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Current Approaches and Future Strategies in Oncology: A Multitumor Educational Symposium in Partnership with Florida Cancer Specialists & Research Institute (Symposium Video Proceedings)
Released October 2023

Featuring perspectives from Dr Tanios Bekaii-Saab, Dr Harold Burstein, Dr Asher Chanan-Khan, Dr Komal Jhaveri, Dr Brad S Kahl, Dr Alicia K Morgans, Dr Philip A Philip, Dr Gregory J Riely, Dr Matthew R Smith and Dr Heather Wakelee. Published October 27, 2023. (Symposium Video Proceedings)

CE Information and Faculty Disclosures

  • TARGET AUDIENCE
    This program is intended for medical oncologists, hematologists, hematology-oncology fellows, radiation oncologists, surgeons and other allied healthcare professionals involved in the treatment of cancer.

    LEARNING OBJECTIVES

    ER-Positive Breast Cancer
    • Evaluate relevant patient- and treatment-related factors to personalize systemic therapy for ER-positive, HER2-negative localized breast cancer (BC).
    • Comprehend available research findings with CDK4/6 inhibitors for localized ER-positive, HER2-negative BC, and assess the current and potential role of these agents as a component of adjuvant treatment.
    • Review available clinical research findings documenting the efficacy of the addition of gonadotropin-releasing hormone agonists to standard endocrine interventions for ER-positive BC, and identify appropriate candidates for this strategy.
    • Recall available research findings documenting the correlation between the presence of various biomarkers (eg, PIK3CA mutations, ESR1 mutations, low levels of HER2 expression) and response to specific therapies, and develop optimal testing algorithms for patients with ER-positive metastatic BC (mBC).
    • Appraise published efficacy and safety data from randomized clinical trials evaluating CDK4/6 inhibitors for ER-positive mBC in order to appropriately counsel patients regarding the optimal clinical use of these agents.
    • Recognize the frequency of phosphoinositide-3 kinase pathway mutations in individuals with ER-positive mBC, and employ evidence-based approaches designed to target these aberrations.
    • Understand the mechanism of action of, published research findings with and current and future clinical role of oral selective estrogen receptor degraders for patients with relapsed/refractory (R/R) ER-positive mBC.
    • Appreciate the incidence, characteristics and clinical relevance of HER2-low mBC, and understand available management approaches for this disease subset.
    • Assess published data with and ongoing studies evaluating novel agents and treatment strategies under development for localized and metastatic ER-positive BC, and counsel patients regarding the potential benefits of clinical trial participation.
    Prostate Cancer
    • Appraise published research findings with novel treatment approaches for patients with biochemical recurrence after local treatment for prostate cancer (PC), and counsel appropriate individuals regarding the potential benefits of systemic therapy.
    • Evaluate the published research database supporting the FDA approvals of secondary hormonal agents for the management of nonmetastatic castration-resistant PC, and apply this information in the discussion of nonresearch treatment options.
    • Explore available data with treatment intensification with cytotoxic therapy, secondary hormonal therapy or combinations of these approaches for metastatic hormone-sensitive PC, and effectively integrate these strategies into current clinical management algorithms.
    • Establish an evidence-based approach to the selection and sequencing of available therapeutic options for patients with metastatic castration-resistant PC (mCRPC), considering age, comorbidities, prior therapeutic exposure and other relevant clinical and biological factors.
    • Assess the available research database supporting the use of PARP inhibitors as monotherapy or in combination with androgen receptor pathway inhibitors for patients with mCRPC harboring a homologous recombination repair gene alteration, and discern how to optimally incorporate these agents into current clinical management algorithms.
    • Appreciate available and emerging Phase III data documenting the efficacy of PSMA-targeted radioligand therapy for patients with PSMA-positive mCRPC, and consider the current and future clinical role of this strategy.
    • Recall the design of ongoing clinical trials evaluating other novel agents and strategies for PC, and counsel appropriate patients about availability and participation.
    Non-Small Cell Lung Cancer
    • Evaluate available data documenting the efficacy and safety of anti-PD-1/PD-L1 antibody-based approaches as neoadjuvant, adjuvant or consolidation therapy for patients with nonmetastatic non-small cell lung cancer (NSCLC).
    • Acknowledge the FDA approval of adjuvant EGFR tyrosine kinase inhibitor (TKI) therapy for patients with localized EGFR mutation-positive NSCLC, and identify individuals for whom treatment with this approach would be warranted.
