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.
The BCOP Clinical Sessions are part of the professional development program for the recertification of board-certified oncology pharmacists by the Board of Pharmacy Specialties and jointly provided by ACCP and the American Society of Health-System Pharmacists (ASHP). In order to earn the BCOP recertification credit, participants must attend the session, claim the continuing pharmacy education credit, and pass the associated posttest. Access to the BCOP Clinical Sessions posttests will be available on December 18, 2024, at www.accp.com/myaccount to anyone who has purchased access to the BCOP posttests. For participants who have not purchased access to the posttest, access can be purchased until 5:30 p.m. on Tuesday, October 15, at the ACCP Registration Desk. The deadline to submit posttests for these sessions will be December 16, 2025.
Learning Objectives
1. Assess clinical data evaluating the integration of PARP inhibitors into the treatment of breast, prostate, ovarian, and pancreatic cancers.
2. Identify patients who are appropriate for initiation of PARP inhibitor therapy.
3. Describe the pathophysiology, incidence, and risk factors of PARP inhibitor-associated secondary myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML).
4. Summarize treatment paradigm changes with the updated classification of MDS and AML.
5. Design a treatment strategy for patients with MDS or AML with previous PARP inhibitor exposure.