Volume 7 Number 2

Multidisciplinary Practice Management Case Study Series in Cutaneous T-Cell Lymphoma (CTCL)

ACTIVITY RELEASE DATE: December 28, 2009

ACTIVITY EXPIRATION DATE: December 27, 2010

ACTIVITY LAST REVIEW DATE: December 28, 2009

AMOUNT OF CME CREDIT: A maximum of 3.5 AMA PRA Category 1 Credits™

LENGTH OF TIME FOR COMPLETION: 3.5 hours

To obtain CME Credit for completing this activity, click on this link

Completion Instructions and How to Obtain CME Credit*

• To obtain AMA PRA Category 1 Credit™ for completing this activity, click on this link
• Follow registration instructions, review CME information
• Complete pre-test
• Read cases
• Complete post-test and evaluation instrument (If you haven't completed the activity in one sitting, you may be required to login to the CME website again before the post-test is available.)
• Print or save certificate

Please contact the Office of CME at the University of Pennsylvania School of Medicine with any questions via phone, 215-898-8005, or email, penncme@mail.med.upenn.edu

Jointly Sponsored by

COMMERCIAL SUPPORT

Supported by an educational grant from Eisai Pharmaceuticals.

PROGRAM OVERVIEW

Cutaneous T-Cell Lymphomas (CTCL) are a heterogeneous group of extranodal non-hodgkin's lymphomas beginning in skin. The clinical presentations of CTCLs are highly variable between patients. In particular, the most common CTCL, called mycosis fungoides and the leukemic variant, Sezary Syndrome, mimick benign inflammatory skin diseases, making an accurate diagnosis difficult and delaying start of therapy. Despite the availability of new classification systems and guidelines for diagnosis, CTCLs remain clinical challenging and are often addressed on a case-by-case basis. In addition, the increased use of combination therapies, as well as new regimens for advanced and refractory CTCL that are in development, present physicians with multiple treatment considerations. Multidisciplinary Practice Management Case Study Series in Cutaneous T-Cell Lymphoma (CTCL) will review the new guidelines and classification systems for CTCL, and present case-based, peer-to-peer learning that reviews rationale and current treatment practices.

TARGET AUDIENCE

This activity has been designed for dermatologists, hematology oncologists, radiation oncologists, and dermatopathologists who are involved in the diagnosis and treatment of CTCL.

EDUCATIONAL OBJECTIVES

Upon completion of this course, participants should be able to:

• Explain how the new guidelines impact the management of CTCL in their patients and practice
• Stage their CTCL patients in accordance with the new classification system
• Enhance the specificity and accuracy of their CTCL diagnoses by incorporating guidelines and classification systems with real-world knowledge and experiences
• Discuss the rationale for and appropriate use of combination therapy in CTCL
• Identify the new agents currently in development for CTCL and their potential role in CTCL management

FACULTY

Chair:

Madeleine Duvic, MD

Professor of Medicine and Dermatology (with tenure), Department of Dermatology, Division of Internal Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX

Deputy Chair, Department of Dermatology, Division of Internal Medicine, UT-MDACC, Houston, TX

Director of the Research Fellowship Program, Department of Dermatology, Division of Internal Medicine, UT-MDACC, Houston, TX

Professor of Medicine and Dermatology, The University of Texas Medical School at Houston (UTMSH), Houston, TX

Faculty:

Oleg E. Akilov, M.D., Ph.D.
Instructor
Clinical Fellow in Cutaneous Oncology
Department of Dermatology
University of Pittsburgh
Pittsburgh, PA 15213

Thomas F Anderson MD
Associate Professor Dermatology
Medical Director Dermatology Treatment Center and Phototherapy
University of Michigan Hospitals
Co-director Cutaneous Lymphoma Program Cancer Center
Ann Arbor, MI

Seema J Daulat, MD
Division of Internal Medicine, Department of Dermatology
The University of Texas M.D. Anderson Cancer Center
Houston, TX

Francine Foss, MD
Professor of Medicine
Assistant Director of Clinical Investigation Hematologic Malignancies
Medical Oncology
Yale Cancer Center
New Haven, CT

Matthew C Fox, MD
Department of Dermatology
University of Michigan
Ann Arbor, MI

Larisa Geskin, MD, FAAD
Director, Cutaneous Oncology and Photopheresis Unit
Dermatology Residency Program Director
Department of Dermatology
University of Pittsburgh
Pittsburgh, PA

Ellen J. Kim, MD
Assistant Professor of Dermatology
Department of Dermatology
University of Pennsylvania
Philadelphia, PA

Youn H. Kim, MD
Joanne and Peter Haas Jr. Professor
for Cutaneous Lymphoma Research
Director, Multidisciplinary Cutaneous Lymphoma Program
Medical Director, Photopheresis Service
Redwood City, CA

Stuart Lessin, MD
Director of Dermatology
Fox Chase Cancer Center
Philadelphia, PA

Jeff Messenger, MD
Division of Hematology-Oncology
Comprehensive Cancer Center
The Ohio State University
Columbus, OH

Elise A. Olsen, MD
Professor of Dermatology and Oncology
Director, Cutaneous Lymphoma Research and Treatment Center
Duke University Medical Center
Durham, NC

Sareeta R. S. Parker, MD
The Emory Clinic
Associate Professor of Dermatology
Co-Director, Dermatology Clinical and Outcomes Research Unit
Emory University Hospital
Chief, Grady Dermatology
Grady Memorial Hospital
Atlanta, GA

Lauren Pinter-Brown, MD
Clinical Professor of Medicine
Geffen School of Medicine at UCLA
Director, UCLA Lymphoma Program

