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Recent Advances and Future Directions in Oncology: A Daylong Multitumor Educational Symposium in Partnership with the NCOA and the SCOS Joint Annual Conference (Webinar Video Proceedings)
Released March 2023

Proceedings from a daylong symposium held in partnership with the North Carolina Oncology Association and the South Carolina Oncology Society, featuring perspectives from Drs Tanios Bekaii-Saab, Michael Birrer, Danielle Brander, Harold Burstein, Ibiayi Dagogo-Jack, Virginia Kaklamani, Stephen Liu, Ursula Matulonis, Rutika Mehta, Craig Moskowitz, Daniel Petrylak and Sandy Srinivas, moderated by Drs Suzanne Fanning, Justin Peter Favaro, Kellie Schneider and Nasfat Shehadeh. Published March 17, 2023. (Webinar Video Proceedings)

CE Information and Faculty Disclosures

  • TARGET AUDIENCE
    This program is intended for medical oncologists, hematologists, hematology-oncology fellows and other allied healthcare professionals involved in the treatment of cancer.

    LEARNING OBJECTIVES

    • Assess published research to guide the selection and duration of neoadjuvant, adjuvant and extended-adjuvant therapy for patients with HER2-overexpressing localized breast cancer.
    • Evaluate the results of genomic assays and other patient- and treatment-related factors to personalize adjuvant systemic therapy for newly diagnosed ER-positive breast cancer.
    • Consider available clinical trial findings with CDK4/6 inhibitors for localized ER-positive, HER2-negative breast cancer, and assess the optimal role of these agents as neoadjuvant or adjuvant treatment.
    • Appreciate available Phase III data documenting the efficacy of adjuvant PARP inhibition for high-risk HER2-negative localized breast cancer with a BRCA mutation, and consider the role of this strategy in clinical practice.
    • Review published data demonstrating the benefit of chemotherapy in combination with anti-PD-1/PD-L1 antibodies for localized triple-negative breast cancer (TNBC), and use this information to make appropriate treatment recommendations.
    • Implement a long-term clinical plan for the management of HER2-positive metastatic breast cancer (mBC), incorporating established and recently approved anti-HER2 therapies.
    • Individualize the selection and sequencing of systemic therapy for patients with ER-positive mBC, considering age, menopausal status, prior treatment course, PIK3CA and ESR1 mutation status, level of HER2 expression, comorbidities, symptomatology and extent and sites of disease.
    • Evaluate published research findings guiding the selection and sequencing of available therapeutic agents for metastatic TNBC.
    • Appraise published efficacy and safety data with PARP inhibitors for patients with mBC harboring BRCA1/2 mutations, and consider the diagnostic and therapeutic implications for nonresearch care.
    • Recall the mechanisms of action of, early data with and ongoing clinical trials evaluating other novel agents and treatment strategies under development for localized and metastatic breast cancer.
    • Optimize the use of adjuvant chemotherapy for localized colorectal cancer (CRC), considering various clinical and biologic factors such as patient age, performance status, disease stage, et cetera.
    • Develop a long-term care plan for metastatic CRC, considering the patient’s biomarker profile, tumor location, prior systemic therapy, symptomatology and personal goals of treatment.
    • Use HER2 status, PD-L1 combined positive score and other clinical and biologic factors to optimize the selection and sequencing of systemic therapy for patients with gastric, gastroesophageal junction and esophageal cancers.
    • Consider age, performance status, degree of liver function and other clinical factors in the selection of first- and later-line therapy for patients with unresectable or metastatic hepatocellular carcinoma.
    • Evaluate available and emerging data documenting the efficacy and safety of anti-PD-1/PD-L1 antibody therapy in combination with chemotherapy as first-line treatment for advanced biliary tract cancers (BTCs), and consider the role of this therapeutic strategy.
    • Recognize the molecular heterogeneity of cholangiocarcinoma and other BTCs, and appreciate the biologic rationale for efforts to exploit documented abnormalities in patients with these diseases.
    • Recall clinical trial data with approved and investigational systemic interventions for metastatic pancreatic adenocarcinoma, and establish an evidence-based approach to selection of therapy for patients.
    • Appraise available and emerging data with investigational agents currently in clinical testing for gastrointestinal cancers, and as applicable, refer eligible patients for clinical trial participation.
    • Evaluate available and emerging data documenting the efficacy and safety of anti-PD-1/PD-L1 antibody-based approaches as neoadjuvant, adjuvant or consolidation therapy for patients with nonmetastatic non-small cell lung cancer (NSCLC).
    • Acknowledge the FDA approval of adjuvant EGFR tyrosine kinase inhibitor therapy for patients with localized NSCLC with EGFR mutations, and identify those for whom treatment with this approach would be warranted.
    • Counsel patients with metastatic NSCLC with EGFR mutations regarding available therapeutic considerations, explaining the relevance of mutation type, symptomatology, sites and extent of metastases and other factors.
    • Understand the biology of EGFR exon 20 insertion mutations, and evaluate how recently approved agents should be employed in the care of patients with these abnormalities.
    • Recall published data with commercially available agents exploiting other oncogenic pathways (eg, ALK, RET, MET, HER2, KRAS G12C) mediating the pathogenesis of tumors in unique patient subsets.