    • Evaluate published and emerging clinical trial findings supporting the use of EGFR TKI therapy alone and in combination with other systemic treatments as first-line therapy for patients with metastatic NSCLC and an actionable EGFR mutation, and consider the effect of this information on current and future clinical practice.
    • Describe mechanisms of resistance to EGFR TKIs, and discern how available and investigational therapies can be optimally employed in the care of patients with progressive NSCLC with EGFR mutations.
    • Assess the efficacy and safety of commercially available ALK inhibitors for patients with metastatic NSCLC with an ALK rearrangement, and use this information to select these drugs as first- and later-line therapy.
    • Recollect other oncogenic pathways (eg, ROS1, RET, MET, HER2, KRAS) mediating the pathogenesis of NSCLC in unique patient subsets, and recall published data with agents exploiting these targets.
    • Consider recent therapeutic advances related to anti-PD-1/PD-L1 antibodies as monotherapy or in combination with other systemic therapies for metastatic NSCLC, and discern how these approaches can be employed in the management of this disease.
    • Develop a long-term care plan for individuals with progressive NSCLC, considering exposure to prior systemic therapy, performance status and personal goals of treatment.
    • Reflect on investigational agents and strategies currently in testing for NSCLC, and as applicable, refer eligible patients for clinical trial participation.
    Colorectal and Gastroesophageal Cancers
    • Optimize the use of adjuvant chemotherapy for localized colorectal cancer (CRC), considering the influence of various clinical and biological factors (eg, age, performance status, stage) and the potential relevance of molecular residual disease.
    • Develop an understanding of validated biomarkers of response (eg, RAS, BRAF, HER2, microsatellite instability (MSI)/mismatch repair deficiency) found in patients with metastatic CRC (mCRC), and consider the implications for molecular testing and clinical care.
    • Devise a long-term care plan for patients with mCRC, considering biomarker profile, tumor location, prior systemic therapy, symptomatology and personal goals of treatment.
    • Apply available research, including recently presented Phase III clinical trial findings, to optimize the selection and sequencing of later-line therapeutic options for patients with multiregimen-relapsed mCRC.
    • Use HER2 status, PD-L1 combined positive score, MSI status, clinical factors and patient preferences to personalize the selection of first-line therapy for patients with metastatic gastric, gastroesophageal junction (GEJ) and esophageal cancer.
    • Describe the published research data with anti-PD-1/PD-L1 antibodies alone or in combination with other systemic therapies for the management of gastric, GEJ and esophageal cancer, and optimally integrate these strategies into nonresearch treatment algorithms.
    • Evaluate the biological rationale for the investigation of claudin 18.2 as a therapeutic target in gastric/GEJ cancer, and assess available data with novel strategies directed at this potential biomarker.
    • Recall available data with novel HER2-targeted agents and strategies for the management of HER2-overexpressing gastric/GEJ cancer and mCRC, and optimally identify candidates who may be appropriate for these approaches.
    • Review the rationale for, available data with and ongoing research studies evaluating novel agents and strategies for the management of CRC and gastroesophageal cancers, and effectively prioritize clinical trial opportunities for eligible individuals.
    Chronic Lymphocytic Leukemia
    • Individualize the selection of systemic therapy for patients with newly diagnosed chronic lymphocytic leukemia (CLL), considering new research findings, clinical presentation, biomarker profile, coexisting medical conditions and patient preferences.
    • Appraise available Phase III data documenting the comparative efficacy and tolerability of first- and second-generation Bruton tyrosine kinase (BTK) inhibitors.
    • Review recently presented data documenting the safety and efficacy of combined BTK and Bcl-2 inhibition for newly diagnosed CLL.
    • Analyze how age, performance status, prior therapeutic exposure and other biological and disease-related factors affect the selection and sequencing of therapy for patients with R/R CLL.
    • Discuss available clinical research findings demonstrating the efficacy and safety of noncovalent BTK inhibitors for R/R CLL.
    • Implement a plan of care to recognize and manage side effects and toxicities associated with recently approved and emerging systemic therapies employed in the management of CLL.
    • Refer eligible patients with CLL for participation in clinical trials evaluating novel agents and strategies.

