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Striving for Consensus on the Optimal Management of Metastatic Non-Small Cell Lung Cancer (Roundtable Audio Proceedings)
Released June 2020

A roundtable discussion featuring clinical investigators Drs Hossein Borghaei, Julie R Brahmer, Edward B Garon, Ramaswamy Govindan, John V Heymach, Leora Horn, Melissa L Johnson and Benjamin Levy, and general medical oncologists Drs Margaret A Deutsch, Joseph T Martins, Maria Picton and G Richard Polkinghorn. (Audio Program)

CE Information and Faculty Disclosures

  • TARGET AUDIENCE
    This educational activity has been designed to meet the educational needs of medical oncologists, hematology-oncology fellows and other healthcare providers involved in the treatment of lung cancer.

    OVERVIEW OF ACTIVITY
    Lung cancer is a devastating disease with broad impact on public health as it accounts for 13% of all new cancer cases in the United States and the most cancer-related deaths among both men and women. The last several years have seen an explosion in the emergence of new treatments, including immunotherapies and targeted therapies, that have transformed the treatment of metastatic non-small cell lung cancer (NSCLC). However, although these therapies have been shown to improve survival, they have also led to changes in the prevailing treatment algorithms and new challenges in the management of this disease. In order to offer optimal patient care, clinicians must be well informed of these advances. This CME program features roundtable discussions with leading lung cancer experts on the optimal clinical care of patients with metastatic NSCLC. By reviewing available clinical trial data in the context of expert perspectives, this activity will assist medical oncologists with the formulation of evidence-based strategies, which in turn will facilitate optimal patient care.

    LEARNING OBJECTIVES

    • Consider emerging research information in the development of a biomarker testing algorithm to optimize first- and later-line therapy for individuals with NSCLC.
    • Evaluate performance status, prior therapeutic exposure and other patient- and disease-related factors to guide the selection of systemic therapy for metastatic NSCLC in the first- and later-line settings.
    • Appraise available data and expert perspectives regarding the selection and sequencing of available therapeutic options for patients with NSCLC with targetable genomic alterations.
    • Appreciate clinical trial data documenting the efficacy of bevacizumab and ramucirumab in patients with metastatic NSCLC, and discern how these agents can be optimally integrated into lung cancer clinical practice.
    • Review recent therapeutic advances in the use of immune checkpoint inhibitors as monotherapy or in combination with chemotherapy for metastatic NSCLC, and discern how these approaches can be optimally employed in clinical practice.
    • Develop strategies to recognize and manage toxicities associated with immune checkpoint inhibitors and targeted therapies used in the management of metastatic NSCLC.

    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
    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 THESE CME ACTIVITIES
    Audio Program: This CME activity consists of an audio component.
    CME credit is no longer available for this issue


    Video Program: 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:

    Clinical Investigators

    Hossein Borghaei, DO, MS
    Professor and Chief, Thoracic Oncology
    The Gloria and Edmund M Dunn Chair in Thoracic Oncology
    Fox Chase Cancer Center
    Philadelphia, Pennsylvania

    Advisory Committee: AbbVie Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Daiichi Sankyo Inc, EMD Serono Inc, Genentech, a member of the Roche Group, Genmab, Lilly, Merck, Novartis, Pfizer Inc, PharmaMar, Regeneron Pharmaceuticals Inc, Takeda Oncology; Consulting Agreements: Amgen Inc, AstraZeneca Pharmaceuticals LP, Axiom Life Sciences Group LLC, Bristol-Myers Squibb Company, HUYA Bioscience International, Lilly, Merck; Contracted Research: Bristol-Myers Squibb Company, Celgene Corporation, Lilly, Merck, Takeda Oncology; Data and Safety Monitoring Board/Committee: Incyte Corporation, Takeda Oncology, University of Pennsylvania, Vanderbilt University; Scientific Advisory Board: Rgenix, Sonnet BioTherapeutics.

    Julie R Brahmer, MD, MSc
    Professor of Oncology
    Director of the Upper Aerodigestive Cancer Disease Program
    Co-Director of the Cancer Immunology Program
    Co-Director of the Upper Aerodigestive Cancer Program at
    Bloomberg-Kimmel Institute for Cancer Immunotherapy
    Director of the Johns Hopkins Kimmel Cancer Center
    on the Johns Hopkins Bayview Campus
    The Sidney Kimmel Comprehensive Cancer Center
    Johns Hopkins Medicine
    Baltimore, Maryland

    Advisory Committee: Amgen Inc, Bristol-Myers Squibb Company (uncompensated), Genentech, a member of the Roche Group, GlaxoSmithKline, Lilly, Merck; Consulting Agreements: Amgen Inc, Bristol-Myers Squibb Company, GlaxoSmithKline, Sanofi Genzyme; Contracted Research: Bristol-Myers Squibb Company, Genentech, a member of the Roche Group, RAPT Therapeutics, Revolution Medicines; Data and Safety Monitoring Board/Committee: GlaxoSmithKline, Sanofi Genzyme.

    Edward B Garon, MD, MS
    Associate Professor
    Director, Thoracic Oncology Program
    Director, Signal Transduction and Therapeutics Research Program
    David Geffen School of Medicine at UCLA
    Jonsson Comprehensive Cancer Center
    Los Angeles, California

    Advisory Committee: Dracen Pharmaceuticals, EMD Serono Inc, GlaxoSmithKline, Mirati Therapeutics, Novartis; Contracted Research: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Dynavax Technologies, EMD Serono Inc, Genentech, a member of the Roche Group, Iovance Biotherapeutics, Lilly, Merck, Mirati Therapeutics, Neon Therapeutics, Novartis.

