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Point-Counterpoint: Investigators Discuss and Debate Clinical Questions and Controversies in Non-Small Cell Lung Cancer
Released August 2017

Proceedings from a CME symposium held at the 2017 ASCO Annual Meeting. Featuring perspectives from Drs Ramaswamy Govindan, Leora Horn, Corey J Langer, Gregory J Riely and Jean-Charles Soria. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This program is intended for medical oncologists, hematology-oncology fellows and other allied healthcare professionals involved in the treatment of non-small cell lung cancer (NSCLC).

    OVERVIEW OF ACTIVITY
    Lung cancer is a devastating disease with a broad impact on public health: In the year 2017 it is estimated that 222,500 individuals will be diagnosed and 155,870 will die of the disease in the United States alone. A major focus of recent lung cancer research has been the development of molecular-targeted agents and the identification of biomarkers to help guide treatment selection for individuals who harbor specific oncogenic alterations. This and a number of subsequent drug approvals have created a paradigm shift in the way patients with advanced NSCLC are initially stratified and counseled, moving from a “one-size-fits-all” approach to a customized, biomarker-driven treatment algorithm. In addition, deeper insights into how to harness the body’s immune system are now being applied to the management of this lethal disease, stemming from an improved understanding of the mechanism of tumor immune response and its evasion by certain cancers. The advent of these treatment options presents new promise of efficacy and safety for patients with lung cancer but also poses a challenge to oncologists and their support staff in appropriately selecting individuals who may benefit from specific agents and in determining how to integrate these therapies into standard treatment algorithms.

    These video proceedings from a CME symposium held during the 2017 ASCO Annual Meeting feature renowned lung cancer clinical investigators weighing in on challenging questions and cases from a panel of community-based general oncologists and reviewing relevant data. By providing information on the latest research developments and their potential application to routine practice, this activity is designed not only to improve clinicians’ knowledge of the rapidly evolving oncology treatment landscape but also to provide them with practical perspectives to help them become better and more effective caregivers.

    LEARNING OBJECTIVES

    • Design evidence-based strategies for the management of localized and locally advanced NSCLC, considering the potential contributions of systemic and local therapeutic modalities.
    • Compare and contrast expert perspectives on the indications for mutation and/or PD-L1 analysis for patients with localized and metastatic NSCLC, and, when appropriate, use validated testing platforms to obtain this information.
    • Review recent FDA approvals and available research data documenting the safety and efficacy of pembrolizumab alone or in combination with carboplatin/pemetrexed for patients with previously untreated metastatic NSCLC, and use this information to appropriately integrate the use of pembrolizumab into this setting.
    • Consider age, performance status and other patient- or disease-related factors to guide the selection of first-line therapy for patients with newly diagnosed metastatic squamous and nonsquamous NSCLC without an identifiable driver mutation.
    • Appreciate available clinical trial data documenting the efficacy of necitumumab and ramucirumab in metastatic NSCLC, and discern how these agents can be optimally integrated into clinical practice for patients with PD-L1-positive and PD-L1-negative squamous and nonsquamous disease.
    • Educate patients about the side effects associated with recently approved novel agents and immunotherapeutic approaches, and provide preventive strategies to reduce or ameliorate these toxicities.
    • Consider published safety and efficacy data with available and emerging targeted therapeutic strategies, and appropriately incorporate these therapies into the care of patients with identified tumor driver mutations or alterations.
    • Recall the scientific rationale for ongoing investigation of novel agents or therapeutic approaches in NSCLC, and counsel appropriately selected patients about study participation.

    ACCREDITATION STATEMENT
    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CREDIT DESIGNATION STATEMENT
    Research To Practice designates this enduring material for a maximum of 2.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
    Successful completion of this CME activity,which includes participation in the evaluation component, enables the participant to earn up to 2.25 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    Please note, this program has been specifically designed for the following ABIM specialty: medical oncology.

    Personal information and data sharing: Research To Practice aggregates deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of a video component. To receive credit, the participant should watch the video, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/ASCOLung17/CME.

    CONTENT VALIDATION AND DISCLOSURES
    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

    FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Ramaswamy Govindan, MD
    Professor of Medicine
    Co-Director, Section of Medical Oncology
    Division of Oncology
    Washington University School of Medicine
    St Louis, Missouri

    Advisory Committee: AbbVie Inc, Ariad Pharmaceuticals Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, INC Research, Roche Laboratories Inc; Consulting Agreements: AbbVie Inc, Ariad Pharmaceuticals Inc, Astellas Pharma Global Development Inc, Baxalta Inc, Bristol-Myers Squibb Company, Genentech BioOncology, INC Research; Contracted Research and Speakers Bureau: AbbVie Inc, Ariad Pharmaceuticals Inc, Baxalta Inc, INC Research.

    Leora Horn, MD, MSc
    Associate Professor of Medicine
    Clinical Director, Thoracic Oncology Research Program
    Assistant Vice Chairman for Faculty Development
    Vanderbilt University Medical Center
    Nashville, Tennessee

    Advisory Committee: Celgene Corporation, Genentech BioOncology, Lilly, Merck; Consulting Agreements: Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Xcovery; Other Remunerated Activities: EMD Serono Inc.

    Corey J Langer, MD
    Director of Thoracic Oncology
    Abramson Cancer Center
    Professor of Medicine
    Perelman School of Medicine
    University of Pennsylvania
    Vice Chair, Radiation Therapy Oncology Group
    Philadelphia, Pennsylvania

    Advisory Committee: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Genentech BioOncology, Lilly, Merck, Pfizer Inc, Roche Laboratories Inc, Takeda Oncology; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Eisai Inc, Genentech BioOncology, Lilly, Merck, Novartis, Pfizer Inc, Roche Laboratories Inc, Takeda Oncology; Contracted Research: Advantagene Inc, Ariad Pharmaceuticals Inc, GlaxoSmithKline, Inovio Pharmaceuticals Inc, Merck, Takeda Oncology; Data and Safety Monitoring Board: Amgen Inc.

    Gregory J Riely, MD, PhD
    Associate Attending
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Consulting Agreement: Genentech BioOncology; Contracted Research: Ariad Pharmaceuticals Inc, Astellas Pharma Global Development Inc, Novartis, Pfizer Inc.

    Jean-Charles Soria, MD, PhD
    Full Professor, Paris University XI
    Head of Drug Development Department
    Institut Gustave Roussy
    Villejuif, France

    Honoraria: Astex Pharmaceuticals, AstraZeneca Pharmaceuticals LP, GamaMabs Pharma, GlaxoSmithKline, Lilly, Merus BV, MSD, Pfizer Inc, Pharma Mar SA, Pierre Fabre, Roche Laboratories Inc, Sanofi Genzyme, Servier, Takeda Oncology, Symphogen A/S.

    MODERATOR AND CO-CHAIR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals Inc.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no relevant conflicts of interest to disclose.

    This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantor.

    This activity is supported by an educational grant from Lilly.

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
    Adobe Flash Player 10.2 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: August 2017
    Expiration date: August 2018

    After completing the Post-test, learners may download and review the answers here in order to identify further areas of study.

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