This activity is for healthcare professionals outside of the UK.

This activity is funded by an independent medical education grant from Gilead Sciences, Inc.

The activity is jointly provided by USF Health and touchIME.

touchIME is an EBAC® accredited provider.

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Breast Cancer CE/CME ACCREDITED Watch Time: 33 mins

touchMDT ADCs in metastatic breast cancer: Managing toxicities and optimizing quality of life

A multidisciplinary team and a patient advocate discuss antibody–drug conjugate (ADC) related toxicities in metastatic breast cancer.

 Overview & Learning Objectives
Patient with metastatic breast cancer
  • Safety profiles of current and emerging ADCs in patients with metastatic breast cancer
    Nurse and oncologist
    Play Arrow Watch Video

    Watch a medical oncologist and a nurse practitioner review and discuss the safety profiles of current and emerging ADCs in patients with metastatic breast cancer.

    Time: 10:52
    Dr Freeman, Dr Diéras
    Play Arrow Watch Video
  • Communicating ADC treatment toxicities to patients
    Oncologist, nurse and patient advocate
    Play Arrow Watch Video

    Watch a medical oncologist, a nurse practitioner and a patient advocate discuss effective strategies for communicating the potential side effects associated with ADC treatment to patients with metastatic breast cancer.

    Time: 11:52
    Dr Diéras, Dr Freeman, Mrs Turner
    Play Arrow Watch Video
  • Identifying and managing key ADC treatment toxicities in patients with metastatic breast cancer
    Oncologist, nurse and pharmacist
    Play Arrow Watch Video

    Watch a medical oncologist, a nurse practitioner and a clinical oncology pharmacy specialist consider the strategies to avoid, mitigate, identify and effectively manage side effects associated with ADCs in patients with metastatic breast cancer.

    Time: 10:44
    Dr Diéras, Dr Freeman, Dr Edwards
    Play Arrow Watch Video

Expert Spotlight

Dr Kayla Freeman
Emory Winship Cancer Institute, Atlanta, GA, USA
Dr Véronique Diéras
Centre Eugène Marquis, Rennes, France

Dr Kayla Freeman and Dr Véronique Diéras review and discuss the safety profiles of current and emerging ADCs in patients with metastatic breast cancer.

Get the Audio Version

Tutorial

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Poll

How familiar are you with the safety profiles of ADCs used in metastatic breast cancer?

Submit your answer to see the results

Very familiar
   
Somewhat familiar
   
Slightly familiar
   
Not at all familiar
   
Nurse and oncologist
Get the Audio Version
Safety profiles of current and emerging ADCs in patients with metastatic breast cancer
Time: 10:52
Dr Freeman, Dr Diéras

Watch a medical oncologist and a nurse practitioner review and discuss the safety profiles of current and emerging ADCs in patients with metastatic breast cancer.

Watch Next
Oncologist, nurse and patient advocate

Communicating ADC treatment toxicities to patients

Watch Now

Expert Spotlight

Dr Véronique Diéras
Centre Eugène Marquis, Rennes, France
Dr Kayla Freeman
Emory Winship Cancer Institute, Atlanta, GA, USA
Mrs Lesley Turner
Independent Cancer Patients’ Voice, UK

Dr Véronique Diéras, Dr Kayla Freeman and Mrs Lesley Turner discuss effective strategies for communicating the potential side effects associated with ADC treatment to patients with metastatic breast cancer.

Get the Audio Version

Tutorial

This icon indicates there is a poll question. Click it when you see it to interact with your peers.

Poll

What do you find most effective for patient communication on side effects?

Submit your answer to see the results

Sharing detailed written information
   
Sharing simplified written information
   
Directing them to charity/patient websites
   
Other
   
Oncologist, nurse and patient advocate
Get the Audio Version
Communicating ADC treatment toxicities to patients
Time: 11:52
Dr Diéras, Dr Freeman, Mrs Turner

Watch a medical oncologist, a nurse practitioner and a patient advocate discuss effective strategies for communicating the potential side effects associated with ADC treatment to patients with metastatic breast cancer.