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

    CME CREDIT DESIGNATION STATEMENT
    Video Program: Research To Practice designates this enduring material for a maximum of 5.25 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 and a post-test, enables the participant to earn up to 5.25 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 specialties: medical oncology and hematology.

    PRIVACY POLICY
    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 review the CME information, 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/FCS2023/Video/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 and adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of an accredited continuing education activity, including faculty, planners, reviewers and others, are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of this activity. In addition, all activity content is reviewed by 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 reported relevant financial relationships with ineligible entities:

    Tanios Bekaii-Saab, MD
    Professor, Mayo Clinic College of Medicine and Science
    Program Leader, Gastrointestinal Cancer
    Mayo Clinic Cancer Center
    Consultant, Mayo Clinic in Arizona
    Chair, ACCRU Research Consortium
    Phoenix, Arizona

    Consulting Agreements (to Institution): Arcus Biosciences, Bayer HealthCare Pharmaceuticals, Eisai Inc, Genentech, a member of the Roche Group, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Merck, Merck KgaA, Merus BV, Pfizer Inc, Seagen Inc, Servier Pharmaceuticals LLC; Consulting Agreements (to Self): AbbVie Inc, Aptitude Health, AstraZeneca Pharmaceuticals LP, BeiGene Ltd, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Caladrius Biosciences, Celularity, Daiichi Sankyo Inc, Deciphera Pharmaceuticals Inc, Exact Sciences Corporation, Exelixis Inc, Foundation Medicine, GSK, Illumina, Janssen Biotech Inc, Kanaph Therapeutics, Natera Inc, Sanofi, Sobi, Stemline Therapeutics Inc, Treos Bio Ltd, Zai Lab; Data and Safety Monitoring Board/Committee: 1Globe Health Institute, AstraZeneca Pharmaceuticals LP, Eisai Inc, Exelixis Inc, FibroGen Inc, Merck, Suzhou Kintor; Inventions/Patents: WO/2018/183488 licensed to Imugene, WO/2019/055687 licensed to Recursion; Research Funding (to Institution): AbGenomics, Agios Pharmaceuticals Inc, Arcus Biosciences, Arrys Therapeutics, a wholly owned subsidiary of Kyn Therapeutics, Atreca, Bayer HealthCare Pharmaceuticals, Bristol Myers Squibb, Celgene Corporation, Clovis Oncology, Eisai Inc, Genentech, a member of the Roche Group, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Lilly, Merus BV, Mirati Therapeutics Inc, Novartis, Pfizer Inc, Seagen Inc, Sumitomo Dainippon Pharma Oncology Inc; Scientific Advisory Board: Artiva Biotherapeutics Inc, Immuneering Corporation, Imugene, Panbela Therapeutics Inc, Replimune, Xilis; Nonrelevant Financial Relationship: MJH Life Sciences, Pancreatic Cancer Action Network, UpToDate, The Valley Hospital.

    Harold J Burstein, MD, PhD
    Institute Physician, Dana-Farber Cancer Institute
    Professor of Medicine, Harvard Medical School
    Boston, Massachusetts

    No relevant conflicts of interest to disclose.

