Advances in Extended Adjuvant HER2-Positive Early Breast Cancer

A continuing education activity for nurse practitioners, PAs, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians.

This activity is supported by an unrestricted educational grant from Puma Biotechnology.

Release date: January 26, 2018                        Estimated time to complete activity: 1.5 hours
Expiration date: January 26, 2019


G. Thomas Budd, MD
Taussig Cancer Center at Cleveland Clinic

Wendy H. Vogel, MSN. FNP, AOCNP®
Wellmont Cancer Institute

Activity Rationale and Purpose

For women, breast cancer is the most frequently diagnosed tumor type and remains the second leading cause of cancer death. In 2017, it was estimated 252,710 new cases of breast cancer would be diagnosed in women in the United States. HER2 (ERBB2)-positive breast cancer comprises approximately 20 to 25% of the entire breast cancer population. HER2 protein overexpression or HER2 gene amplification in breast cancer tumors is associated with more aggressive clinical disease and a poorer prognosis. The current standard of care for patients with HER2-positive early stage breast cancer is surgery and radiation followed by chemotherapy and one year of adjuvant trastuzumab, and women with hormone-sensitive tumors will also receive a course of endocrine therapy. However, approximately 20% of patients with HER2-positive early breast cancer will recur within 5 years after adjuvant therapy. A variety of phase 3 clinical trials are evaluating novel agents that could potentially improve patient outcomes. Oncology advanced practitioners (APs) need to be familiar with data from these trials so they can incorporate novel agents into clinical practice.

Intended Audience

The intended audience for this enduring internet activity is nurse practitioners, PAs, clinical nurse specialists, advanced degree nurses, hematology/oncology nurses, pharmacists, and physicians who specialize in the field of oncology.

Learning Objectives

After completing this educational activity, participants should be able to:

  • Describe the mechanisms of action of novel extended adjuvant therapies for early HER2-positive breast cancer
  • Utilize evidence-based strategies for prophylaxis of diarrhea and other side effects
  • Optimize patient selection for treatment with extended adjuvant therapies
  • Implement HER2-status testing in accordance with the latest clinical practice guidelines

Continuing Education

Statement of Credit—Participants who successfully complete this activity (including the submission of the post-test and evaluation form) will receive a statement of credit.


This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the Annenberg Center for Health Sciences at Eisenhower, the Advanced Practitioner Society for Hematology and Oncology, and the Journal of the Advanced Practitioner in Oncology. The Annenberg Center is accredited by the ACCME to provide continuing medical education for physicians.

The Annenberg Center for Health Sciences at Eisenhower designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Annenberg Center for Health Sciences is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
A maximum of 1.5 contact hours may be earned for successful completion of this activity.

Provider approved by the California Board of Registered Nursing, Provider No. 13664, for 1.5 contact hours.


This knowledge-based accredited education lecture is intended for pharmacists involved in the care of cancer patients. This educational activity is sponsored by the Annenberg Center for Health Sciences at Eisenhower.

The Annenberg Center for Health Sciences at Eisenhower is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program has been assigned ACPE Universal Program # 0797-9999-18-032-H01-P. This program is designated for up to 1.5 contact hours (0.15 CEUs) of continuing pharmacy educational credit.

Financial Disclosures

All individuals in positions to control the content of this activity (eg, planners, faculty, content reviewers) are expected to disclose all financial relationships with commercial interests that may have a direct bearing on the subject matter of this continuing education activity. Participants have the responsibility to assess the impact (if any) of the disclosed information on the educational value of the activity.


Dr. Budd has received research funding from CytRx, Eisai, Genentech, and Tracon.

Ms. Vogel has served on speakers’ bureaus for AMAG, Celgene, Genentech, Ipsen, Janssen, Novartis, Pfizer, and Takeda.

Lead Nurse Planner

Dorothy Caputo, MA, BSN, RN, has nothing to disclose.


Jeannine Coronna has nothing to disclose.
Claudine Kiffer has nothing to disclose.
Pamela Hallquist Viale, RN, MS, CS, ANP, has nothing to disclose.
Patricia McLafferty has nothing to disclose.
Chris Cherry has nothing to disclose.
Lynn Rubin has nothing to disclose.
Annie Yueh has nothing to disclose.

Content Reviews
Dorothy Caputo, MA, BSN, RN has nothing to disclose.

Annenberg Center for Health Sciences at Eisenhower
John Bayliss, VP, Business Development, spouse is an employee of Amgen, Inc.; Charles Willis, Director, Continuing Education, consults for Pfizer Inc.; all other staff at the Annenberg Center for Health Sciences at Eisenhower have no relevant commercial relationships to disclose.


This activity has been designed to provide continuing education that is focused on specific objectives. In selecting educational activities, clinicians should pay special attention to the relevance of those objectives and the application to their particular needs. The intent of the Annenberg Center for Health Sciences, Harborside Medical Education, and JADPRO for all educational opportunities is to provide learning that will improve patient care. Clinicians are encouraged to reflect on this activity and its applicability to their own patient population.

The opinions expressed in this activity are those of the faculty and reviewers and do not represent an endorsement by Harborside Medical Education of any specific therapeutics or approaches to diagnosis or patient management.

Product Disclosure

This educational activity may contain discussion of published as well as investigational uses of agents that are not approved by the U.S. 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.

How to Earn Credit

Statement of Credit: Participants who successfully complete this activity (including scoring of a minimum of 70% on the learning assessment and complete and submit the evaluation form) will be able to download a statement of credit.

Course summary
Available credit: 
  • 1.50 ACPE
  • 1.50 AMA PRA Category 1 Credit(s)™
  • 1.50 Attendance
  • 1.50 ANCC
Course opens: 
Course expires: 

Available Credit

  • 1.50 ACPE
  • 1.50 AMA PRA Category 1 Credit(s)™
  • 1.50 Attendance
  • 1.50 ANCC


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