    • Review recent therapeutic advances related to anti-PD-1/PD-L1 antibodies as monotherapy or in combination with chemotherapy, chemobiologic therapy or anti-CTLA-4 antibodies for metastatic NSCLC, and discern how these approaches can be optimally employed in the management of this disease.
    • Develop a long-term care plan, including the option of clinical trial participation, for patients with progressive NSCLC, considering prior systemic therapy, symptomatology, performance status and personal goals of treatment.
    • Reflect on investigational agents and strategies currently in testing for lung cancer, and as applicable, refer eligible patients for clinical trial participation.
    • Individualize the selection and sequencing of systemic therapy for patients with newly diagnosed or relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL), considering clinical presentation, age, performance status, biomarker profile and coexisting medical conditions.
    • Understand published research data informing the selection, sequencing or combining of available therapeutic agents in the nonresearch care of patients with previously untreated or R/R follicular lymphoma (FL).
    • Recognize the mechanisms of action and the efficacy and safety of approved and investigational agents for diffuse large B-cell lymphoma (DLBCL) to determine the current and potential utility of those agents in clinical practice.
    • Consider patient age, performance status and other clinical and biologic factors in the up-front and subsequent treatment of mantle cell lymphoma (MCL).
    • Incorporate available and emerging therapeutic strategies into the best-practice management of newly diagnosed and R/R Hodgkin lymphoma.
    • Assess available and emerging clinical trial findings with the use of CD19-directed chimeric antigen receptor T-cell therapy for R/R DLBCL, MCL, FL or CLL, and counsel appropriately selected patients regarding the potential benefits of this strategy.
    • Recall new data with agents and strategies currently under investigation for CLL and various lymphoma subtypes, and discuss ongoing trial opportunities with eligible patients.
    • Evaluate the published research database supporting the use of secondary hormonal agents in the management of nonmetastatic castration-sensitive and castration-resistant prostate cancer, and apply this information in the discussion of nonresearch treatment options.
    • Explore available data with cytotoxic and secondary hormonal therapy or combinations of these approaches for metastatic hormone-sensitive prostate cancer to design effective treatment plans for patients.
    • Establish an evidence-based approach to the selection and sequencing of therapeutic options for patients with metastatic castration-resistant prostate cancer (mCRPC), considering age, comorbidities, prior therapeutic exposure and other factors.
    • Assess available and emerging research supporting the use of PARP inhibitors for mCRPC, and discern how to optimally incorporate these agents into current and future clinical management algorithms.
    • Review available clinical trial evidence with immune checkpoint inhibitors as monotherapy or as maintenance after platinum-based chemotherapy in the treatment of newly diagnosed metastatic urothelial bladder cancer (UBC), and determine the current utility of these agents in clinical practice.
    • Recall pivotal clinical trial findings leading to the FDA approval of novel compounds with unique mechanisms of action for previously treated locally advanced or metastatic UBC, and identify patients for whom these agents would be appropriate.
    • Apply research findings and other clinical and biologic factors in the best-practice selection of first-line therapy for metastatic renal cell carcinoma (mRCC).
    • Develop a rational approach to the selection and sequencing of systemic therapies for patients with mRCC who experience disease progression on first-line treatment.
    • Consider available data supporting the use of anti-PD-1 antibody therapy for nonmetastatic UBC or RCC, and determine how this strategy can be appropriately integrated into patient care.
    • Reflect on available and emerging data with investigational agents and strategies currently in testing for prostate cancer, UBC and RCC, and as applicable, refer eligible patients for clinical trial participation.
    • Assess available clinical trial data with and approved indications for FDA-endorsed PARP inhibitors for newly diagnosed and recurrent ovarian cancer (OC) to optimally incorporate these agents into patient care.
    • Appreciate the biologic rationale for and published trial data with the combination of PARP inhibitors with other systemic therapies, and consider the implications for current and future OC management and research.
    • Recognize the rationale for targeting folate receptor alpha in OC, and determine optimal testing methods and the current role of novel approaches to therapeutically exploit this newly relevant biomarker.
    • Review the benefits observed with anti-PD-1/PD-L1 antibodies for advanced microsatellite instability-high or mismatch repair-deficient endometrial cancer (EC), and appropriately integrate these agents into patient care.
    • Consider the biologic rationale for and available data with the combination of anti-PD-1/PD-L1 antibodies and agents targeting the VEGF pathway, and select patients with metastatic EC for this novel therapeutic approach.
    • Understand published efficacy and safety findings with anti-PD-1 antibodies as monotherapy or in combination with chemotherapy for metastatic cervical cancer (CC), and consider the current role of immune checkpoint inhibition in therapy for this disease.
    • Reflect on investigational agents and strategies currently in testing for OC, EC and CC, and as applicable, refer eligible patients for clinical trial 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
    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

