TKI Treatment Failure: What You Need to Know

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Release Date: April 02, 2015
Expiration Date: April 02, 2016

Expected time to complete this activity as designed: 30 minutes
There are no fees for participating in or receiving credit for this online activity.

Program Overview

Over the last decade and a half, outcomes for patients with chronic myelogenous leukemia (CML) has improved dramatically with the introduction of the first BCR-ABL tyrosine kinase inhibitor imatinib. While the majority of CML patients do very well on imatinib, 25-35% of patients require a change of therapy. Furthermore, the vast majority of patients treated on the IRIS trial evaluating imatinib as frontline treatment in chronic-phase CML entered a complete cytogenetic remission. However, newer data looking at major molecular response shows that only about half of the patients achieved major molecular response at 5 years, indicating that many of the patients who apparently look like they are doing well actually still have a significant amount of disease burden. These patients may develop further problems as time goes on. The introduction of second- and third-generation TKIs has not just broadened options, but has also improved upon the first-generation TKI as realized through more rapid as well as deeper responses to therapy that translate into a more significant progression-free survival advantage than previously realized with the first-generation TKI, while also allowing for additional options for those patients who fail on primary or subsequent lines of therapy. Of those that do fail on primary and subsequent lines of TKI therapy, only a portion are caused by resistance mutations that arise as a consequence of treatment. Therefore, when a patient fails to achieve a target response goal or loses response to therapy, it is essential that medical oncologists and their multidisciplinary team members who care for CML patients rapidly and accurately evaluate the cause to ensure optimal treatment and management planning that will translate into extended survival as well as optimal quality of life for the patient.

Join our Managing CML team experts, Stuart Goldberg, MD, chief of the Division of Leukemia at the John Theurer Cancer Center in Hackensack, New Jersey, and Karen Seiter, MD, professor of medicine at New York Medical College, Division of Oncology/Hematology in Valhalla, New York, as they share their personal practice experiences in patients who have developed primary and secondary treatment resistance. Their discussion, centered around actual case encounters in their practice, provides health care professionals that treat and care for CML patients with what they need to know about both primary and secondary treatment resistance, including how to rapidly assess the causes of failure and implement strategies to overcome them.

Target Audience

This activity is designed for hematologists, oncologists, and associated multidisciplinary clinical specialists who provide care to patients with CML.

Learning Objectives

Upon completion of this educational activity, participants should be able to:

  • Describe the primary causes of treatment resistance, including resistance that develops over the course of therapy due to BCR-ABL1 mutations, including the T315I mutation
  • Summarize the potential impact of treatment resistance on the patient with CML, focusing on the consequences of delay in the therapeutic strategies that are specifically designed to address this resistance
  • Outline the impact of treatment resistance on therapeutic decisions in CML, and identify therapeutic strategies that are designed to address patients who either are or have become treatment resistant or treatment intolerant during the course of therapy


TKI Treatment Failure: What You Need to KnowStuart L. Goldberg, MD, and Karen P. Seiter, MD

Instructions for Participation and Credit

This activity is eligible for credit through April 2, 2016. After this date, this activity will expire and no further credit will be awarded.

  1. Read the target audience, learning objectives, and faculty disclosures.
  2. You may be asked to complete a short pre-test before accessing the educational content. This must be completed in order to move forward in the activity.
  3. Complete the educational content as designed.
  4. Complete the post-test. To receive a certificate, you must receive a passing score of 70%.
  5. Complete the activity evaluation survey to provide feedback and information useful for future programming.
  6. Certificates for CME credit may be printed immediately after successfully completing the post-test and activity evaluation. Pharmacist credit will be uploaded to CPE Monitor 4 weeks following receipt of a completed, qualified form.

Faculty Biographies

Stuart L. Goldberg, MD
Division of Leukemia
John Theurer Cancer Center
Hackensack, New Jersey

Dr. Stuart Goldberg received his medical degree from Pennsylvania State University, Milton S. Hershey Medical Center. He completed his internal medicine residency and his hematology-oncology fellowship at George Washington University Medical Center. He also completed a bone marrow transplantation fellowship at Fred Hutchinson Cancer Research Center. Dr. Goldberg is part of the Division of Leukemia, John Theurer Cancer Center in Hackensack, New Jersey.

