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Beyond the Guidelines: Clinical Investigators Provide Perspectives on Biomarker-Guided Decision-Making for Patients with Non-Small Cell Lung Cancer
Released March 2018

Featuring perspectives from Dr Alexander E Drilon. (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 lung cancer.

    OVERVIEW OF ACTIVITY
    Recent developments have led to an explosion in lung cancer genetic and biologic knowledge, but the integration of anti-PD-1/PD-L1 checkpoint inhibitors into treatment and the evolution of targeted therapy have complicated decision-making for clinicians caring for patients with metastatic non-small cell lung cancer (NSCLC). To bridge the gap between research and patient care, this video presentation by Alexander E Drilon 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 lung cancer with the formulation of up-to-date clinical management strategies.

    LEARNING OBJECTIVES

    • Evaluate existing guideline recommendations regarding the indications and optimal testing platform for mutational analysis for patients with metastatic NSCLC, and use this information to implement a comprehensive approach to genomic assessment.
    • Use mutation status, clinical characteristics and tumor histology to appropriately prioritize front-line and subsequent treatment approaches for patients with metastatic NSCLC.
    • Employ an understanding of personalized medicine to individualize the use of available EGFR inhibitors in the long-term management of EGFR mutation-positive NSCLC, and discern how novel EGFR tyrosine kinase inhibitors can be optimally administered to patients with progressive EGFR mutation-positive disease.
    • Communicate the efficacy and safety of approved and other emerging ALK inhibitors to appropriate patients with NSCLC, considering the predictive utility of ALK mutation testing.
    • Recall existing and emerging research information demonstrating the efficacy and safety of anti-PD-1/PD-L1 antibodies for patients with squamous and nonsquamous metastatic NSCLC, and use this information to guide treatment planning.
    • Recall the design of ongoing clinical trials evaluating novel investigational agents in NSCLC, and counsel appropriately selected patients about availability and 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 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/GrandRoundsLung18/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

    Alexander E Drilon, MD
    Clinical Director
    Developmental Therapeutics Clinic
    Assistant Attending Physician
    Thoracic Oncology Service
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Consulting Agreements: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, GlaxoSmithKline, Ignyta Inc, Loxo Oncology Inc, Pfizer Inc, Roche Laboratories Inc, TP Therapeutics Inc.

    Project Steering Committee Members

    Julie R Brahmer, MD
    Director, Thoracic Oncology Program
    Interim Director, Johns Hopkins Kimmel Cancer Center at Bayview
    Associate Professor of Oncology
    Sidney Kimmel Comprehensive Cancer Center
    Johns Hopkins School of Medicine
    Baltimore, Maryland

    Advisory Committee: Bristol-Myers Squibb Company, Merck; Consulting Agreements: Bristol-Myers Squibb Company, Celgene Corporation, Lilly, Merck; Contracted Research: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, MedImmune Inc, Merck.

    Paul A Bunn Jr, MD
    Distinguished Professor and James Dudley Chair in Cancer Research
    University of Colorado Cancer Center
    Aurora, Colorado

    Advisory Committee: Genentech BioOncology, Lilly, Merck, Pfizer Inc; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Genentech BioOncology, Lilly, Pfizer Inc.

    D Ross Camidge, MD, PhD
    Professor of Medicine/Oncology
    Joyce Zeff Chair in Lung Cancer Research
    University of Colorado Cancer Center
    Aurora, Colorado

    Advisory Committee: Mersana Therapeutics; Contracted Research and Other Remunerated Activities: Roche Laboratories Inc, Takeda Oncology.

    David E Gerber, MD
    Associate Professor
    Division of Hematology-Oncology
    Associate Director for Clinical Research
    Co-Leader, Experimental Therapeutics Program
    Co-Director, Lung Disease Oriented Team
    Harold C Simmons Comprehensive Cancer Center
    University of Texas Southwestern Medical Center
    Dallas, Texas

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Guardant Health Inc, MSPharma, Peregrine Pharmaceuticals Inc, Samsung Bioepis, Synta Pharmaceuticals Corp; Contracted Research: ArQule Inc, BerGenBio ASA, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Genentech BioOncology, ImmunoGen Inc, Karyopharm Therapeutics, Peregrine Pharmaceuticals Inc.

    Sarah B Goldberg, MD, MPH
    Assistant Professor of Medicine
    Medical Oncology
    Yale Cancer Center
    New Haven, Connecticut

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Lilly; Contracted Research: AstraZeneca Pharmaceuticals LP.

    Roy S Herbst, MD, PhD
    Ensign Professor of Medicine (Oncology)
    Professor of Pharmacology
    Chief of Medical Oncology
    Director, Thoracic Oncology Research Program
    Associate Director for Translational Research
    Yale Comprehensive Cancer Center
    Yale School of Medicine
    Smilow Cancer Hospital
    New Haven, Connecticut

    Consulting Agreements: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Lilly, Merck, Pfizer Inc; Contracted Research: Genentech BioOncology, Merck.