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    HOW TO USE THIS CME ACTIVITY
    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 and adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of an accredited continuing education activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of this activity. In addition, all activity content is reviewed by 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 reported relevant financial relationships with ineligible entities:

    Tanios Bekaii-Saab, MD
    Professor, Mayo Clinic College of Medicine and Science
    Program Leader, Gastrointestinal Cancer
    Mayo Clinic Cancer Center
    Consultant, Mayo Clinic in Arizona
    Chair, ACCRU Research Consortium
    Phoenix, Arizona

    Consulting Agreements (to Institution): Arcus Biosciences, Bayer HealthCare Pharmaceuticals, Eisai Inc, Genentech, a member of the Roche Group, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Merck, Merck KgaA, Merus BV, Pfizer Inc, Seagen Inc; Consulting Agreements (to Self): AbbVie Inc, Aptitude Health, AstraZeneca Pharmaceuticals LP, BeiGene Ltd, Boehringer Ingelheim Pharmaceuticals Inc, Caladrius Biosciences, Celularity, Daiichi Sankyo Inc, Deciphera Pharmaceuticals Inc, Exact Sciences Corporation, Foundation Medicine, Illumina, Janssen Biotech Inc, Kanaph Therapeutics, Natera Inc, Sanofi, Sobi, Stemline Therapeutics Inc, Treos Bio Ltd, Zai Lab; Data and Safety Monitoring Board/Committee: 1Globe Health Institute, AstraZeneca Pharmaceuticals LP, Eisai Inc, Exelixis Inc, FibroGen Inc, Merck, Suzhou Kintor; Inventions/Patents: WO/2018/183488 licensed to Imugene, WO/2019/055687 licensed to Recursion; Research Funding (to Institution): AbGenomics, Agios Pharmaceuticals Inc, Arcus Biosciences, Arrys Therapeutics, a wholly owned subsidiary of Kyn Therapeutics, Atreca, Bayer HealthCare Pharmaceuticals, Bristol Myers Squibb, Celgene Corporation, Clovis Oncology, Eisai Inc, Genentech, a member of the Roche Group, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Lilly, Merus BV, Mirati Therapeutics Inc, Novartis, Pfizer Inc, Seagen Inc, Sumitomo Dainippon Pharma Oncology Inc; Scientific Advisory Board: Artiva Biotherapeutics Inc, Immuneering Corporation, Imugene, Panbela Therapeutics Inc, Replimune, Xilis; Nonrelevant Financial Relationship: MJH Life Sciences, Pancreatic Cancer Action Network, UptoDate.

