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Consensus or Controversy? Clinical Investigators Provide Perspectives on the Current and Future Role of Immune Checkpoint Inhibitors in the Management of Lung Cancer
Released March 2018

Proceedings from a CME symposium held at the 2018 ASCO-SITC Clinical Immuno-Oncology Symposium. Featuring perspectives from Drs Matthew D Hellmann, Corey J Langer, David R Spigel and Heather Wakelee. (Video Program)

CE Information and Faculty Disclosures

  • TARGET AUDIENCE
    This activity is intended for medical, radiation and thoracic oncologists and other healthcare providers involved in the treatment of lung cancer.

    OVERVIEW OF ACTIVITY
    The past several years have seen an explosion in the emergence of new potential therapies that leverage the natural ability of the human body to attack and treat cancer. Known as immune-mediated therapies or cancer immunotherapies, these promising treatments are taking center stage at medical conferences and generating excitement all over the world. Perhaps the most exciting arena in this regard has been the development and assessment of a class of checkpoint inhibitors that inhibit PD-1 or PD-L1. To date, studies with these agents have demonstrated a high degree of activity with limited toxicity in the metastatic and, more recently, locally advanced settings. The availability of these novel compounds has rapidly upended traditional therapeutic sequencing and caused both shifts and rifts in clinical management algorithms, and a number of controversies and questions remain with regard to the current application of these agents in clinical practice.

    These video proceedings from a CME symposium held during the 2018 ASCO-SITC Clinical Immuno-Oncology Symposium feature discussions with leading researchers with an expertise in lung cancer. By providing information on the latest research developments and their potential application to routine practice, this activity is designed to assist medical, radiation and thoracic oncologists and other healthcare providers with the optimal incorporation of immune checkpoint inhibitors in lung cancer.

    LEARNING OBJECTIVES

    • Compare and contrast the mechanisms of action, efficacy and safety/toxicity of approved and investigational anti-PD-1/PD-L1 antibodies for the treatment of non-small cell lung cancer (NSCLC) to determine the current and/or potential utility of each in clinical practice.
    • Review published research data documenting the safety and efficacy of anti-PD-1 antibodies as monotherapy or in combination with chemotherapy for newly diagnosed metastatic NSCLC.
    • Appraise emerging research data documenting the benefits and risks of sequential anti-PD-L1 antibody therapy for patients with unresectable Stage III NSCLC who have not experienced disease progression after standard platinum-based chemotherapy concurrent with radiation therapy.
    • Recognize immune-related adverse events and other common side effects associated with approved and developmental immune checkpoint inhibitors, and offer supportive management strategies to minimize and/or manage these toxicities.
    • Recall the design of ongoing clinical trials evaluating novel immunotherapeutic approaches alone or in combination with other systemic therapies for NSCLC, and counsel appropriate patients about availability and participation.
    • Describe the biologic rationale and eligibility criteria for late-stage clinical trials evaluating novel applications of immune checkpoint inhibitors alone or in combination with other approaches (eg, anti-PD-1/PD-L1 antibodies in combination with other checkpoint inhibitors, radiation therapy, et cetera) for small cell lung cancer, and, where applicable, refer eligible patients for participation or other expanded access programs.

    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
    CME credit is no longer available for this issue

    AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
    CME credit is no longer available for this issue

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of a video component.
    CME credit is no longer available for this issue

    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:

    Matthew D Hellmann, MD
    Medical Oncologist
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Consulting Agreements: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Genentech BioOncology, Janssen Biotech Inc, Merck, Novartis.

    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, Lilly, Peregrine Pharmaceuticals Inc, Synta Pharmaceuticals Corp.

    David R Spigel, MD
    Program Director, Lung Cancer Research
    Sarah Cannon Research Institute
    Nashville, Tennessee

    No relevant conflicts of interest to disclose.

    Heather Wakelee, MD
    Professor of Medicine
    Division of Oncology
    Stanford University School of Medicine
    Stanford Cancer Institute
    Stanford, California

    Consulting Agreements: ACEA Biosciences Inc, Genentech BioOncology, Helsinn Group, Peregrine Pharmaceuticals Inc, Pfizer Inc; Contracted Research: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Exelixis Inc, Genentech BioOncology, Gilead Sciences Inc, Lilly, MedImmune Inc, Novartis, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Roche Laboratories Inc, Xcovery; Honoraria: ACEA Biosciences Inc, Helsinn Group, Peregrine Pharmaceuticals Inc.

    MODERATOR — 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, administered by Janssen Scientific Affairs LLC, 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, Pfizer Inc, 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 AstraZeneca Pharmaceuticals LP.

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
    Adobe Flash Player 27 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: March 2018
    Expiration date: March 2019

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