Watch Next
Oncologist, nurse and pharmacist

Identifying and managing key ADC treatment toxicities in patients with metastatic breast cancer

Watch Now

Expert Spotlight

Dr Véronique Diéras
Centre Eugène Marquis, Rennes, France
Dr Kayla Freeman
Emory Winship Cancer Institute, Atlanta, GA, USA
Dr Scott Edwards
Dr. H. Bliss Murphy Cancer Center, St. John’s, Newfoundland, Canada

Dr Véronique Diéras, Dr Kayla Freeman and Dr Scott Edwards consider the strategies to avoid, mitigate, identify and effectively manage side effects associated with ADCs in patients with metastatic breast cancer.

Get the Audio Version

Tutorial

This icon indicates there is a poll question. Click it when you see it to interact with your peers.

Poll

What are the main challenges with ADC-related side effects in your patients?

Submit your answer to see the results

Implementing side-effect monitoring strategies
   
Patient side-effect reporting
   
Managing low-grade toxicities
   
Managing high-grade toxicities
   
Other
   
Oncologist, nurse and pharmacist
Get the Audio Version
Identifying and managing key ADC treatment toxicities in patients with metastatic breast cancer
Time: 10:44
Dr Diéras, Dr Freeman, Dr Edwards

Watch a medical oncologist, a nurse practitioner and a clinical oncology pharmacy specialist consider the strategies to avoid, mitigate, identify and effectively manage side effects associated with ADCs in patients with metastatic breast cancer.

Watch Next
Oncologist, nurse and pharmacist

Identifying and managing key ADC treatment toxicities in patients with metastatic breast cancer

Watch Now
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Overview & Learning Objectives
Overview

In this activity, a medical oncologist, a nurse practitioner, a clinical oncology pharmacy specialist and a patient advocate review the safety profiles of antibody–drug conjugates (ADCs) used in the treatment of patients with metastatic breast cancer, discuss the importance of patient education and shared decision-making in breast cancer care, and share insights on strategies to promptly identify and effectively manage the toxicities associated with ADC therapy in this patient population.

This activity is jointly provided by USF Health and touchIME.

touchIME is an EBAC® accredited provider.

This activity has been designed to meet the educational needs of oncologists, oncology nurses, oncology nurse practitioners and physician assistants, and oncology pharmacists involved in the management of patients with metastatic breast cancer.

USF Accreditation

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Dr Véronique Diéras discloses:  Advisory board/panel fees from AbbVie, AstraZeneca, Daiichi Sankyo, Eisai, Gilead, Lilly, Medac GmbH, MENARINI, MSD, Novartis, Pfizer, Pierre Fabre Oncologie, Roche Genentech and Sanofi. Independent Data Monitoring Committee for AstraZeneca, Daiichi Sankyo, Lilly, Sanofi and Seagen. Consultancy fees from Roche Genentech.

Dr Kayla Freeman has no financial interests/relationships or affiliations to disclose in relation to this activity.

Dr Scott Edwards discloses: Advisory board/panel fees from Bayer, Ipsen, Novartis and Pfizer. Speakers’ bureau fees from Apobiologix, Astellas Pharma, AstraZeneca, Bayer, Eisai, Gilead, Ipsen, Janssen, Merck, Novartis and Pfizer.

Mrs Lesley Turner discloses: Speakers’ bureau fees from MASCC – Novartis (relationship terminated).

Content reviewer

Rebecca Margaret Gonzalez-Winegar, PharmD, BCOP has no relevant financial relationships to disclose.

Touch Medical Contributors

Hannah Fisher has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact cpdsupport@usf.edu. 

Accreditations

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Nurses

USF Health is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

A maximum of 0.75 contact hour(s) may be earned by learners who successfully complete this  continuing professional development activity. USF Health, the accredited provider, acknowledges touchIME as the joint provider in the planning and execution of this CNE activity.

This activity is awarded 0.75 ANCC pharmacotherapeutic contact hour.

Pharmacists

USF Health is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This knowledge-based program has been approved for 0.75 contact hours (0.75 CEUs). Universal program number is as follows: UAN 0230-9999-25-007-H05-P.

Date of original release: 31 March 2025. Date credits expire: 31 March 2026.

If you have any questions regarding credit please contact cpdsupport@usf.edu.

EBAC® Accreditation

touchIME is an EBAC® accredited provider since 2023.

This program is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) for 48 minutes of effective education time.