    Michael J Birrer, MD, PhD
    Vice Chancellor, UAMS
    Director, Winthrop P Rockefeller Cancer Institute
    Director, Cancer Service Line
    Professor of Biochemistry and Molecular Biology
    Director’s Endowed Chair for the Winthrop P Rockefeller Cancer Institute
    University of Arkansas for Medical Sciences
    Little Rock, Arkansas

    Advisory Board: AstraZeneca Pharmaceuticals LP, GSK, Mersana Therapeutics Inc.

    Danielle M Brander, MD
    Assistant Professor of Medicine
    Director, CLL and Lymphoma Clinical Research Program
    Division of Hematologic Malignancies and Cellular Therapy
    Duke University and Health System
    Duke Cancer Institute
    Durham, North Carolina

    Advisory Committee: AbbVie Inc, Genentech, a member of the Roche Group, Pfizer Inc, TG Therapeutics Inc; Consulting Agreements: AbbVie Inc, Genentech, a member of the Roche Group, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company; Contracted Research: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, ArQule Inc, Ascentage Pharma, AstraZeneca Pharmaceuticals LP, BeiGene Ltd, Bristol Myers Squibb, Catapult Therapeutics, CATO SMS, Celgene Corporation, DTRM Biopharma Co Ltd, Genentech, a member of the Roche Group, Juno Therapeutics, a Celgene Company, MEI Pharma Inc, Newave Pharmaceutical Inc, Novartis, Pharmacyclics LLC, an AbbVie Company, TG Therapeutics Inc; Nonrelevant Financial Relationship: CLL Society (expert medical council), NCCN (panel member).

    Harold J Burstein, MD, PhD
    Institute Physician, Dana-Farber Cancer Institute
    Professor of Medicine, Harvard Medical School
    Boston, Massachusetts

    No relevant conflicts of interest to disclose.

    Ibiayi Dagogo-Jack, MD
    Assistant Professor of Medicine
    Harvard Medical School
    Massachusetts General Hospital
    Boston, Massachusetts

    Consulting Fees: AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, BostonGene, Bristol Myers Squibb, Catalyst Pharmaceuticals, Genentech, a member of the Roche Group, Janssen Biotech Inc, Novocure Inc, Pfizer Inc, Sanofi, Syros Pharmaceuticals Inc, Xcovery; Honoraria: Aptitude Health, DAVA Oncology, Foundation Medicine; Research Support: Array BioPharma Inc, a subsidiary of Pfizer Inc, BostonGene, Genentech, a member of the Roche Group, Guardant Health, Novartis, Pfizer Inc; Nonrelevant Financial Relationship: American Lung Association, ASCO Post, Creative Educational Concepts LLC, Medscape, OncLive, Total Health Conferencing, Triptych Health Partners.

    Virginia Kaklamani, MD, DSc
    Professor of Medicine
    Ruth McLean Bowman Bowers Chair in Breast Cancer Research and Treatment
    AB Alexander Distinguished Chair in Oncology
    Leader, Breast Oncology Program
    UT Health San Antonio MD Anderson Cancer Center
    San Antonio, Texas

    Consulting Agreements: AstraZeneca Pharmaceuticals LP, Gilead Sciences Inc, Puma Biotechnology Inc, TerSera Therapeutics LLC; Contracted Research: Eisai Inc; Data and Safety Monitoring Board/Committee: Bristol Myers Squibb; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Daiichi Sankyo Inc, Exact Sciences Corporation, Genentech, a member of the Roche Group, Gilead Sciences Inc, Novartis, Pfizer Inc, Seagen Inc.

