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Lung Cancer Update, Issue 2, 2016 (Video Program)
Released September 2016

Proceedings from video interviews with Drs Roy S Herbst and Alice Shaw on the treatment of lung cancer.

CE Disclosures and Faculty Information

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

    OVERVIEW OF ACTIVITY
    Lung cancer is the leading cause of cancer mortality in the United States for both men and women. In 2016, it is estimated that 224,390 new cases of lung and bronchus cancer will be diagnosed and 158,080 deaths will occur in the United States. Traditional chemotherapy, surgery and radiation therapy have had a modest effect on long-term outcomes for patients with lung cancer. However, the advent of biologic and immunotherapeutic agents has led to recent improve­ments in disease-free and overall survival in select populations. In order to offer optimal patient care, including the option of clinical trial participation, clinicians must be well informed of these advances.

    To provide clinicians with therapeutic strategies to address the disparate needs of patients with lung cancer, this program features information on the latest research developments and is designed to assist medical and radiation oncologists with the formulation of up-to-date strategies for the care of patients with lung cancer.

    LEARNING OBJECTIVES

    • Review the benefits and risks associated with systemic therapies used in the evidence-based treatment of lung cancer, including targeted biologic agents and chemotherapy.
    • Compare and contrast expert perspectives on the indications for mutation analysis in patients with localized and metastatic non-small cell lung cancer (NSCLC), and, when appropriate, use validated testing platforms to obtain this information.
    • Formulate a plan to incorporate immune checkpoint inhibitor therapy into the treatment of advanced NSCLC, and subsequently monitor immune-related side effects when they occur.
    • Communicate the efficacy and safety of crizotinib, ceritinib, alectinib and other emerging ALK inhibitors to appropriate patients with NSCLC, considering the predictive utility of ALK mutation testing.
    • Assess new oncogenic pathways mediating the growth of unique NSCLC tumor subsets, and recall emerging data with experimental agents exploiting these targets.

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

    CME credit is no longer available for this issue

    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:

    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
    New Haven, Connecticut

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

    Alice Shaw, MD, PhD
    Associate Professor of Medicine
    Harvard Medical School
    Center for Thoracic Cancers
    Massachusetts General Hospital
    Boston, Massachusetts

    Advisory Committee: EMD Serono Inc, Genentech BioOncology, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc; Consulting Agreements: Blueprint Medicines, Daiichi Sankyo Inc, EMD Serono Inc, Ignyta Inc, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Taiho Oncology Inc.

    EDITOR — 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, Agendia Inc, Amgen 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, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, 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 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, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Foundation Medicine, Genentech BioOncology, Lilly, Merck and Novartis Pharmaceuticals Corporation.

    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: September 2016
    Expiration date: September 2017

Acknowledge and close

Watch video
(WIFI is recommended for best performance):
Management of metastatic non-small cell cancer (NSCLC) with no identifiable tumor mutations
Selection of induction and maintenance systemic therapy for patients with metastatic NSCLC without an identifiable driver mutation
Perspective on the clinical significance of ramucirumab/docetaxel for advanced NSCLC
Immune checkpoint inhibitors
PD-L1 expression and correlation with response to anti-PD-1/anti-PD-L1 antibodies
Immune-related adverse events and clinical experience with checkpoint inhibitor-associated pneumonitis
Results of the Phase II POPLAR trial: Atezolizumab versus docetaxel for patients with previously treated advanced NSCLC
Reevaluating clinical trial endpoints and assessing duration of benefit with immune checkpoint inhibitors
Tolerability and duration of treatment with immune checkpoint inhibitors
Actionable mutations in NSCLC: EGFR, BRAF, HER2, RET
Choosing among available EGFR tyrosine kinase inhibitors: afatinib, gefitinib or erlotinib
Incidence of BRAF mutations and interim results of a Phase II trial evaluating dabrafenib with trametinib for BRAF V600E mutation-positive metastatic NSCLC
Case discussion: A 48-year-old woman and never smoker with metastatic adenocarcinoma of the lung receives a positive HER2 mutation result on multiplex testing
Identification of actionable mutations in squamous and nonsquamous NSCLC
Activity and tolerability of cabozantinib in patients with advanced RET-rearranged NSCLC
Incidence of MET mutations and amplifications in NSCLC
EML4-ALK fusion and ALK inhibitors
Activity and safety of alectinib in patients with crizotinib-resistant ALK-rearranged NSCLC and brain metastases
Mechanisms of resistance to ALK inhibitors and treatment strategies for patients with disease progression on ceritinib or alectinib
Dosage and administration of ceritinib
Optimal sequencing of crizotinib, alectinib and ceritinib
Activity of pemetrexed as second-line therapy for patients with ALK-rearranged lung cancer
Molecular profiling in early-stage NSCLC
ALCHEMIST: An ongoing trial of genetic testing in screening patients with Stage IB to IIIA NSCLC that has been or will be surgically removed