EBAC® holds an agreement on mutual recognition of substantive equivalency with the US Accreditation Council for CME (ACCME) and the Royal College of Physicians and Surgeons of Canada, respectively.

Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) and the American Medical Association, physicians may convert EBAC® External CME credits to AMA PRA Category 1 CreditTM. Information on the process to convert EBAC® credit to AMA credit can be found on the AMA website. Other health care professionals may obtain from the AMA a certificate of having participated in an activity eligible for conversion of credit to AMA PRA Category 1 CreditTM.

EBAC® is a member of the International Academy for CPD Accreditation (IACPDA) and a partner member of the International Association of Medical Regulatory Authorities (IAMRA).

Faculty Disclosure Statement / Conflict of Interest Policy

In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

Requirements for Successful Completion

Certificates of Completion may be awarded upon successful completion of the post-test and evaluation form. If you have completed one hour or more of effective education through EBAC® accredited CE activities, please contact us at accreditation@touchime.org to receive your EBAC® CE credit certificate. EBAC® grants 1 CE credit for every hour of education completed.

Date of original release: 31 March 2025. Date credits expire: 31 March 2027.

Time to complete: 48 minutes.

If you have any questions regrading the EBAC® credits, please contact accreditation@touchime.org.

Learning Objectives

After watching this activity, participants should be better able to:

  • Describe the safety profiles and key adverse events for current and emerging antibody–drug conjugates (ADCs) used in the treatment of patients with metastatic breast cancer (mBC)
  • Use effective communication strategies when educating patients on the potential ADC treatment toxicities and encourage shared decision-making when managing patients with mBC
  • Apply strategies to promptly identify and effectively manage the toxicities associated with ADCs
Faculty & Disclosures
Dr Véronique Diéras

Centre Eugène Marquis, Rennes, France

Dr Véronique Diéras is a senior medical oncologist and head of the Breast Cancer Group in the Department of Medical Oncology at the Centre Eugène Marquis in Rennes, France, and former head of clinical research, Department of Medical Oncology, Institute Curie, Paris, France. read more

Dr Diéras’s main focus is breast cancer treatment and research, including early drug development. She is involved in early clinical trials, breast cancer trials and a translational research programme focusing primarily on predictive factors of response to treatment, and is principal investigator for several national and international studies of breast and other cancers assessing adjuvant treatment in metastatic disease. 

Dr Diéras is a member of several societies, including the European Society for Medical Oncology (ESMO; Scientific Committee and track chair Metastatic Breast Cancer 2020), the American Society of Clinical Oncology (ASCO), the European Organisation for Research and Treatment of Cancer (EORTC), the French Drug Agency, Institut National du Cancer, UNICANCER (breast board, early clinical trials group, personalized medicine). She is a participant in the European School of Oncology. Dr Diéras serves on the editorial board of Lettre du Cancérologue and as a reviewer for various oncology journals. She is author or co-author of more than 280 publications in journals such as Journal of Clinical Oncology, New England Journal of Medicine, Annals of Oncology, Lancet Oncology and JAMA Oncology, among others.

Dr Véronique Diéras discloses Advisory board/panel fees from AbbVie, AstraZeneca, Daiichi Sankyo, Eisai, Gilead, Lilly, Medac GmbH, MENARINI, MSD, Novartis, Pfizer, Pierre Fabre Oncologie, Roche Genentech and Sanofi. Independent Data Monitoring Committee for AstraZeneca, Daiichi Sankyo, Lilly, Sanofi and Seagen. Consultancy fees from Roche Genentech.

Dr Kayla Freeman

Emory Winship Cancer Institute, Atlanta, GA, USA

Dr Kayla Freeman serves as the lead advanced practice provider in breast oncology at Emory Winship Cancer Institute in Atlanta, GA, USA. read more

Dr Freeman obtained her doctorate of nursing practice from Augusta University and completed the advanced practice provider fellowship programme at Emory Winship, gaining expertise in haematology, medical oncology, bone marrow transplant and radiation oncology.

With a dedicated focus on breast cancer for the past 4 years, she actively collaborates as a co-principal investigator on various clinical trials aimed at advancing breast cancer treatment and overall patient outcomes.