    Asher Chanan-Khan, MD
    Professor of Medicine and Oncology
    Mayo Clinic
    Jacksonville, Florida

    Advisory Committee, Consulting Agreements and Stock Options: Ascentage Pharma, Cellectar Biosciences Inc, Starton Therapeutics; Contracted Research: Ascentage Pharma.

    Komal Jhaveri, MD
    Associate Attending Physician
    Breast Medicine Service and Early Drug Development Service
    Section Head, Endocrine Therapy Research Program
    Clinical Director, Early Drug Development Service
    Department of Medicine
    Memorial Sloan Kettering Cancer Center
    Associate Professor of Medicine
    Weill Cornell College of Medicine
    New York, New York

    Consultant/Advisory Board: AbbVie Inc, AstraZeneca Pharmaceuticals LP, Blueprint Medicines, Bristol Myers Squibb, Daiichi Sankyo Inc, Eisai Inc, Genentech, a member of the Roche Group, Gilead Sciences Inc, Jounce Therapeutics, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Menarini Group, Novartis, Olema Oncology, Pfizer Inc, Scorpion Therapeutics, Seagen Inc, Stemline Therapeutics Inc, Sun Pharma Advanced Research Company Ltd, Taiho Oncology Inc; Research Funding: AstraZeneca Pharmaceuticals LP, Debiopharm, Genentech, a member of the Roche Group, Gilead Sciences Inc, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Novartis, Pfizer Inc, Puma Biotechnology Inc, Scorpion Therapeutics, Zymeworks Inc.

    Brad S Kahl, MD
    Professor of Medicine
    Washington University School of Medicine
    Director, Lymphoma Program
    Siteman Cancer Center
    St Louis, Missouri

    Consulting Agreements: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, ADC Therapeutics, AstraZeneca Pharmaceuticals LP, BeiGene Ltd, Celgene Corporation, Genentech, a member of the Roche Group, Genmab US Inc, Janssen Biotech Inc, Kite, A Gilead Company, Lilly, Novartis, Roche Laboratories Inc.

    Alicia K Morgans, MD, MPH
    Associate Professor of Medicine
    Harvard Medical School
    Medical Director, Survivorship Program
    Dana-Farber Cancer Institute
    Boston, Massachusetts

    Consulting Agreements: Advanced Accelerator Applications, Astellas, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Exelixis Inc, Foundation Medicine, Janssen Biotech Inc, Lantheus, Merck, Myovant Sciences, Novartis, Pfizer Inc, Sanofi, Telix Pharmaceuticals Limited; Contracted Research: Bayer HealthCare Pharmaceuticals, Myovant Sciences, Pfizer Inc; Data and Safety Monitoring Board/Committee: Gilead Sciences Inc.

    Philip A Philip, MD, PhD, FRCP
    Professor of Oncology and Pharmacology
    Leader, GI and Neuroendocrine Oncology
    Henry Ford Cancer Institute
    Wayne State University
    Detroit, Michigan

    Advisory Committee: Bayer HealthCare Pharmaceuticals, Ipsen Biopharmaceuticals Inc, Merus BV, Novocure Inc, Pfizer Inc, Seagen Inc, Servier Pharmaceuticals LLC; Consulting Agreements: BioNTech SE, Totus Medicines; Contracted Research: Taiho Oncology Inc; Data and Safety Monitoring Board/Committee: Cyclacel Pharmaceuticals Inc, Oncolytics Biotech Inc; Speakers Bureau: Incyte Corporation, Servier Pharmaceuticals LLC.

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

    Contracted Research: Lilly, Mirati Therapeutics Inc, Novartis, Pfizer Inc, Rain Oncology, Roche Laboratories Inc, Takeda Pharmaceuticals USA Inc; Data and Safety Monitoring Board/Committee: Novartis (uncompensated).

