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Current Controversies, Recent Developments and Emerging Strategies in the Practical Management of Non-Small Cell Lung Cancer (Video Program)
Released March 2014

Video excerpts from a clinical investigator Think Tank held on November 15, 2013. Featuring perspectives from Drs Chandra P Belani, Ramaswamy Govindan, John V Heymach, Gregory J Riely, Mark A Socinski and David R Spigel. (Video Program)

CE Disclosures and Faculty Information

    This activity has been designed to meet the educational needs of medical oncologists, hematologist-oncologists, radiation oncologists, fellows and other healthcare providers involved in the treatment of lung cancer.

    Lung cancer is increasingly being recognized as a heterogeneous group of tumors. Not long ago, it was clinically sufficient to make a differentiation between small cell lung cancer and non-small cell lung cancer (NSCLC). Today, individualized treatment decisions are increasingly driven by genetic biomarkers in addition to histological subtype and patient-specific characteristics.

    Determining which treatment approach is most appropriate in a given case requires careful consideration of patient and disease characteristics as well as available health system resources. To facilitate appropriate decision-making for the various presentations of NSCLC, oncology clinicians must be kept abreast of key research developments related to this rapidly evolving field. This CME program uses a roundtable discussion with leading lung cancer clinical investigators to assist practicing clinicians in this regard and ensure they are delivering state-of-the-art care.


    • Identify distinct subtypes of adenocarcinoma of the lung — including those with EGFR mutations, EML4-ALK gene fusions, MET amplification and other recently identified driver mutations — and the approved and investigational treatment options for patients with these mutations.
    • Assess new oncogenic pathways mediating the growth of unique NSCLC tumor subsets, and recall emerging data with experimental agents exploiting these targets.
    • Apply the results of existing and emerging clinical research to the multimodality treatment of Stage II and III NSCLC.
    • Develop an evidence-based approach to the selection of induction and maintenance biologic therapy and/or chemotherapy for patients with advanced NSCLC.
    • Describe emerging data on the efficacy and safety of tumor immunotherapy directed at the PD-1/PD-L1 pathway in lung cancer, and consider this information when counseling patients regarding clinical trial participation.


    CME credit is no longer available for this issue


    CME credit is no longer available for this issue

    This CME activity consists of a video component. The participant should watch the video.

    CME credit is no longer available for this issue

    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent 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 real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Chandra P Belani, MD
    Miriam Beckner Distinguished Professor of Medicine
    Penn State College of Medicine
    Deputy Director
    Penn State Hershey Cancer Institute
    Hershey, Pennsylvania

    Consulting Agreements: Genentech BioOncology, Lilly.

    Ramaswamy Govindan, MD
    Professor of Medicine
    Co-Director, Section of Medical Oncology
    Division of Oncology
    Washington University School of Medicine
    St Louis, Missouri

    Consulting Agreements: Abbott Laboratories, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Covidien, Mallinckrodt Pharmaceuticals, Merck, Pfizer Inc, Roche Laboratories Inc.

    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: Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Genentech BioOncology, GlaxoSmithKline, Pfizer Inc; Consulting Agreement: OSI Oncology; Contracted Research: Bayer HealthCare Pharmaceuticals, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly, Pfizer Inc.

    Gregory J Riely, MD, PhD
    Assistant Attending
    Memorial Sloan-Kettering Cancer Center
    Assistant Professor
    Weill Cornell Medical College
    New York, New York

    Consulting Agreement: ARIAD Pharmaceuticals Inc; Contracted Research: Astellas, Bristol-Myers Squibb Company, Chugai Pharmaceutical Co Ltd, GlaxoSmithKline, Infinity Pharmaceuticals Inc, Novartis Pharmaceuticals Corporation, Pfizer Inc.

    Mark A Socinski, MD
    Professor of Medicine and Thoracic Surgery
    Director, Lung Cancer Section
    Division of Hematology/Oncology
    Co-Director, UPMC Lung Cancer Center of Excellence
    Co-Director, Lung and Thoracic Malignancies Program
    University of Pittsburgh
    UPMC Cancer Pavilion
    Pittsburgh, Pennsylvania

    Contracted Research: Celgene Corporation, Genentech BioOncology, GlaxoSmithKline, Lilly, Pfizer Inc, Synta Pharmaceuticals Corp; Data and Safety Monitoring Board: Abbott Laboratories; Speakers Bureau: Celgene Corporation, Genentech BioOncology, Lilly.

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

    Advisory Committee: Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly, Novartis Pharmaceuticals Corporation, Pfizer Inc, Sanofi.

    MODERATORDr 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, Algeta US, Amgen Inc, Astellas, AstraZeneca Pharmaceuticals LP, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, Biodesix Inc, Biogen Idec, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, Exelixis Inc, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Incyte Corporation, Lilly, Medivation Inc, Merck, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc, Teva Oncology and VisionGate Inc.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no real or apparent 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, Biodesix Inc, Genentech BioOncology, Lilly 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: March 2014
    Expiration date: March 2015

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(WIFI is recommended for best performance):

Anti-PD-1 and anti-PD-L1 antibodies
Case presentation (Dr Spigel): An 82-year-old woman with metastatic squamous cell lung cancer who received nivolumab
Anti-PD-1 and anti-PD-L1 antibodies
Treatment for patients with EGFR tumor mutations
Sensitivity of various mutations to EGFR TKIs
Choice of first-line EGFR TKI: Erlotinib or afatinib?
Management of disease progression on an EGFR TKI
CO-1686, an irreversible, highly selective TKI of activating and T790M EGFR mutations
Treatment for patients with tumors containing ALK rearrangements
Disease progression on crizotinib
Next-generation TKIs in ALK-rearranged lung cancer: LDK378, alectinib
Case presentation (Dr Heymach): A 55-year-old man with response to LDK378 after a CR then disease progression on crizotinib
Use of targeted therapy to treat brain metastases
Treatment for patients with tumors containing BRAF mutations
Treatment for patients with tumors containing BRAF mutations
Treatment for patients with pan-wild-type metastatic adenocarcinoma
Maintenance treatment in metastatic adenocarcinoma of the lung
PointBreak study of chemotherapy and bevacizumab
Trial of carboplatin/pemetrexed → pemetrexed maintenance versus carboplatin/paclitaxel/bevacizumab → bevacizumab maintenance
VeriStrat® assay
VeriStrat assay         

Adjuvant treatment
Case presentation (Dr Riely): An 81-year-old woman s/p surgical resection of Stage II adenocarcinoma of the lung
Locally advanced disease
Case presentation (Dr Govindan): A 49-year-old man with locally advanced disease and an EGFR L858R tumor mutation