Pierluigi Porcu, MD
Associate Professor of Medicine
Division of Hematology-Oncology
Comprehensive Cancer Center
The Ohio State University
Columbus, OH

Christiane Querfeld, MD, PhD
Section of Dermatology
Department of Medicine
University of Chicago
Chicago, IL

Rakhshandra Talpur, MD
Division of Internal Medicine, Department of Dermatology
The University of Texas M.D. Anderson Cancer Center
Houston, TX

John A. Zic, MD
Associate Professor of Medicine/Dermatology
Director, VU Cutaneous Lymphoma Clinic
Vanderbilt Dermatology
Vanderbilt University School of Medicine
Nashville, TN

Please contact the Office of CME at the University of Pennsylvania School of Medicine with any questions via phone, 215-898-8005, or email, penncme@mail.med.upenn.edu

ACCREDITATION

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Pennsylvania School of Medicine and PharmaCompass. The University of Pennsylvania School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

DESIGNATION OF CREDIT

The University of Pennsylvania School of Medicine designates this educational activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

DISCLOSURE

It is policy at the University of Pennsylvania School of Medicine for individuals who are in a position to control the content of an educational activity to disclose to the learners all relevant financial relationships that they have with any commercial interest that provides products or services that may be relevant to the content of this continuing medical education activity. For this purpose we consider relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.

The intent of this policy is not to prevent expert faculty with relevant relationship(s) with commercial interest(s) from involvement in CME, but rather to ensure that Penn CME-certified activities promote quality and safety, are effective in improving medical practice, are based on valid content, and are independent of control from commercial interests and free of commercial bias. Peer review of all content was conducted for all faculty presentations whose disclosure information provided to the Penn Office of CME was found to contain relationships that created a conflict of interest relative to the topic of their presentation. In addition, all faculty were instructed to provide balanced, scientifically rigorous and evidence-based presentations.

The staff in the Office of CME at the University of Pennsylvania School of Medicine, PharmaCompass, the joint sponsor, and the peer reviewer, Zalman Agus, MD, Associate Dean for Continuing Medical Education, have reported that they have no relevant financial relationships with any commercial interests related to the content of this educational activity.

The following individuals have disclosed that they have no relevant financial relationships with any commercial interests related to the content of this educational activity:

FACULTY NAME

• Oleg Akilov
• Seema J Daulat, MD
• Matthew Fox, MD
• Ellen Kim, MD
• Jeff Messenger
• Elise Olsen
• Sareeta Parker, MD
• Lauren Pinter-Brown, MD
• Pierluigi Porcu, MD
• Christiane Querfeld, MD, PhD
• Rakhshandra Talpur, MD
• John Zic, MD

The following individuals have reported the listed relevant financial relationships with commercial interests related to the content of this educational activity.

FACULTY NAME	NAME OF COMMERCIAL INTEREST	RELATIONSHIP
Thomas Anderson, MD	Eisai	Consultant
Madeleine Duvic, MD	Allos, Celgene, Curagen, Cyclacel, Dermatex, Genmab, HanaBiosciences, Hoffman-LaRoche, Memorial Sloan-Kettering, Ortho-Biotek MSK, Scott & White, TopoTarget, Yaupon	Investigator
	BioCryst, Kyowa Hakko Kirin Pharma (Biowa), Eisai	Consultant/Advisory Board
	Eli Lilly, Novartis, Vertex	Consultant
	Merck, Therakos	Advisory Board
Francine Foss, MD	Eisai Allos, Merck	Speaker Consultant
Larisa Geskin, MD, FAAD	Merck Therakos Eisai	Speaker Speaker, Advisory Board Consultant, Advisory Board
Youn H. Kim, MD	Eisai, Merck	Advisory Board
Stuart Lessin, MD	Yaupon Therapeutics	Consultant

Relevant Financial Relationships: Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received or expected.

INVESTIGATIONAL AND/OR OFF-LABEL USE OF COMMERCIAL PRODUCTS AND DEVICES

The University of Pennsylvania School of Medicine requires all faculty to disclose any planned discussion of an investigational and/or off-label use of a pharmaceutical product or device within their presentation. Participants should note that the use of products outside FDA-approved labeling should be considered experimental and are advised to consult current prescribing information for approved indications.

The following faculty reported specific mentions of off-label and/or investigational use of products within their presentations.

FACULTY	PRODUCT	INVESTIGATIONAL AND/OR OFF-LABEL USE
Thomas Anderson, MD	Acitretin	Used in conjunction with UV light for treatment of CTCL
Madeleine Duvic, MD	Combination therapies	Off label
Francine Foss, MD	Ontak Bexarotene	Peripheral T-cell lymphoma Peripheral T-cell lymphoma
Matthew Fox, MD	Acitretin	Off label
Ellen Kim, MD	Methotrexate PUVA Phototherapy Interferon alpha	Lymphomatoid Papulosis
Stuart Lessin, MD	Topical nitrogen mustard	Off label
Lauren Pinter-Brown, MD	Denileukin diflitox AZT/interferon	ATLL ATLL
Christiane Querfeld, MD, PhD	Lenalidomide	CTCL

Original Articles

Reviews

Case Reports

Letter to the Editor

Archived volumes

2009 - Volume 7 Number 2

2009 - Volume 7 Number 1

2008 - Volume 6 Number 2

2007 - Volume 6 Number 1

2007 - Volume 5 Number 2

2007 - Volume 5 Number 1

2006 - Volume 4 Number 2

2006 - Volume 4 Number 1

2006 - Volume 3 Number 2

2005 - Volume 3 Number 1

2004 - Volume 2 Number 2

2003 - Volume 2 Number 1

2002 - Volume 1 Number 2

2001 - Volume 1 Number 1