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Lung Cancer Update, Issue 3, 2016 (Video Program)
Released February 2017

Highlights from video interviews with Drs George R Blumenschein Jr and Tony SK Mok on the treatment of lung cancer. (Video Program)

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 2017, it is estimated that 222,500 new cases of lung and bronchus cancer will be diagnosed and 155,870 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

    • Describe existing and emerging data on the efficacy and safety of tumor immunotherapy, including approaches directed at the PD-1 and PD-L1 pathways, and of antibody-drug conjugates in lung cancer and mesothelioma, and consider this information when counseling patients regarding protocol and clinical treatment options.
    • Consider published safety and efficacy data with available and emerging therapeutic strategies, and appropriately incorporate targeted therapies into the care of patients with identified tumor driver mutations or alterations.
    • Recognize the recent FDA approvals of ramucirumab and necitumumab for patients with metastatic non-small cell lung cancer (NSCLC), and discern how these agents can be safely administered to appropriate patients with squamous and nonsquamous disease.
    • Compare and contrast the variable CNS permeability of approved ALK inhibitors, and use this information to guide selection of appropriate treatment for patients with ALK-positive NSCLC and brain metastases.
    • Recall the scientific rationale for ongoing investigation of novel agents or therapeutic approaches in NSCLC, and counsel appropriately selected patients about study 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 1.75 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 enables the participant to earn up to 1.75 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 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/LCU316/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. 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:

    George R Blumenschein Jr, MD
    Professor, Department of Thoracic/Head and Neck Medical Oncology
    Division of Cancer Medicine
    The University of Texas
    MD Anderson Cancer Center
    Houston, Texas

    Advisory Committee: AbbVie Inc, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Celgene Corporation, Merck; Consulting Agreements: AbbVie Inc, Ariad Pharmaceuticals Inc, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Celgene Corporation, EMD Serono Inc, Genentech BioOncology, Merck, Novartis Pharmaceuticals Corporation; Contracted Research: AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Merck, Novartis Pharmaceuticals Corporation, Xcovery.

    Tony SK Mok, MD
    Chairman, Department of Clinical Oncology
    The Chinese University of Hong Kong
    Hong Kong, China

    Advisory Committee: ACE Pharmaceuticals, Amgen Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, GeneCode Ltd, Lilly, Merck, Novartis Pharmaceuticals Corporation, OncoGenex Pharmaceuticals Inc, Pfizer Inc, Roche Laboratories Inc, Vertex Pharmaceuticals Incorporated; Consulting Agreements: ACE Pharmaceuticals, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, GeneCode Ltd, GlaxoSmithKline, Lilly, Merck, Novartis Pharmaceuticals Corporation, OncoGenex Pharmaceuticals Inc, Pfizer Inc, Roche Laboratories Inc, SFJ Pharmaceuticals Group, Vertex Pharmaceuticals Incorporated; Contracted Research: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, SFJ Pharmaceuticals Group; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, GlaxoSmithKline, Lilly, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories 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, 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, Daiichi Sankyo Inc, 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, 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 Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, 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: February 2017
    Expiration date: February 2018

    After completing the Post-test, learners may download and review the answers here in order to identify further areas of study.

Acknowledge and close

Watch video
(WIFI is recommended for best performance):
First- and second-generation EGFR tyrosine kinase inhibitors (TKIs) for EGFR mutation-positive non-small-cell lung cancer (NSCLC)
Topics:
  • LUX-Lung 7 trial: Gefitinib versus afatinib as first-line therapy for EGFR mutation-positive NSCLC
  • IMPRESS: Results of a Phase III trial of gefitinib and chemotherapy versus placebo and chemotherapy for patients with EGFR mutation-positive NSCLC with disease progression on first-line gefitinib
  • Afatinib/cetuximab for patients with T790M mutation-negative NSCLC
Osimertinib and treatment options for patients with disease progression on an EGFR TKI
Topics:
  • T790M mutation testing and treatment of metastatic nonsquamous NSCLC after disease progression
  • Case discussion: A 56-year-old woman and never smoker with EGFR exon 19-positive, TTF1-positive metastatic adenocarcinoma of the lung
  • Case discussion: A 70-year-old man with EGFR mutation-positive metastatic NSCLC experiences disease progression on an EGFR TKI and is determined to have T790M mutation-positive disease
  • Treatment options after disease progression on osimertinib
  • Clinical trials of osimertinib as first-line therapy for EGFR mutation-positive metastatic NSCLC
  • Antitumor activity and ongoing investigation of the third-generation EGFR TKIs olmutinib (BI 1482694) and ASP8273 for advanced EGFR mutation-positive NSCLC
  • Treatment of T790M mutation-negative disease after progression on an EGFR TKI
Other targetable mutations in NSCLC: ALK rearrangement; MET exon 14 splice mutation
Topics:
  • Algorithm for mutation testing in metastatic nonsquamous NSCLC
  • J-ALEX trial: Alectinib versus crizotinib in ALK inhibitor-naïve NSCLC
  • Case discussion: A 45-year-old man with ALK-positive NSCLC and brain metastases
  • MET amplification and exon 14 splice site mutations define unique molecular subgroups of NSCLC
Application of immune checkpoint inhibitors in NSCLC
Topics:
  • Immune checkpoint inhibitors as second-line therapy for NSCLC
  • Use of immune checkpoint inhibitors alone or in combination regimens for patients with targetable mutations
  • Case discussion: A 53-year-old woman with recurrent KRAS mutation-positive adenocarcinoma of the lung and brain metastases receives an immune checkpoint inhibitor
  • Use of immune checkpoint inhibitor therapy for patients with preexisting autoimmune disease
Systemic and localized treatment approaches for NSCLC
Topics:
  • Neoadjuvant chemotherapy in locally advanced NSCLC
  • ECOG-E1505: A Phase III trial of adjuvant chemotherapy with or without bevacizumab for early-stage NSCLC — A subset analysis of outcomes by chemotherapy
  • PROCLAIM trial: Pemetrexed/cisplatin or etoposide/cisplatin with radiation therapy followed by consolidation chemotherapy for locally advanced nonsquamous NSCLC
  • Use of local consolidative therapy improves progression-free survival for patients with oligometastatic NSCLC who receive systemic induction therapy
  • Case discussion: A 68-year-old man and former smoker with Stage IIIA pan-wild-type NSCLC
Small cell lung cancer, mesothelioma and squamous NSCLC
Topics:
  • Activity of the antibody-drug conjugate rovalpituzumab tesirine in small cell lung cancer
  • Case discussion: A 55-year-old man with recurrent epithelioid mesothelioma
  • MAPS study of chemotherapy and bevacizumab for malignant pleural mesothelioma
  • Activity and tolerability of the antimesothelin antibody-drug conjugate anetumab ravtansine for mesothelioma
  • JAVELIN trial: Efficacy and safety of the anti-PD-L1 antibody avelumab in unresectable advanced mesothelioma
  • First- and second-line therapy options for squamous cell NSCLC
  • Multiplex testing in squamous cell NSCLC
  • Lung Master Protocol (SWOG-S1400) evaluating biomarker-targeted second-line therapy for recurrent Stage IV squamous cell lung cancer