Activity Details

0.5 AMA PRA Category 1 Credit(s)
0.5 Contact Hour(s)
Released: December 16, 2019
Expires: December 16, 2020
30 minutes to complete

Accredited By


Target Audience

Medical oncologists, community oncologists, nurse practitioners, and physician assistants. Other healthcare professionals such as radiation oncologists, primary care physicians, pharmacists, and nurses who treat patients with HR+, HER2- metastatic breast cancer (mBC) may benefit from participation in the proposed educational activities. 

Learning Objectives

  • Upon completion of this activity, participants should be able to:
    • Engage patients with HR+ HER2- mBC in a shared decision making (SDM) process on the goals of treatment, treatment plan development, and treatment modification.
    • Identify strategies to enhance symptom management and increase adherence to treatment.

Activity Description

The advent of CDK4/6 inhibitors as effective treatment for mBC is a great milestone for patients with mBC but requires a deep understanding of the benefits and risks of the treatment options. From SDM simulation to symptom management, breast cancer specialists, Erika Hamilton, MD, and Lauren Czapla, NP, team up to provide a practical update for integrating SDM in practice and strategies to enhance symptom management and increase adherence.

Statement of Educational Need

Cancer treatment decision making is challenging because there are multiple effective therapies that are interconnected, with a complex interplay between their benefits and risks. SDM is a best practice health care process used to help patients but is not fully integrated in breast cancer care.


  • Overview of SDM to improve treatment adherence and patient outcomes.
  • Simulation of SDM with a patient with HR+, HER2- mBC.
  • Overview of strategies to enhance symptom management and increase adherence to treatment.


Erika P. Hamilton, MD
Director, Breast and Gynecologic Cancer Program
Sarah Cannon Research Institute/Tennessee Oncology
Nashville, Tennessee

Lauren E. Czapla, RN, MS, WHNP-BC, AOCNP
Nurse Practitioner,
Breast Oncology
Oncofertility Program
Dana-Farber Cancer Institute
Boston, Massachusetts

Conflict of Interest Policy/Disclosure Statement

Disclosure Statement
Educational activities provided by Forefront Collaborative must demonstrate balance, independence, and scientific rigor. All those in a position to control the content of an activity must disclose all relevant financial relationship(s) with commercial interest(s). The disclosures will be listed in the activity handout.

Disclosure and Conflict of Interest Resolution
Educational activities provided by Forefront Collaborative must demonstrate balance, independence, and scientific rigor. All those in a position to control the content of an activity must disclose all relevant financial relationship(s) with commercial interest(s)*. For this educational activity, all conflicts of interest have been resolved through peer review and revisions to ensure independence, evidence base, fair balance, and absence of commercial bias. Disclosures appear below.

*The ACCME defines a commercial interest as any entity producing, marketing, reselling, or distributing health care goods or services consumed by or used on patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests – unless the provider of clinical service is owned, or controlled by, an ACCME-defined commercial interest.

The following individuals have indicated that neither they nor their spouses/partners have had, in the past 12 months, financial relationship(s) with commercial interests relative to the content of this CME activity:

  • Planners (Forefront Collaborative):
    Megan Ragan
  • Faculty:
    Lauren E. Czapla, RN, MS, WHNP-BC, AOCNP
The following individuals have disclosed that they and/or their spouse/partner has had a financial relationship in the past 12 months:
  • Faculty:
    Erika P. Hamilton, MD
    • Consultant—Pfizer (institutional compensation, not personal), Cascadian Therapeutics, and Lilly (institutional compensation only, not personal)
      Speakers bureau—Genentech/Roche (institutional compensation only, not personal)
      Advisory board—Lilly (institutional compensation only, not personal)
      Contracted research—Lilly, Pfizer, Genentech/Roche, Hutchison MediPharma, OncoMed, MedImmune, Stemcentrx, AbbVie, Curis, Verastem, Zymeworks, Syndax, Lycra, Rgenix, Novartis, Mersana, TapImmune, BerGenBio, Tesaro, Medivation, Kadmon, Boehringer Ingelheim, Eisai, H3 Biomedicine, Radius Health, Acerta, Takeda, MacroGenics, Immunomedics, Fujifilm, Effector, Syros, Unum, Sutro, Aravive, Deciphera, Clovis, and Sermonix

  • Planners (Forefront Collaborative):
    Wambui Gathirua-Mwangi’s spouse receives a salary from Lilly for work as a research scientist in dermatology.

Accreditation Statement

Forefront Collaborative is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

IPMA holds accreditation with commendation from the Accreditation Council for Continuing Medical Education (ACCME) and is approved by the American Board of Medical Specialties as a Multispecialty Portfolio Provider.

Credit Designation Statement

Forefront Collaborative designates this activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


NP: This activity is approved for 0.5 contact hour(s) of continuing education by the American Association of Nurse Practitioners. Activity ID 19103994. This activity was planned in accordance with AANP Accreditation Standards and Policies.

RN: IPMA is approved by the California Board of Registered Nursing, Provider Number 6971, for 0.5 contact hours. Each person should retain this certificate for 4 years after the course has been completed. RNs outside of California must verify with their licensing agency for approval of this course.

Instructions for Receiving Credit

Participants must complete and submit the online CME evaluation form at the conclusion of the activity and achieve a passing score of 100%. Certificates will be generated upon completion and submission of the evaluation form.

Statement of Commercial Support

This activity is supported by an educational grant from Lilly. For further information concerning Lilly grant funding, visit

Disclaimer Statement/Disclosure of Unlabeled Use

The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views or recommendations of Forefront Collaborative, Interstate Postgraduate Medical Association, and Lilly.

The content of this activity was independently peer reviewed by two reviewers. The reviewers of this activity have no relevant financial relationships to disclose.

This continuing medical education activity will include reference(s) to unlabeled or unapproved uses of drugs or devices.

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