Secondary School: Risk and Management of Secondary Malignancies in the Era of Targeted Therapies

NOTE: This session is part of the Live Intensive Studies and Clinical Sessions packages. All attendees may attend these thought-provoking and highly educational sessions. However, if you are board-certified, you must purchase the package(s) for your specialty to receive the recertification assessment and claim the recertification credit.

Secondary malignancies caused by anticancer agents represent a spectrum of conditions that are both difficult to predict and difficult to treat. Specifically, myeloid-related secondary neoplasms are serious and have a poor prognosis. Conventional anticancer agents, like topoisomerase inhibitors and alkylating agents, have well-characterized risk of secondary malignancies due to their longevity in practice. However, in the era of targeted therapy, novel agents like poly-ADP ribose polymerase (PARP) inhibitors, carry meaningful risk of secondary malignancies; the incidence and risk factors of which are only recently becoming elucidated due to their newness on the world market. Similarly, the treatment of secondary myeloid neoplasms has changed significantly given updates in classification and novel therapies to treat MDS and AML.

Part 1 of this session will focus on pathophysiology, preliminary and long-term data supporting clinical use, and risk of secondary malignancies with PARP inhibitors. Part 2 of this session will focus on the new classification of MDS and AML, with specific attention to the classification of secondary myeloid neoplasms. The session will discuss the shift towards underlying mutations and cytogenetic changes for the diagnosis and treatment of MDS and AML. Data on the presentation, biology, and outcomes of PARP inhibitor exposure-related MDS and AML will be discussed. Recommendations for the management of MDS and AML in a patient with previous PARP inhibitor will be discussed based on available evidence, where no current guidelines exist.

This activity is approved for Board-Certified Oncology Pharmacist (BCOP) recertification credit.