Optimizing Outcomes for Patients with Urothelial Carcinoma

Release Date: September 27, 2019
Expiration Date: September 27, 2020

This educational activity is jointly provided by AXIS Medical Education and the Association of Community Cancer Centers (ACCC).

This activity is supported by educational grants from AstraZeneca Pharmaceuticals LP, Genentech, Astellas, and Seattle Genetics, Inc.

Target audience

The target audience for this initiative includes medical oncologists, urologic oncologists, urologists, advanced practice providers (nurse practitioners, physician assistants, oncology pharmacists), oncology nurses, and other healthcare professionals (HCPs) involved in treating patients with urothelial carcinoma.


Bladder cancer is the most common malignancy in the urinary system. Urothelial carcinoma accounts for 90% of bladder cancers. With the evolving treatment landscape for urothelial carcinoma, community clinicians are challenged to keep abreast with evidence-based practice guidelines, the clinical efficacy for new therapies, monitoring and managing adverse events, and engaging patients sufficiently to help them make informed treatment decisions.

Since community oncologists treat many types of cancers, it is hard for them to gain requisite experience across all tumor types and keep abreast of the evidence-based guidelines for all the cancers. In a recent survey of community cancer care professionals conducted by the Association of Community Cancer Centers (ACCC) in 2018, bladder cancer was reported to be one of the most commonly diagnosed cancers at their cancer center/hospital, after the top 4 most commonly diagnosed cancers in the country, breast, lung, prostate and colorectal cancer. Several knowledge, competence and performance gaps exist in the optimal management of urothelial cancer in the community setting. This initiative will review the mechanism of action for immunotherapies and emerging targeted therapies, summarize recent clinical data for these therapies, and examine best practices for the management of advanced and metastatic urothelial carcinoma. This initiative aims to provide guidance to the multidisciplinary cancer care team on the practical issues and barriers associated with new and emerging therapies in the community setting and strategies to engage patients in the shared decision-making process.


At the end of this educational initiative, for patients with locally advanced or metastatic urothelial carcinoma, participants should be able to …

  • Review available evidence for the use of checkpoint inhibitors and novel agents, including antibody drug conjugates and fibroblast growth factor receptor (FGFR) inhibitors
  • Explore strategies for identification and management of immune-related and FGFR inhibitor-associated adverse events
  • Discuss approaches to communicate safety and efficacy data to facilitate shared clinical decision making
  • Outline effective solutions for improving coordination and communication within the multidisciplinary cancer care team to improve patient outcomes


  • Welcome, Pre-Activity Assessment and Introductions...10 mins
  • Choosing the right therapy... 20 mins
    • Available evidence for immune checkpoint inhibitors, newly approved fibroblast growth factor receptor (FGFR) inhibitor, and antibody drug conjugates
    • Challenges in individualizing and optimizing therapy sequencing
  • Understanding the nuances of administering immunotherapy... 10 mins
    • Identification and optimal management of immune-related and FGFR inhibitor-associated adverse events
  • Educating the multidisciplinary care team and patients...10 mins
    • Care coordination and communication within the care team
    • Shared decision-making
  • Program Evaluation and Post-Activity Assessment...10 mins

Your Faculty

Archana Ajmera, NP, AOCNP
Advance Practice Provider Supervisor
UCSD Moores Cancer Center
Division of Hematology/Oncology

Kirollos S. Hanna, PharmD, BCPS, BCOP
Assistant Professor of Pharmacy, Mayo Clinic College of Medicine;
Hematology/Oncology Clinical Pharmacist, Univ. of Minnesota Medical Center & Mayo Clinic; 
Pharmacist, CVS Health
President, Minnesota Society of Health-System Pharmacists (Southern Affiliate)

Petros Grivas, MD PhD
Associate Professor, Department of Medicine, Division of Oncology
Clinical Director, Genitourinary Cancers Program
Interim Research Director, Phase I Program
University of Washington
Associate Member, Clinical Research Division
Fred Hutchinson Cancer Research Center

Accreditation Statement

Jointly Accredited Provider LogoIn support of improving patient care, this activity has been planned and implemented by AXIS Medical Education and Association of Community Cancer Centers (ACCC). AXIS Medical Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


This activity was planned by and for the healthcare team, and learners will receive 1.0 Interprofessional Continuing Education (IPCE) credit for learning and change.

Credit Designation for Physicians
AXIS Medical Education designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credit Designation for Nursing
AXIS Medical Education designates this continuing nursing education activity for 1.0 contact hours.

Learners are advised that accredited status does not imply endorsement by the provider or ANCC of any commercial products displayed in conjunction with an activity.

AXIS Contact Information
For information about the accreditation of this program please contact AXIS at info@axismeded.org.

Disclosure of Conflicts of Interest

AXIS Medical Education requires instructors, planners, managers and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by AXIS for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity:

Name of  Planner / Manager / Reviewer / AdvisorReported Financial Relationship
Archana Ajmera, NP, AOCNP                                                                                                                                                                                                                                                                     

Nothing to disclose   

Kirollos S. Hanna, PharmD, BCPS,BCOP                          

Consultant: Seattle Genetics. Serve(d) as a speaker or a member of a speaker’s bureau for: AbbVie Inc.; Seattle Genetics

Petros Grivas, MD PhD

Consultant: AstraZeneca Pharmaceuticals LP; Bayer Pharmaceuticals Corp; Clovis Oncology; Driver; EMD Serono, Inc.; Foundation Medicine, Inc.; Heron Therapeutics; Janssen Pharmaceuticals, Inc. - a pharmaceutical company of Johnson & Johnson; Merck & Co., Inc.; Mirati Therapeutics, Inc.; Pfizer, Inc.; QED Therapeutics; Seattle Genetics. Contracted Research: Bavarian Nordic; Bristol Myers Squibb Co.; Clovis Oncology; Debiopharm; Immunomedics, Inc.; Pfizer, Inc.

The planners and managers reported the following financial relationships or relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity:

Name of Planner / Manager / Reviewer / AdvisorReported Financial Relationship

Latha Shivakumar, PhD                             
Nothing to disclose 
Mary Stanley, PMPNothing to disclose 
Leigh M. Boehmer, PharmD, BCOPNothing to disclose 
Marilyn Haas, PhD, RN, CNS, ANP-BCNothing to disclose 
Dee Morgillo, MEd.,CHCPNothing to disclose 
Linda Gracie KingNothing to disclose
Robert Mocharnuk MDCommon Stock: Merck


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. 

Method of Participation and Request for Credit

To receive credit for this activity, participants must review the activity information including learning objectives and faculty/planner disclosures and actively participate in the educational activity. Upon successfully completing the post-test with a score of 75% or better and the post-activity evaluation, your certificate will be made available immediately.


Pre-activity Assessment
5 Questions
Course Content
Open to view video.
Open to view video. After viewing the lecture, please complete the post assessment and the course evaluation to receive CE credit
Post-activity Assessment
4 Questions  |  3 attempts  |  3/4 points to pass
4 Questions  |  3 attempts  |  3/4 points to pass Please take a moment to complete this post-assessment. This assessment is graded. Passing score is required to obtain CE credit.
Course Evaluation
11 Questions
11 Questions This evaluation must be completed to receive credit for this course. Estimated time to complete is 5 minutes.
CME/CNE/Certificate of Participation
Up to 1.00 medical credits available  |  Certificate available
Up to 1.00 medical credits available  |  Certificate available Please note: If you have completed a course prior to May 2020 and need a copy of your CME or CNE certificate, please email rburtnick@accc-cancer.org and include your full name, credentials, course name, and email address.