    Matthew R Smith, MD, PhD
    Claire and John Bertucci Endowed Chair in Genitourinary Cancers
    Professor of Medicine
    Harvard Medical School
    Director, Genitourinary Malignancies Program
    Massachusetts General Hospital Cancer Center
    Boston, Massachusetts

    Advisory Committee: Bayer HealthCare Pharmaceuticals, Janssen Biotech Inc, Lilly, Pfizer Inc; Consulting Agreements: Ambrx, Bayer HealthCare Pharmaceuticals, Janssen Biotech Inc, Lilly, Pfizer Inc; Contracted Research (to Institution): Bayer HealthCare Pharmaceuticals, Janssen Biotech Inc, Lilly, Pfizer Inc; Stock Options/Ownership — Public Company: Ambrx.

    Heather Wakelee, MD, FASCO
    Professor of Medicine
    Chief, Division of Oncology
    Deputy Director
    Stanford Cancer Institute
    President, International Association for the Study of Lung Cancer (IASLC)
    Stanford, California

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Blueprint Medicines, Genentech, a member of the Roche Group (uncompensated), Merck (uncompensated), Mirati Therapeutics Inc; Contracted Research: ACEA Biosciences Inc, Arrys Therapeutics, a wholly owned subsidiary of Kyn Therapeutics, AstraZeneca Pharmaceuticals LP, Bristol Myers Squibb, Clovis Oncology, Genentech, a member of the Roche Group, Helsinn Healthcare SA, Merck, Novartis, Seagen Inc, Xcovery; Nonrelevant Financial Relationship: ECOG-ACRIN (executive committee).

    MODERATOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following companies: AbbVie Inc, Adaptive Biotechnologies Corporation, ADC Therapeutics, Agios Pharmaceuticals Inc, Alexion Pharmaceuticals, Amgen Inc, Array BioPharma Inc, a subsidiary of Pfizer Inc, Astellas, AstraZeneca Pharmaceuticals LP, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, BeiGene Ltd, BeyondSpring Pharmaceuticals Inc, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Bristol Myers Squibb, Celgene Corporation, Clovis Oncology, Coherus BioSciences, CTI BioPharma Corp, Daiichi Sankyo Inc, Eisai Inc, Elevation Oncology Inc, EMD Serono Inc, Epizyme Inc, Exact Sciences Corporation, Exelixis Inc, Five Prime Therapeutics Inc, Foundation Medicine, G1 Therapeutics Inc, Genentech, a member of the Roche Group, Genmab US Inc, Gilead Sciences Inc, Grail Inc, GSK, Halozyme Inc, Helsinn Healthcare SA, ImmunoGen Inc, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Karyopharm Therapeutics, Kite, A Gilead Company, Kronos Bio Inc, Legend Biotech, Lilly, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, MEI Pharma Inc, Merck, Mersana Therapeutics Inc, Mirati Therapeutics Inc, Natera Inc, Novartis, Novartis Pharmaceuticals Corporation on behalf of Advanced Accelerator Applications, Novocure Inc, Oncopeptides, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, R-Pharm US, Sanofi, Seagen Inc, Servier Pharmaceuticals LLC, SpringWorks Therapeutics Inc, Stemline Therapeutics Inc, Sumitomo Dainippon Pharma Oncology Inc, Taiho Oncology Inc, Takeda Pharmaceuticals USA Inc, TerSera Therapeutics LLC, Tesaro, A GSK Company, TG Therapeutics Inc, Turning Point Therapeutics Inc, Verastem Inc, and Zymeworks Inc.

    RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent 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 grantors.

    This activity is supported by educational grants from Astellas, Astellas and Pfizer Inc, AstraZeneca Pharmaceuticals LP, Bristol Myers Squibb, Daiichi Sankyo Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Lilly, Merck, Natera Inc, Novartis, Novocure Inc, Regeneron Pharmaceuticals Inc, Seagen Inc, Stemline Therapeutics Inc, Taiho Oncology Inc, Takeda Pharmaceuticals USA Inc, and TerSera Therapeutics LLC.

    Release date: October 2023
    Expiration date: October 2024

    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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