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Novel and Emerging Strategies in the Management of Gastrointestinal Cancers
Released February 2018

Featuring perspectives from Dr Philip A Philip. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity is intended for medical oncologists and other healthcare providers involved in the treatment of gastrointestinal (GI) cancers.

    OVERVIEW OF ACTIVITY
    The pace of oncology drug development has accelerated in recent years to previously unmatched levels. Fueled by an increased understanding of the biologic underpinnings of tumor development and progression, clinical research platforms largely focused on evaluating the potential benefits of novel targeted therapeutics possessing unique mechanisms of action and safety profiles have led to improved outcomes in a myriad of large and rigorous clinical trials. Although this dynamic appears to be prevalent in many corners of oncology, recent advancements in the management of several prominent GI cancers have made it particularly pronounced in this area.

    The successes yielded by this rational approach to the design and evaluation of new therapies have provided medical oncologists and patients with many beneficial treatments, but the availability of this growing list of novel options may also pose a challenge to the practicing clinician who must maintain knowledge of appropriate clinical management strategies across a vast spectrum of liquid and solid tumors. To bridge the gap between research and patient care, this video presentation by Philip A Philip uses a review of recent relevant publications and presentations, ongoing clinical trials and clinical investigator treatment preferences to assist medical oncologists and other healthcare providers involved in the treatment of GI cancers with the formulation of up-to-date clinical management strategies.

    LEARNING OBJECTIVES

    • Appraise the biologic rationale for and available clinical data with approved and investigational anti-PD-1 and/or anti-PD-L1 antibodies in the treatment of select GI cancers.
    • Appreciate the rationale for and clinical evidence supporting the integration of novel treatment approaches for early pancreatic cancer.
    • Recognize the mechanism of action of and available data with nanoliposomal irinotecan in the management of treatment-refractory metastatic pancreatic cancer, and develop strategies to incorporate this agent into patient-care algorithms.
    • Consider available clinical research data documenting the efficacy of ramucirumab in metastatic colorectal and gastric or gastroesophageal junction cancers, and discern how this agent can be optimally integrated into clinical practice for patients with these diseases.
    • Formulate a plan to include information about the left or right sidedness of colon cancer tumors in prognostication and systemic treatment decision-making.
    • Develop an understanding of emerging Phase III efficacy data with commercially available multikinase inhibitors (eg, regorafenib and lenvatinib) for the management of relapsed/refractory hepatocellular carcinoma.
    • Evaluate available Phase III data with peptide receptor radionuclide therapy with 177Lu-Dotatate for patients with GI neuroendocrine tumors progressing on somatostatin analogue therapy.
    • Appreciate the FDA-approved indication for telotristat ethyl, and consider this information in the selection of patients with carcinoid syndrome-associated diarrhea who might benefit from treatment with this agent.
    • Recall available and emerging data with other investigational agents currently in Phase III testing for various GI cancers, and, where applicable, refer eligible patients for trial participation or 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
    Research To Practice designates this enduring material for a maximum of 1.25 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 1.25 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 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/GrandRoundsGI18/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:

    Presenting Faculty Member

    Philip A Philip, MD, PhD
    Professor of Oncology and Pharmacology
    Director of GI and Neuroendocrine Tumors
    Vice President of Medical Affairs
    Karmanos Cancer Institute
    Wayne State University
    Detroit, Michigan

    Advisory Committee: Bayer HealthCare Pharmaceuticals, Celgene Corporation, Genentech BioOncology, Halozyme Inc, Lilly, Merrimack Pharmaceuticals Inc, Novartis; Consulting Agreements: Celgene Corporation, Halozyme Inc, Lilly; Contracted Research: Bayer HealthCare Pharmaceuticals, Celgene Corporation, Lilly, Merck, Novartis; Speakers Bureau: Amgen Inc, Bayer HealthCare Pharmaceuticals, Celgene Corporation, Genentech BioOncology, Lilly, Merrimack Pharmaceuticals Inc, Novartis, Sanofi Genzyme.

    Project Steering Committee Members

    Tanios Bekaii-Saab, MD
    Professor, Mayo Clinic College of Medicine and Science
    Co-Leader, GI Cancer Program
    Mayo Clinic Cancer Center
    Senior Associate Consultant
    Mayo Clinic Arizona
    Scottsdale, Arizona

    Consulting Agreements: Amgen Inc, ARMO BioSciences, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Celgene Corporation, Exelixis Inc, Genentech BioOncology, Ipsen Biopharmaceuticals Inc, Merck, Roche Laboratories Inc, SillaJen; Contracted Research: Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Lilly.

    Johanna C Bendell, MD
    Director, GI Oncology Research
    Associate Director, Drug Development Unit
    Sarah Cannon Research Institute
    Nashville, Tennessee

    Contracted Research: Abbott Laboratories, AbbVie Inc, Apexigen, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Daiichi Sankyo Inc, Eisai Inc, EMD Serono Inc, Five Prime Therapeutics Inc, Forty Seven Inc, Genentech BioOncology, Gilead Sciences Inc, GlaxoSmithKline, Incyte Corporation, Kolltan Pharmaceuticals Inc, Leap Therapeutics Inc, Lilly, MacroGenics Inc, MedImmune Inc, Merck, Novartis, OncoMed Pharmaceuticals Inc, Onyx Pharmaceuticals, an Amgen subsidiary, Pfizer Inc, Roche Laboratories Inc, Sanofi Genzyme, Stemcentrx, Taiho Oncology Inc, Takeda Oncology, TG Therapeutics Inc.

    Axel Grothey, MD
    Professor of Oncology
    Department of Medical Oncology
    Mayo Clinic
    Rochester, Minnesota

    Advisory Committee: Amgen Inc, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Genentech BioOncology, Roche Laboratories Inc; Contracted Research: Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Eisai Inc, Genentech BioOncology.

    Howard S Hochster, MD
    Associate Director (Clinical Research), Yale Cancer Center
    Professor of Medicine, Yale School of Medicine
    New Haven, Connecticut

    Consulting Agreements: Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Genomic Health Inc.

    Heinz-Josef Lenz, MD
    Professor of Medicine and Preventive Medicine
    J Terrence Lanni Chair in Cancer Research
    Co-Director, USC Center for Molecular Pathways and Drug Discovery
    Keck School of Medicine, University of Southern California
    Associate Director of Adult Oncology
    Co-Director, Colorectal Center
    Scientific Director, Cancer Genetics Unit
    USC/Norris Comprehensive Cancer Center
    Los Angeles, California

    Advisory Committee and Consulting Agreements: Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, EMD Serono Inc, Genentech BioOncology, Roche Laboratories Inc; Contracted Research: Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, EMD Serono Inc, Genentech BioOncology, Merck, Roche Laboratories Inc.

    Bert H O’Neil, MD
    Professor of Medicine
    Director, Phase I and GI Malignancies Programs
    Indiana University Simon Cancer Center
    Indianapolis, Indiana

    Advisory Committee: Amgen Inc, Bayer HealthCare Pharmaceuticals, Genentech BioOncology; Speakers Bureau: Bayer HealthCare Pharmaceuticals.

    PROJECT 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, 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 grantors.

    This activity is supported by educational grants from Boston Biomedical Pharma Inc, Exelixis Inc, Lexicon Pharmaceuticals Inc, Lilly, Merck and Merrimack Pharmaceuticals Inc.

    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: February 2018
    Expiration date: February 2019

    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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