Dr Kayla Freeman has no financial interests/relationships or affiliations to disclose in relation to this activity.
Dr Scott Edwards

Dr. H. Bliss Murphy Cancer Center, St. John’s, Newfoundland, Canada

Dr Scott Edwards is the clinical oncology pharmacy specialist at the Dr. H. Bliss Murphy Cancer Center in St. John’s, Newfoundland, Canada. He is also an assistant professor at the School of Pharmacy and the Discipline of Oncology, Faculty of Medicine, Memorial University of Newfoundland. read more

Dr Edwards is active in clinical cancer research in the area of chemotherapy toxicities, supportive care and oral chemotherapy adherence. He graduated from Memorial University of Newfoundland with a BSc (neuroscience) in 1994 and a BSc (pharmacy) in 1997. In 2005, he graduated with a doctor of pharmacy degree from the University of Washington. He completed a master’s degree in oncology from Newcastle University in 2015.

Dr Scott Edwards discloses: Advisory board/panel fees from Bayer, Ipsen, Novartis and Pfizer. Speakers’ bureau fees from Apobiologix, Astellas Pharma, AstraZeneca, Bayer, Eisai, Gilead, Ipsen, Janssen, Merck, Novartis and Pfizer.
Mrs Lesley Turner

Independent Cancer Patients’ Voice, UK

Mrs Lesley Turner has a background in law, having previously practised as a defendant clinical negligence litigator and head of facilities at the International Law Firm DAC Beachcroft LLP. In 2005, she was diagnosed with invasive breast cancer. She has been involved with patient and public involvement work since 2009. read more

Mrs Turner was previously a member of the National Cancer Research Institute (NCRI) Supportive and Palliative Care Clinical Studies Group and sat as the chair of the NCRI Breast Clinical Studies Group working on symptom management issues. She was a member of the NCRI Consumer Forum and is an active member of Independent Cancer Patients’ Voice. Mrs Turner previously chaired the Patient and Public Involvement (PPI) workstream for the National Institute for Health and Care Research Cancer and Nutrition Collaboration.

Mrs Turner was a member of Breast Cancer Now’s Tissue Bank Advisory Council and Catalyst Grant Committee, who funded studies worth a total value of approximately £10 million. She is currently on the organizing committee for the UK Interdisciplinary Breast Cancer Symposium hosted by Breast Cancer Now. She has worked with the World Cancer Research Fund and was the first lay member on their international Regular Grant Programme Panel. Mrs Turner is also a co-applicant on numerous funded trials and is chair of the PPI panels for two major programme grants.

Mrs Lesley Turner discloses: Speakers’ bureau fees from MASCC – Novartis (relationship terminated).
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This activity is funded by:

An independent medical education grant from Gilead Sciences, Inc.

The activity is jointly provided by USF Health and touchIME.
touchIME is an EBAC® accredited provider.

The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

USF

USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

Date of original release: 31 March 2025. Date credits expire: 31 March 2026.

EBAC® 

touchIME is an EBAC® accredited provider since 2023.

In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

This content is intended for healthcare professionals.

Date of original release: 31 March 2025. Date credits expire: 31 March 2027.

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Question 1/5
Which of the following was one of the most common adverse events observed in patients with metastatic breast cancer treated with datopotamab deruxtecan in clinical trials?
Correct

Datopotamab deruxtecan, a TROP2-targeting ADC, was assessed versus investigator’s choice of chemotherapy in patients with inoperable or metastatic breast cancer in the TROPION-Breast01 clinical trial.1 The most common any-grade treatment-related adverse events were nausea (51%), stomatitis (50%) and alopecia (36%).1 Datopotamab deruxtecan is approved in the USA for patients with unresectable or metastatic HR+/HER2– breast cancer who have received prior endocrine-based therapy and chemotherapy for unresectable or metastatic disease.2 The prescribing information includes a special warning and precaution for stomatitis/oral mucositis as well as other toxicities.2

Abbreviations

ADC, antibody–drug conjugate; HER2–, human epidermal growth factor receptor 2-negative; HR+, hormone receptor positive; TROP2, trophoblast cell surface antigen 2.

