Objectives
  • To be able to perform specialist assessment, treatment and counselling of patients who are receiving systemic therapy, including chemotherapy, (anti)hormonal therapy, biological therapy, targeted therapy or immunotherapy, for their specific cancer

Awareness
  • Awareness of the existence of the different types of cancer chemotherapy agents

  • Awareness of the existence of the different types of (anti)hormonal agents

  • Awareness of the existence of the different types of biological agents

  • Awareness of the existence of the different types of targeted agents

  • Awareness of the existence of the different types of immunotherapy agents

  • Awareness of the importance of the multimodality approach to treat individual cancers with locally advanced disease

  • Awareness of the importance of the multimodality approach to treat individual cancers with advanced, metastatic disease

  • Awareness of the importance of using biomarkers to administer personalised therapy for patients with specific cancer types

Knowledge
  • Knowledge of the classification of an anticancer agent as cytotoxic chemotherapy, (anti)hormonal agent, biological agent, targeted agent and/or immunotherapy

  • Knowledge of the specific mechanisms of action of an individual anticancer agent

  • Knowledge of the specific mechanisms of resistance that have been identified for an individual anticancer agent

  • Knowledge of key clinical pharmacology principles of individual anticancer agents, including absorption, distribution, metabolism and clearance/elimination (ADME)

  • Knowledge of the main clinical indications for an individual anticancer agent

  • Knowledge of the recommended dosing for an individual anticancer agent and how to adapt it to individual tolerability

  • Knowledge of food–drug interactions for an individual anticancer agent, especially as they relate to the use of oral anticancer therapy

  • Knowledge of drug–drug interactions, which include drug–herb and drug–nutritional supplement interactions, for an individual anticancer agent

  • Knowledge of the main side effects associated with an individual anticancer agent

  • Knowledge of the specific black-box warnings for an individual anticancer agent

  • Knowledge of dosing of an individual anticancer agent in the setting of liver and/or kidney dysfunction (see subsection 4.12)

  • Knowledge of specific considerations for an individual anticancer agent, such as potential interactions with the oral anticoagulants coumarin or warfarin, monitoring for signs and symptoms of fluid retention, close monitoring of complete blood counts (CBCs), monitoring of QT interval, monitoring for infusion reactions etc

  • Knowledge of the use of molecular biomarkers and specific diagnostic tests for the selection of targeted agents in the treatment of specific cancer types (see subsection 4.2)

  • Knowledge of newly registered anticancer agents and their indication

Skills
  • Ability to contribute to discussions on the role of anticancer agents for the treatment of individual cancer types

  • Ability to contribute to multimodality discussions as to the specific role of anticancer agents and to determine the optimal sequence for the multidisciplinary strategy

  • Ability to prescribe anticancer agents as monotherapy and in combination regimens with other anticancer agents, such as immunotherapeutic agents, targeted agents and/or with radiation therapy

  • Ability to adequately appreciate the role of anticancer agents in the neoadjuvant treatment setting for patients with locally advanced disease

  • Ability to adequately appreciate the role of anticancer agents in the adjuvant setting following surgical resection of the primary tumour

  • Ability to adequately appreciate the role of anticancer agents in the treatment of advanced, metastatic disease

  • Ability to adequately appreciate the key clinical factors (such as performance status, age, presence of comorbid illnesses, prior therapies and organ functional status) that are important for considering when to initiate and when to stop treatment with anticancer agents

  • Ability to prescribe and administer chemotherapeutic agents parenterally

  • Ability to assess how to administer targeted therapy according to the molecular marker status of the individual cancer type

  • Ability to prevent and/or manage the short-term acute side effects associated with anticancer agents including prevention and management of chemotherapy extravasation (see chapter 4.3.6)

  • Ability to prevent and/or manage the long-term chronic side effects associated with anticancer agents (see chapter 4.3.6)

  • Ability to contribute actively to discussions on the pros and cons of treatment choice and alternative treatment strategies with patients