Curriculum standards

• For each pharmacological therapy:
  • assessment and adaptation of dose and scheduling
  • pharmacology:
    • pharmacogenomics
    • pharmacokinetics
  • radiotherapy:
    • basic scientific principles and logistics
    • benefits and risks
    • indications
    • the role of concurrent chemotherapy as a radiosensitiser, and common chemoradiation regimens
  • specific dosing considerations
  • supportive care, such as antiemetics and bone modifying agents
  • surgery:
    • indications in primary and palliative settings
  • toxicity profile and monitoring (acute and long term)

Major therapies used in cancer

• Systemic anticancer therapies:
  • antibody-drug conjugates
  • chemotherapy
  • hormonal agents
  • immune checkpoint inhibitor therapy
  • molecularly targeted therapy
  • monoclonal antibodies
  • theranostics
  • tumour vaccines
  • tyrosine kinase inhibitors

• Cancer stage and goals of care
• Identification and assessment of special conditions that influence the treatment of older people with malignant disorders
• Identification of the potential effect of patients’ comorbid medical conditions on the toxicity and efficacy of treatment
• Impact of cultural, geographical, psychological, socioeconomic, and spiritual factors in the accessibility and suitability of specific treatments
• Indications for specific anticancer therapies (pharmacological and non-pharmacological) in different settings, such as:
  • adjuvant
  • concomitant
  • definitive
  • neoadjuvant
  • palliative

• Indications and role of repeat biopsies and predictive testing:
  • repeating immunohistochemistry or molecular testing after progression to guide future therapy
• Management of complex presentations:
  • conflicts in care decisions
  • delayed diagnoses
  • oncological emergencies
  • pregnancy
  • recognition of complex interplay between:
    • care wishes
    • medical and psychological comorbidities
    • socioeconomic and cultural factors in patient presentations
    • therapy choices
• Principles and indications for specific predictive testing, such as:
  • dihydropyrimidine dehydrogenase enzyme deficiency testing when considering fluoropyrimidine-based chemotherapy
  • role of molecular oncology in guiding treatment decisions

• Administration management of chemotherapy:
  • informed consent for treatment
  • management of extravasation
  • management of infusion reactions
  • types of venous access devices, management, and complications
• Education of patients on identifying and managing toxicities related to anticancer therapies, including prompts for emergency escalation
• Identification, assessment, and management of the unique toxicities associated with immune checkpoint inhibitors, including:
  • cardiotoxicity
  • cutaneous toxicity
  • endocrinopathies, including such as thyroid toxicity
  • gastrointestinal toxicity, including colitis
  • haematological toxicity
  • hepatotoxicity
  • musculoskeletal toxicity
  • neurological toxicity
  • ocular toxicity
  • pulmonary toxicity
  • renal toxicity
• Identification, assessment, and management of toxicities of systemic anticancer therapies, such as:
  • constipation
  • cytokine release syndrome (CRS)
  • cytopenia and use of granulocyte-colony stimulating factors
  • diarrhoea
  • fatigue
  • febrile neutropenia and infections
  • impact on sex and fertility
  • mucositis
  • nausea and vomiting:
    • cardiac toxicities
    • cutaneous toxicities
    • neuropathy
    • ocular toxicities
    • organ-specific effects
    • pneumonitis
• Knowledge of biochemical, clinical, and radiological markers of responsiveness to therapy
• Supportive treatments during anticancer therapy:
  • complementary therapies
  • including role for multidisciplinary care