Dr. Goldberg specializes in medical oncology and leukemia, and is board certified in medical oncology, hematology and internal medicine. He is a member of the American College of Physicians, American Society of Blood and Marrow Transplantation, American Society of Hematology, American Society of Clinical Oncology, Eastern Cooperative Oncology Group, Southwest Oncology Group, and the Myelodysplastic Foundation, among others. Dr. Goldberg specializes in treating all types of leukemia and myelodysplastic syndromes with a variety of treatment modalities, including chemotherapy and stem cell transplantation.

Karen P. Seiter, MD
Professor of Medicine
New York Medical College
Division of Oncology/Hematology
Valhalla, New York

Dr. Karen Seiter received her medical degree from New York Medical College, Valhalla, New York. She continued her postdoctoral education with an internship/residency in internal medicine at Bronx Municipal Hospital Center of the Albert Einstein College of Medicine, and as a fellow in hematology/oncology at Memorial Sloan Kettering Cancer Center. Dr. Seiter is professor of medicine at New York Medical College and director of Leukemia Service at Westchester Medical Center.

Dr. Seiter is board certified in internal medicine, medical oncology, and hematology. She holds professional membership in the American College of Physicians, American Association for Cancer Research, American Society of Clinical Oncology, American Society of Hematology, and the Infectious Diseases Society of America, among others. In addition, she is on the Oncology Leadership Council at Westchester Medical Center; chairman, Committee for Protection of Human Subjects (IRB), Oncology Division; associate director, Fellowship Program, and director of Adult Allogeneic Bone Marrow Transplantation Program, Westchester Medical Center; as well as chairman of the Bone Marrow Transplant Quality Improvement Subcommittee. Dr. Seiter has written over 100 book chapters and peer-reviewed journal articles focusing on colorectal cancer and leukemia.


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Designation Statement: MediCom Worldwide, Inc. designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

MediCom Worldwide, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This activity is acceptable for 0.5 contact hours of Continuing Education Credit. Universal Activity Number: 827-0000-15-027-H01-P. Knowledge-based CPE activity.

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As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Pharmacy Education (ACPE) and California State Board of Registered Nursing, MediCom Worldwide, Inc. requires everyone who is a position to control the content of an educational 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. Accordingly, the following disclosures were made.

Faculty Disclosures

Dr. Stuart Goldberg has received honoraria related to speakers’ bureau activities from ARIAD, Bristol-Myers Squibb Company, and Novartis. He has received grant support related to research activities from ARIAD, Bristol-Myers Squibb, Novartis, and Pfizer Inc. Dr. Goldberg has been employed by COTA (Cancer Outcomes Tracking Analysis).

Dr. Karen Seiter has received honoraria related to formal advisory activities from Alexion and Novartis AG; the development of educational materials from Novartis; and speakers’ bureau activities from Alexion, Celgene Corporation, and Novartis. She has received grant support related to research activities from Celgene, F. Hoffmann-La Roche Ltd., and Novartis.

Planning Committee Disclosures

The individuals listed below from MediCom Worldwide, Inc. reported the following for this activity: Joan Meyer, RN, MHA, executive director, and Eugene R. Tombler, PhD, FACME, medical director, oncology, have no relevant financial relationships.

Peer Reviewer Disclosure

In accordance with MediCom Worldwide, Inc. policy, all content is reviewed by external independent peer reviewers for balance, objectivity and commercial bias. The peer reviewers have no relevant financial relationships to disclose.

Off-Label Disclosures/Investigational Disclosures

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

Dr. Goldberg has indicated that he does not intend to discuss off-label uses of drugs, mechanical devices, biologics or diagnostics approved by the US Food and Drug Administration (FDA) for use in the US.

Dr. Seiter has indicated that she does intend to discuss off-label uses of drugs, mechanical devices, biologics or diagnostics approved by the US Food and Drug Administration (FDA) for use in the US.

Dr. Goldberg and Dr. Seiter have indicated that they do not intend to discuss investigational drugs, mechanical devices, biologics or diagnostics not approved by the FDA for use in the US.

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Provided by MediCom Worldwide, Inc.
This activity is supported by educational grants from ARIAD Pharmaceuticals, Inc., Novartis, and Teva Pharmaceuticals.

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