Statement of Need
Despite treatment advances, multiple myeloma (MM) remains an incurable disease for most patients and has a median survival of 4-5 years. In 2009, an estimated 20,580 new cases will be reported in the United States, and 10,580 patients are expected to die of the disease. High-dose chemotherapy followed by transplantation has led to improvement in response rates and survival times in patients, although disease relapse remains universal. High-risk patients with poor prognostic factors, such as loss of chromosome 13 (del13), >70 years of age, high serum levels of ß₂-microglobulin, or renal insufficiency, have a significantly poorer outcome. Clinical presentations of MM include destructive bone lesions, hypercalcemia, anemia, and renal failure. In addition, debilitating side effects from chemotherapy regimens such as peripheral neuropathy, deep vein thrombosis, cardiotoxicity, and dermatologic reactions can greatly impact overall survival and/or patient quality of life. The application of effective supportive care strategies can greatly improve patient care and extend life by eliminating the need for dosage reductions or discontinuation of therapeutic agents. As the use of novel therapeutic regimens expands, monitoring and managing drug side effects becomes especially important. By reducing comorbidities as well as minimizing complications arising from drug toxicities, healthcare professionals can augment treatment options for patients upon relapse.

Nurses contribute to all aspects of care for patients with MM. Their role is central to helping patients manage their disease and maintain the best possible quality of life. Important aspects of nursing a patient with MM include preventing and managing complications (of both the disease and its treatments) and being an accessible source of information and support. To achieve the latter, oncology nurses must be knowledgeable of the increasing number of treatment options for MM and of the effective strategies to manage the side effects of treatment. At the conclusion of this program, participants will be able to describe the novel treatment regimens for MM, identify potential side effects of drugs used to treat MM, and apply strategies for improving treatment outcomes by effectively managing drug-related adverse events.

Target Audience
This activity is intended for oncology nurses, nurse practitioners, and advanced practice nurses interested in identifying potential side effects of drugs used to treat MM, and improving treatment outcomes by effectively managing drug-related adverse events.

Educational Objectives
Upon completion of this activity, participants will be able to

1. Assess the current and emerging treatment approaches that combine targeted agents with chemotherapy for patients with MM.
2. Describe common adverse effects such as peripheral neuropathy and thromboembolic complications that can be expected in patients who receive novel agent–based therapies for MM.
3. Summarize adverse effects such as dermatologic reactions and cardiotoxicity that may be experienced by patients who receive chemotherapy for MM.
4. Evaluate management strategies for patients with MM who experience adverse events associated with current therapeutic regimens.

Method of Participation for Webcast
This activity requires that your computer be configured to access the Internet. A high-speed Internet connection may be required to view large files. The webcast will be available on www.thecbce.com and will also be a featured program on the CBCE CME app, which may be downloaded from the Apple^® App Store for use on the iPhone™ or iPod Touch^®.

Method of Participation for iPhone™ or iPod Touch^®
This activity can be accessed using an iPhone™ or iPod Touch^® and will be a featured program on the CBCE CME app, which may be downloaded from the Apple^® App Store.

Accreditation
Nurses: The CBCE™ (The Center for Biomedical Continuing Education) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

The CBCE designates this educational activity for 1.0 contact hour.

Accreditation by the American Nurses Credentialing Center’s Commission on Accreditation refers to recognition of educational activities and does not imply approval or endorsement of any product.

Webcast Credit Instructions
Successful completion of this activity includes the following:

• Score 70% or above on the posttest.
• Complete the Evaluation and Request for Credit Form.
• Fax the completed posttest and form to the CBCE, (214) 260-0509.

 Participants will receive their certificate 4-6 weeks after the CBCE receives their posttest and form.

CBCE CME App Credit Instructions
Successful completion of this activity includes the following:

• Complete the online posttest and score 70% or above.
• Complete the online Evaluation and Request for Credit Form.

Participants will receive their certificates via e-mail 4-6 weeks after submission of the online Evaluation and Request for Credit Form.

 Participants of the live activity are not eligible to receive credit for this activity.

Acknowledgement of Commercial Support
The CBCE gratefully acknowledges the educational grants provided by Celgene Corporation and Centocor Ortho Biotech Inc.

Educational Inquiries
For further information, please contact the CBCE, 1707 Market Place Blvd., Suite 370, Irving, TX 75063; Phone: (214) 260-9024; Fax: (214) 260-0509; E-mail: info@thecbce.com.

Disclaimer
The content and views presented in this educational activity are those of the faculty and do not necessarily reflect the opinions or recommendations of the CBCE, Celgene Corporation, or Centocor Ortho Biotech Inc. This material has been prepared based on a review of multiple sources of information but is not comprehensive. Participants are advised to critically appraise the information presented, and they are encouraged to consult the available literature on any product or device mentioned in this program.

Disclosure of Unlabeled Uses
This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the US Food and Drug Administration. For additional information about approved uses, including approved indications, contraindications, and warnings, please refer to the prescribing information for each product or consult the latest edition of the Physicians’ Desk Reference.

Disclosure of Financial Relationships With Any Commercial Interest
As a provider accredited by the ACCME, it is the policy of the CBCE to require that everyone who is in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest, and identify and resolve all conflicts of interest prior to the educational activity. The CBCE defines “relevant financial relationships” as any amount occurring within the past 12 months.

Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honorarium, ownership interest (eg, 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, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. The CBCE considers relationships of the person involved in the educational activity to include financial relationships of a spouse or partner.

Faculty who refuse to disclose relevant financial relationships will be disqualified from being a planning committee member, a teacher, or an author, and cannot have control of or responsibility for the development, management, presentation, or evaluation of the educational activity. For an individual with no relevant financial relationship, participants must be informed that no relevant financial relationship exists.

Disclosure of Potential Conflicts of Interest
The CBCE assesses conflicts of interest with its faculty, planners, and managers of CBCE activities. Identified conflicts of interest are thoroughly evaluated for fair balance, scientific objectivity relative to studies utilized in this activity, and patient-care recommendations. The CBCE is committed to providing participants with high-quality, unbiased, and state-of-the-art education.

The following faculty reported real or apparent conflicts of interest, and these conflicts have been resolved through a peer-review process:

Carol S. Viele, RN, MS, CNS, OCN^®
Honoraria
Bristol-Myers Squibb Company
Celgene Corporation
Merck & Co., Inc.
Novartis Pharmaceuticals Corporation


Institutional Disclosure
The CBCE receives educational grants from the pharmaceutical industry and other commercial sources. Companies providing grants to the CBCE include the commercial supporters of this activity as well as the manufacturers of certain drugs and/or devices discussed in this activity.

Staff Disclosure
The CBCE staff have declared they have no financial relationships that require disclosure.