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Putting It in Perspective: Clinical Investigators Discuss the Use of Biomarkers to Guide Adjuvant Therapy for Breast and Colon Cancer (Video Program)
Released July 2015

Video excerpts from a clinical investigator Think Tank featuring perspectives from Drs Steven R Alberts, Harold J Burstein, Joseph A Sparano, Alan P Venook and Norman Wolmark on the use of biomarkers to guide adjuvant decision-making for patients with breast and colon cancer. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity is intended for medical oncologists, hematology-oncology fellows and other healthcare providers involved in the treatment of breast and colon cancer.

    OVERVIEW OF ACTIVITY
    Many controversies and clinical questions currently surround the management of localized breast and colorectal cancers. Central among these is the use and effectiveness of available biomarkers in guiding decision-making regarding adjuvant treatment. This CME program brings together leading clinical investigators in the fields of breast and colon cancer to provide perspectives on the development, assessment and clinical utility of select genomic assays and biomarkers that are available to assist clinicians managing these highly prevalent diseases. By reviewing available clinical trial data and relevant case scenarios, this initiative will help learners to ascertain the effectiveness of diagnostic, prognostic and predictive biomarkers as they relate to the adjuvant treatment of breast and/or colorectal cancer.

    LEARNING OBJECTIVES

    • Recognize the evolving application of biomarkers and multigene assays in the management of breast and colon cancer, and effectively use these tools to refine or individualize treatment plans for selected patients.
    • Determine the utility of the Oncotype DX® Recurrence Score® assay in counseling patients with ER-positive early breast cancer about their risk of recurrence and the potential benefits of adjuvant chemotherapy.
    • Counsel patients with Stage II and Stage III colon cancer about their individual risk of recurrence based on clinical, pathologic and genomic biomarkers, and consider adjuvant therapeutic options based on an evaluation of this information.
    • Assess the utility of the Oncotype DX DCIS Score assay in counseling patients with DCIS about their risk of recurrence and the potential benefits of radiation therapy.
    • Evaluate the evidence-based benefits of adjuvant chemotherapy for patients with Stage II colon cancer and the risks and benefits of oxaliplatin-containing chemotherapy in lower-risk Stage III disease.
    • Counsel appropriately selected patients about participation in ongoing clinical trials.

    ACCREDITATION STATEMENT

    CME credit is no longer available for this issue

    CREDIT DESIGNATION STATEMENT

    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 potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent 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 his spouse/partner) reported real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Steven R Alberts, MD, MPH
    Chair, Division of Medical Oncology
    Professor of Oncology
    Mayo Clinic
    Rochester, Minnesota

    Data and Safety Monitoring Board: BioSphere Medical, Pfizer Inc.

    Harold J Burstein, MD, PhD
    Associate Professor of Medicine
    Harvard Medical School
    Breast Oncology Center
    Dana-Farber Cancer Institute
    Boston, Massachusetts

    No financial interests or affiliations to disclose.

    Joseph A Sparano, MD
    Professor of Medicine and Women’s Health
    Albert Einstein College of Medicine
    Associate Chairman, Department of Oncology
    Montefiore Medical Center
    Bronx, New York

    Advisory Committee: Amgen Inc, Celldex Therapeutics, Curis Inc, Eisai Inc, Johnson & Johnson Pharmaceuticals, MetaStat Inc, Pfizer Inc; Consulting Agreement: Genentech BioOncology; Contracted Research: ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company; Paid Research: Merck, Takeda Oncology.

    Alan P Venook, MD
    Professor of Clinical Medicine
    University of California, San Francisco
    San Francisco, California

    Advisory Committee: Bayer HealthCare Pharmaceuticals; Consulting Agreements: Bayer HealthCare Pharmaceuticals, Sanofi; Contracted Research: Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Genentech BioOncology, GlaxoSmithKline, Lilly, Onyx Pharmaceuticals, an Amgen subsidiary.

    Norman Wolmark, MD
    Chairman, National Surgical Adjuvant Breast and Bowel Project
    Professor of Surgery
    Temple University School of Medicine
    Philadelphia, Pennsylvania

    Advisory Committee: Genentech BioOncology; Other Remunerated Activities: Sanofi.

    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, Amgen Inc, Astellas Scientific and Medical Affairs Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, ImmunoGen Inc, Incyte Corporation, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Myriad Genetic Laboratories Inc, NanoString Technologies, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Teva Oncology, Tokai Pharmaceuticals Inc and VisionGate Inc.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no real or apparent 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 Genomic Health Inc.

    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: July 2015
    Expiration date: July 2016

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Watch video
(WIFI is recommended for best performance):

BREAST CANCER
Biomarkers and Genomic Assays
Predictive and prognostic value of the Oncotype DX® Recurrence Score® (RS) in ER-positive, node-positive breast cancer (BC)
Use of the Oncotype DX assay in ER/PR-positive, node-positive BC
Limitations of the 21-gene RS assay compared to traditional clinicopathologic markers
Comparison of the Oncotype DX RS assay and Adjuvant! Online for women with ER-positive, node-negative BC
A 37-year-old woman with a 2.1-cm ER-positive, HER2-negative, node-negative BC and a 21-gene RS of 19
A 45-year-old woman with Stage IB ER/PR-positive, HER2-negative IDC, 1 positive node and an Oncotype DX RS of 12
Prognostic discrimination using a 70-gene signature among patients with ER-positive BC and an intermediate 21-gene RS
Advantages of the 21-gene RS compared to the MammaPrint assay
Current utility of the Oncotype DX DCIS Score in decision-making about radiation therapy
A 72-year-old woman with a 1.2-cm focus of ductal carcinoma in situ (DCIS) and an Oncotype DCIS score of 20
COLON CANCER
Biomarkers and Genomic Assays
Biological determinants of tumor recurrence in Stage II colon cancer
Validation of the 12-gene RS as a predictor of recurrence in patients with Stage II and Stage III colon cancer
Potential prognostic utility of the 12-gene Recurrence Score for patients with colon cancer
A 68-year-old man with Stage II T3N0 mismatch repair–proficient adenocarcinoma of the colon and a 12-gene RS of 15
A 63-year-old man with a 3-cm T3N1 adenocarcinoma of the colon and a 12-gene RS of 14 receives 5-FU/leucovorin
A 51-year-old woman with Stage II, MSI-H, BRAF V600E mutation-positive adenocarcinoma of the colon
A 92-year-old man with moderately differentiated adenocarcinoma of the colon with 7 of 32 positive nodes
Independent validation of the prognostic ColoPrint® genomic signature for patients with Stage II colon cancer
BREAST AND COLON CANCERS
Other Discussion
Clinical utility of the Oncotype 21- and 12-gene assays for breast and colon cancers, respectively
Perspectives on the value and limitations of the Adjuvant! Online program in breast and colon cancers