    Ramaswamy Govindan, MD
    Professor of Medicine
    Director, Section of Oncology
    Anheuser-Busch Endowed Chair in Medical Oncology
    Washington University School of Medicine
    St Louis, Missouri

    Advisory Committee: AbbVie Inc, Achilles Therapeutics; Consulting Agreement: Amgen 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: AstraZeneca Pharmaceuticals LP, BrightPath Biotherapeutics Co Ltd, Bristol-Myers Squibb Company, EMD Serono Inc, Foundation Medicine, GlaxoSmithKline, Guardant Health, Hengrui Therapeutics Inc, Kairos Venture Investments LLC, Lilly, Roche Laboratories Inc, Spectrum Pharmaceuticals Inc; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Hengrui Therapeutics Inc, Kairos Venture Investments LLC, Lilly; Contracted Research: AACR-Johnson & Johnson Lung Cancer Innovation Science Grants, American Cancer Society, AstraZeneca Pharmaceuticals LP, Cancer Prevention & Research Institute of Texas, Checkmate Pharmaceuticals, National Cancer Institute at the National Institutes of Health, Spectrum Pharmaceuticals Inc; Patents and Royalties: Bio-Tree Systems Inc, Spectrum Pharmaceuticals Inc.

    Leora Horn, MD, MSc
    Ingram Associate Professor of Cancer Research
    Director, Thoracic Oncology Research Program
    Assistant Vice Chairman for Faculty Development
    Vanderbilt University Medical Center
    Nashville, Tennessee

    Advisory Committee: Amgen Inc, EMD Serono Inc, Genentech, a member of the Roche Group, Xcovery; Consulting Agreements: AstraZeneca Pharmaceuticals LP, EMD Serono Inc, Genentech, a member of the Roche Group, Incyte Corporation, Merck, Xcovery; Contracted Research: Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Xcovery.

    Melissa L Johnson, MD
    Associate Director, Lung Cancer Research
    Sarah Cannon Research Institute
    Nashville, Tennessee

    Consulting Agreements: AbbVie Inc, Achilles Therapeutics, AstraZeneca Pharmaceuticals LP, Atreca, Boehringer Ingelheim Pharmaceuticals Inc, Calithera Biosciences, Genentech, a member of the Roche Group, GlaxoSmithKline, Gritstone Oncology, Guardant Health, Incyte Corporation, Janssen Biotech Inc, Lilly, Merck, Mirati Therapeutics, Novartis, Pfizer Inc, Ribon Therapeutics, Sanofi Genzyme; Contracted Research: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Adaptimmune, Amgen Inc, Apexigen, Arcus Biosciences, Array BioPharma Inc, AstraZeneca Pharmaceuticals LP, Atreca, BeiGene, BerGenBio ASA, Boehringer Ingelheim Pharmaceuticals Inc, Calithera Biosciences, Checkpoint Therapeutics Inc, Corvus Pharmaceuticals, CytomX Therapeutics, Daiichi Sankyo Inc, Dynavax Technologies Corporation, EMD Serono Inc, Genentech, a member of the Roche Group, Genmab, Genocea Biosciences Inc, GlaxoSmithKline, Gritstone Oncology, Guardant Health, Hengrui Therapeutics Inc, Immunocore, Incyte Corporation, Janssen Biotech Inc, Jounce Therapeutics, Lilly, Merck, Mirati Therapeutics, Neovia Oncology, Novartis, OncoMed Pharmaceuticals Inc, Pfizer Inc, Regeneron Pharmaceuticals Inc, Ribon Therapeutics, Sanofi Genzyme, Seven and Eight Biopharmaceuticals Inc, Shattuck Labs, Stemcentrx, Syndax Pharmaceuticals Inc, Takeda Oncology, Tarveda Therapeutics, TCR2 Therapeutics, University of Michigan, WindMIL Therapeutics.

    Benjamin Levy, MD
    Associate Professor, Johns Hopkins School of Medicine
    Clinical Director, Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial
    Medical Director, Thoracic Oncology Program
    Washington, DC

    Consulting Agreements: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Genentech, a member of the Roche Group, Lilly, Merck, Pfizer Inc, Takeda Oncology; Contracted Research: Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech, a member of the Roche Group, Lilly.

    General Medical Oncologists

    Margaret A Deutsch, MD
    Medical Oncologist
    Duke Cancer Center Raleigh
    Raleigh, North Carolina

    No financial interests or affiliations to disclose.

    Joseph T Martins, MD
    Associate Professor of Medicine
    UT Health East Texas HOPE Cancer Center
    Tyler, Texas

    No financial interests or affiliations to disclose.

    Maria Picton, MD
    Physicians East
    Greenville, North Carolina

    No financial interests or affiliations to disclose.

    G Richard Polkinghorn, MD
    Medical Director
    Harold Alfond Center for Cancer Care
    Augusta, Maine

    No financial interests or affiliations to disclose.

    EDITOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Array BioPharma Inc, Astellas, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, EMD Serono Inc, Exelixis Inc, Foundation Medicine, Genentech, a member of the Roche Group, Genmab, Genomic Health Inc, Gilead Sciences Inc, GlaxoSmithKline, Guardant Health, 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, A Gilead Company, Lexicon Pharmaceuticals Inc, Lilly, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Oncopeptides, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, a Novartis Division, Sanofi Genzyme, Seattle Genetics, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro, A GSK Company, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

    RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent 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 grantor.

    This activity is supported by an educational grant from Lilly.

    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

    Release date: July 2020
    Expiration date: July 2021

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