Estimated Time to Complete Activity: 30 minutes

Chronic myeloid leukemia (CML) accounts for approximately 20% of adult leukemias diagnosed in the United States. CML is characterized by the presence of the Philadelphia chromosome, which is generated through a translocation between chromosomes 9 and 22 and creates the BCR-ABL oncogene. The resultant BCR-ABL protein has constitutive tyrosine kinase activity and affects the transformation, growth, and survival of hematopoietic cells.

Imatinib was the first tyrosine kinase inhibitor (TKI) of the BCR-ABL protein to be developed and is now considered the standard of care for first-line treatment of CML. Despite high response rates to imatinib, the development of resistance to therapy, particularly for those with advanced CML, has emerged as a major problem. The second-generation BCR-ABL TKIs, dasatinib and nilotinib, were subsequently developed to combat imatinib-resistant disease. However, not all imatinib-resistant clones respond to treatment and some clones develop resistance to second-line TKIs. Thus, new agents and combination strategies are being developed to further improve the outcomes of patients with CML. At the end of this program, participants will be able to describe the optimal use of TKI therapies in the first- and second-line settings, and the importance of prompt recognition and classification of imatinib resistance.

This activity is intended for hematologists, oncologists, nurses, pharmacists, physician assistants, and other healthcare professionals involved in the treatment and management of patients with CML.

Upon completion of this activity, participants will be able to

1. Discuss therapeutic options for overcoming primary and secondary resistance to therapy for CML.
2. Discuss novel strategies under investigation for imatinib-resistant or relapsing disease that may impact treatment of patients with CML.

This radio program will be made available on www.reachmd.com/weekendcme and www.thecbce.com.

This activity can be accessed using an iPhone^® or iPod touch^® and will be a featured program on the CBCE CME App and ReachMD MedicalRadio iPhone App, which may be downloaded from the Apple^® App Store.

Physicians: The CBCE™ (The Center for Biomedical Continuing Education) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The CBCE designates this educational activity for a maximum of .50 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in this activity.

Physician Assistants: AAPA accepts certificates of participation for educational activities certified for Category 1 credit from AOACCME, Prescribed credit from AAFP, and AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of .50 hour of Category 1 credit for completing this program.

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 .50 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.

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

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.

The CBCE gratefully acknowledges the educational grant provided by Bristol-Myers Squibb Company.

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.

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 or Bristol-Myers Squibb Company. 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 activity.

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.

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.

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:

Jane F. Apperley, MBChB, MD, FRCP, FRCPath
Grant/Research Support
Genzyme Corporation - Imperial College Healthcare NHS Trust received remuneration 
Honoraria
Bristol-Myers Squibb Company
Novartis Pharmaceuticals Corporation

Jorge E. Cortes, MD
Grant/Research Support
Bristol-Myers Squibb Company
Novartis Pharmaceuticals Corporation
Wyeth Pharmaceuticals Inc.

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

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