References

  1. Bardia A, et al. J Clin Oncol. 2024;43:285–96.
  2. FDA. Datopotamab deruxtecan PI. Available at: https://bit.ly/3EdvjV3 (accessed 26 February 2025).
Question 2/5
Your patient with metastatic breast cancer is eligible for treatment with trastuzumab deruxtecan. Based on the safety profile of this ADC, which of the following do you do prior to treatment initiation?

ADC, antibody–drug conjugate; HbA1c, glycated haemoglobin.
 Correct

Left ventricular dysfunction is listed as a special warning and precaution in the US prescribing information and EU summary of product characteristics for trastuzumab deruxtecan.1,2 Standard cardiac function testing (electrocardiogram or multigated acquisition scanning) should be performed to assess left ventricular ejection fraction prior to initiation of trastuzumab deruxtecan and at regular intervals during treatment as clinically indicated.1,2

References

  1. FDA. Trastuzumab deruxtecan PI. Available at: https://bit.ly/4d4PjWd (accessed 26 February 2025).
  2. EMA. Trastuzumab deruxtecan SmPC. Available at: https://bit.ly/4bmhRtk (accessed 26 February 2025).
Question 3/5
Which of the following is an effective way of communicating ADC-related side effects to patients?

ADC, antibody–drug conjugate.
 Correct

The clinical information and treatment decisions that patients must make are complex and often overwhelming.1 A systematic knowledge building approach, which starts by educating patients with simple information about key facts related to their treatment, can be effective in improving knowledge about complex treatment trade-offs.1 Studies have shown that communication interventions tailored to the communication needs of patients with cancer and/or family members increased acceptance of the intervention and improved completion rate.2 The content, style, timing and preference needs of patients and/or caregivers should be considered.2 Providing a printed copy of the information ensures the patient can review the discussion later without relying on memory.3

References

  1. Hawley ST, et al. Trials. 2023;24:16.
  2. Li J, et al. J Oncol. 2020;2020:7432849.
  3. National Cancer Institute. 2025. Available at: www.cancer.gov/about-cancer/coping/adjusting-to-cancer/communication-pdq (accessed 26 February 2025).
Question 4/5
In a follow-up call with a patient who is receiving treatment with trastuzumab emtansine, they mention feeling very tired and lethargic. They are not experiencing any other symptoms and you rule out any potentially more serious underlying causes of the fatigue. How would you help your patient?
 Correct

American Society of Clinical Oncology guidelines for supportive care during cancer treatment are based on a systematic review of the literature and expert panel recommendations.1 The guidelines state that oncology providers should recommend aerobic and resistance exercise to patients during active cancer treatment to mitigate side effects of treatment, including fatigue.1 Independent systematic reviews have shown that exercise programmes implemented during or after cancer treatments can have a positive impact on fatigue reduction in patients with breast cancer.2,3

References

  1. Ligibel JA, et al. J Clin Oncol. 2022;40:2491–507.
  2. Belloni S, et al. Acta Oncol. 2021;60:1678–87.
  3. Zhou H-J, et al. Support Care Cancer. 2022;30:10421–40.
Question 5/5
Your patient telephones 2 weeks after their first dose of sacituzumab govitecan, noting recent onset of diarrhoea (4–5 stools per day) and abdominal cramping. In addition to recommending fluid and electrolyte replacement, what do you do to help your patient with these side effects?
 Correct

The US prescribing information and EU summary of product characteristics for sacituzumab govitecan include a special warning and precaution for severe diarrhoea.1,2 Clinical trial data showed the median time to onset of diarrhoea following the start of the first treatment cycle was 13 days and the median duration of diarrhoea was 8 days.2 Patients who experience diarrhoea while receiving sacituzumab govitecan should be evaluated for infectious causes; if negative, loperamide should be initiated promptly1,2 and discontinued 12 hours after the diarrhoea resolves.1 Patients should be monitored and given fluid and electrolytes as needed.1,2 Sacituzumab govitecan should not be administered in patients with grade 3 or 4 diarrhoea at the time of scheduled treatment and treatment should only be continued when resolved to grade ≤1.1,2

References

  1. FDA. Sacituzumab govitecan PI. Available at: https://bit.ly/3Ym55XM (accessed 26 February 2025).
  2. EMA. Sacituzumab govitecan SmPC. Available at: https://bit.ly/4eOONwE (accessed 26 February 2025).
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