    John V Heymach, MD, PhD
    Professor and Chair
    Thoracic/Head and Neck Medical Oncology
    The University of Texas MD Anderson Cancer Center
    Houston, Texas

    Advisory Committee and Consulting Agreements: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, EMD Serono Inc, Genentech BioOncology, Lilly, Merck, Novartis, Roche Laboratories Inc, Spectrum Pharmaceuticals Inc.

    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: AbbVie Inc, Genentech BioOncology, Merck; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Lilly, Xcovery; Paid Travel: Boehringer Ingelheim Pharmaceuticals Inc.

    Edward S Kim, MD
    Professor and Chair
    Department of Solid Tumor Oncology and Investigational Therapeutics
    Levine Cancer Institute
    Carolinas HealthCare System
    Charlotte, North Carolina

    Consulting Agreements and Contracted Research: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Genentech BioOncology, Lilly.

    Mark G Kris, MD
    William and Joy Ruane Chair in Thoracic Oncology
    Attending Physician, Thoracic Oncology Service
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Consulting Agreement: AstraZeneca Pharmaceuticals LP.

    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.

    Renato G Martins, MD, MPH
    Stephen H Petersdorf Endowed Chair in Cancer Care
    Associate Medical Director
    Solid Tumor Adult Oncology
    Seattle Cancer Care Alliance
    Professor
    University of Washington
    Seattle, Washington

    Contracted Research: Eisai Inc, Lilly, Merck.

    Joel W Neal, MD, PhD
    Assistant Professor of Medicine
    Division of Oncology
    Stanford Cancer Institute
    Stanford University
    Palo Alto, California

    Advisory Committee and Consulting Agreements: Ariad Pharmaceuticals Inc, ARMO BioSciences, Boehringer Ingelheim Pharmaceuticals Inc, Clovis Oncology, Lilly, Nektar, Physician Resource Management Inc; Contracted Research: Ariad Pharmaceuticals Inc, ArQule Inc, Boehringer Ingelheim Pharmaceuticals Inc, Genentech BioOncology, Merck, Nektar, Novartis, Roche Laboratories Inc.

    Paul K Paik, MD
    Assistant Attending Physician
    Clinical Director, Thoracic Oncology Service
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Advisory Committee: Bristol-Myers Squibb Company, Celgene Corporation, Lilly.

    Jyoti D Patel, MD
    Professor of Medicine
    The University of Chicago
    Chicago, Illinois

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Takeda Oncology.

    Nathan A Pennell, MD, PhD
    Associate Professor, Hematology and Medical Oncology
    Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
    Director, Cleveland Clinic Lung Cancer Medical Oncology Program
    Cleveland, Ohio

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Regeneron Pharmaceuticals Inc; Consulting Agreement: Lilly; Contracted Research: Merck.

    Suresh S Ramalingam, MD
    Professor of Hematology and Medical Oncology
    Assistant Dean for Cancer Research
    Emory University School of Medicine
    Deputy Director, Winship Cancer Institute
    Atlanta, Georgia

    Advisory Committee and Consulting Agreements: Amgen Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly, Merck, Takeda Oncology.

    Lecia V Sequist, MD, MPH
    Associate Professor of Medicine
    Harvard Medical School
    Center for Thoracic Cancers
    Massachusetts General Hospital Cancer Center
    Boston, Massachusetts

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Genentech BioOncology, Pfizer Inc; Contracted Research: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Merrimack Pharmaceuticals Inc, Novartis.

    Mark A Socinski, MD
    Executive Medical Director
    Member, Thoracic Oncology Program
    Florida Hospital Cancer Institute
    Orlando, Florida

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Pfizer Inc; Contracted Research: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly, Takeda Oncology.

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

    Advisory Committee: Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly, Novartis, Pfizer Inc, Roche Laboratories Inc; Consulting Agreement: AstraZeneca Pharmaceuticals LP.

    Thomas E Stinchcombe, MD
    Thoracic Oncology Program
    Duke University Medical Center
    Durham, North Carolina

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Regeneron Pharmaceuticals Inc.

    Anne S Tsao, MD
    Professor
    Director, Mesothelioma Program
    Director, Thoracic Chemo-Radiation Program
    Department of Thoracic/Head and Neck Medical Oncology
    The University of Texas MD Anderson Cancer Center
    Houston, Texas

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, EMD Serono Inc, Genentech BioOncology, Lilly, Merck, Novartis, Roche Laboratories Inc; Consulting Agreements: Lilly, Novartis, Roche Laboratories Inc; Contracted Research: Ariad Pharmaceuticals Inc, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Epizyme Inc, Merck, Polaris Group, Seattle Genetics, Takeda Oncology.

    Everett E Vokes, MD
    John E Ultmann Professor
    Chairman, Department of Medicine
    Physician-in-Chief, University of Chicago Medicine and Biological Sciences
    Chicago, Illinois

    Advisory Committee: AstraZeneca Pharmaceuticals LP, EMD Serono Inc; Consulting Agreements: Abbott Laboratories, Amgen Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, EMD Serono Inc, Genentech BioOncology, Lilly, Merck, Regeneron Pharmaceuticals Inc, Takeda Oncology, VentiRx Pharmaceuticals Inc.

    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.

    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 Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Genentech BioOncology and Merck.

    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

    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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