actively participate in the educational activity. Upon successfully completing the post-test with a score of 75% or better and the post-activity evaluation, your certificate will be made available immediately.