Preventing Recurrence and Improving Outcomes for Your Patients Following Resection of Stage IIB/C Melanoma: The Role of Adjuvant Immunotherapy
Post-Test/Evaluation
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All of the following biomarkers are associated with risk of melanoma recurrence except:
Lower intratumoral PD-L1 and CD8 levels
Lower tumor mutational burden
Lower ctDNA
Higher serum C-reactive protein
Higher tumor mitotic rate
Adjuvant treatment with either nivolumab or pembrolizumab are both effective in improving recurrence-free survival in patients with resected stage IIB/C melanoma.
True
False
Which of the following treatments are ideal for managing Grade 3 irAEs in early-stage melanoma patients receiving immunotherapy?
Administer corticosteroids while continuing immunotherapy
CT scan and initiate albuterol
Continue immunotherapy but monitor the patient closely
Stop immunotherapy, administer high-dose corticosteroids; infliximab may be used if symptoms do not improve
A 45-year-old tennis player presented to the clinic concerned about a few moles on her arms. She had noticed that one of the moles was growing in size. She comes with a history of mild hypothyroidism. Biopsy results confirm a 3.2 mm melanoma with ulceration, wild-type
BRAF
, and a mitotic rate of 12 mits/HPF. The dermatologist determines surgery, and the patient is very clear she would like to reduce her risk of recurrence as much as possible. What treatment option would you recommend?
Dabrafenib + trametinib
Encorafenib + binimetinib
Nivolumab or Pembrolizumab
Observation
Nivolumab + relatlimab
A 60-year-old patient who has been on pembrolizumab for six months for Stage III melanoma develops severe abdominal pain and diarrhea that requires taking time off from work. What would be the best next step?
Stop treatment for 1 month and reassess
Initiate NSAIDs for ulcerative colitis
Start high-dose corticosteroids and consider referral for a gastroenterology consult
Start patient on loperamide hydrochloride, continue treatment
What is your job role?
Primary Care Physician
Nurse Practitioner
Dermatologist
Medical Oncologist
Registered Nurse
Pharmacist
Surgeon
Physician Assistant
Other
What is your type of practice?
Community/Private
Clinic
Academic
Hospital
HMO/MCO
Other
How many years have you been in practice?
Fewer than 5
5 to 9
10 to 15
More than 15
N/A
Please estimate the number of patients with melanoma that you treat each month:
1-10
11-25
26-50
51-75
> 75
N/A
How many years have you been using immunotherapy treatments in the clinic?
Never used them
Fewer than 5
5 to 9
10 to 15
> 15
Were the following learning objectives met?
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Interpret data from studies evaluating the use of adjuvant immunotherapy following resection of stage IIB/C melanoma
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Facilitate the inclusion of adjuvant immunotherapy following resection of stage IIB/C melanoma as part of individualized patient management plans
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Prepare strategies for detecting and mitigating the irAEs associated with immunotherapies used for the treatment of patients with early-stage melanoma
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Support multidisciplinary team approaches to the management of patients with early-stage melanoma
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Please rate your confidence in your ability to manage patients with stage IIB/C melanoma on a scale of 1 to 5, where 1 means "not confident at all" and 5 means "very confident."
Confidence
1
2
3
4
5
As a result of this course, I will likely make changes to my practice.
Yes
No
N/A
If YES, in which of the following categories?
(Please check all that apply)
Diagnosis
Treatment Approach
Patient Safety
Coordination of Care
Patient Communication/Patient Education
In particular, as a result of this course, I will be more likely to implement the following changes:
(Please check all that apply)
Be better able to identify Stage IIB/C melanoma patients who can receive adjuvant immunotherapy following surgery
Readily integrate adjuvant immunotherapy in the treatment of patients following surgical resection of Stage IIB/C melanoma
Have the confidence to recognize irAEs in patients with early-stage melanoma, and deliver the appropriate treatment strategy
Be mindful of the need for a multidisciplinary team of experts when caring for patients with early-stage melanoma
Additionally, I will change:
What barriers may prevent/inhibit changes in practice recommended in this activity?
(Please check all that apply.)
:
Cost
Time
# of Patients
Access/Availability
Patient Understanding
Compliance
Other
Please evaluate this activity as a whole.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
The learning format was interactive and engaging
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
The content was pertinent to my professional needs
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
The activity will ultimately benefit patient care
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
I would recommend this activity to colleagues
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Do you feel a commercial product, device, or service was inappropriately promoted in this educational activity?
Yes
No
If YES, please comment:
What was the most effective aspect(s) of this learning activity?
(Please check all that apply.)
:
Faculty Expertise
Educational Format
Visual Aids
Content
Case Studies
Other
Do you have suggestions for improving the session or for topics for future activities?
(Please check all that apply.)
:
New and Emerging Therapies
Diagnostic Tools/Techniques
Patient Education/Communication
Other Treatment Modalities
Coordination of Care
Other
Please evaluate the faculty: Jason J. Luke, MD
Poor
Fair
Average
Good
Excellent
Med Learning Group has my permission to fax or email information to me about further programs.
Yes
No
At times, MLG partners to conduct educational outcomes analyses on treatment and/or diagnosis behavior that are all deidentified and rolled-up across all learners.
I give permission to use my deidentified outcomes data for further research related to the impact of CME.
I decline the use of my deidentified outcomes data for further research related to the impact of CME.
Any additional comments are welcome below.
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