    Stephen V Liu, MD
    Associate Professor of Medicine
    Georgetown University Hospital
    Washington, DC

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Bristol Myers Squibb, Eisai Inc, Elevation Oncology, Genentech, a member of the Roche Group, Gilead Sciences Inc, Guardant Health, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Novartis, Regeneron Pharmaceuticals Inc, Sanofi, Takeda Pharmaceuticals USA Inc; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Catalyst Pharmaceuticals, Daiichi Sankyo Inc, Eisai Inc, Elevation Oncology, Genentech, a member of the Roche Group, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Merck Sharp & Dohme LLC, Novartis, Regeneron Pharmaceuticals Inc, Sanofi, Takeda Pharmaceuticals USA Inc, Turning Point Therapeutics Inc; Contracted Research: Alkermes, Bristol Myers Squibb, Elevation Oncology, Genentech, a member of the Roche Group, Gilead Sciences Inc, Merck, Merus BV, Nuvalent, Pfizer Inc, RAPT Therapeutics, Turning Point Therapeutics Inc; Data and Safety Monitoring Board/Committee: Candel Therapeutics.

    Ursula Matulonis, MD
    Chief, Division of Gynecologic Oncology
    Brock-Wilson Family Chair
    Dana-Farber Cancer Institute
    Professor of Medicine
    Harvard Medical School
    Boston, Massachusetts

    Advisory Committee: Allarity Therapeutics, ImmunoGen Inc, NextCure; Consulting Agreements: Agenus Inc, AstraZeneca Pharmaceuticals LP, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, CureLab Oncology, GSK, Merck, MorphoSys, Novartis, Trillium Therapeutics Inc; Data and Safety Monitoring Board/Committee: Alkermes, Symphogen A/S; Nonrelevant Financial Relationship: Clearity, Med Learning Group, Ovarian Cancer Research Alliance, Rivkin Foundation.

    Rutika Mehta, MD, MPH
    Associate Member in the Department of Gastrointestinal Oncology
    Moffitt Cancer Center
    Associate Professor in the Department of Oncologic Sciences
    University of South Florida
    Tampa, Florida

    Advisory Committee: Astellas, BostonGene, Bristol Myers Squibb, Guardant Health, Lilly, Novartis, Seagen Inc; Consulting Agreements: Astellas, Lilly; Speakers Bureau: Daiichi Sankyo Inc, Natera Inc.

    Craig Moskowitz, MD
    Physician in Chief and Interim Deputy Cancer Center Director
    Sylvester Comprehensive Cancer Center
    Professor of Medicine, Miller School of Medicine
    University of Miami Health System
    Miami, Florida

    Research Support: ADC Therapeutics, BeiGene Ltd, Incyte Corporation, Merck, Seagen Inc; Scientific Advisory Board: ADC Therapeutics, Incyte Corporation, Kite, A Gilead Company.

    Daniel P Petrylak, MD
    Professor of Internal Medicine (Medical Oncology) and Urology
    Yale School of Medicine
    New Haven, Connecticut

    Consulting Agreements: Advanced Accelerator Applications, Amgen Inc, Astellas, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bicycle Therapeutics, Boehringer Ingelheim Pharmaceuticals Inc, Bristol Myers Squibb, Clovis Oncology, Exelixis Inc, Gilead Sciences Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, Lilly, Merck, Mirati Therapeutics Inc, Monopteros Therapeutics, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Regeneron Pharmaceuticals Inc, Roche Laboratories Inc, Sanofi, Seagen Inc, UroGen Pharma; Contracted Research: Advanced Accelerator Applications, Agensys Inc, Arvinas, Astellas, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, BioXcel Therapeutics, Bristol Myers Squibb, Clovis Oncology, Daiichi Sankyo Inc, Eisai Inc, Endocyte Inc, Ferring Pharmaceuticals, Genentech, a member of the Roche Group, Gilead Sciences Inc, Innocrin Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Mirati Therapeutics Inc, Novartis, Pfizer Inc, Progenics Pharmaceuticals Inc, Replimune, Roche Laboratories Inc, Sanofi, Seagen Inc.

    Sandy Srinivas, MD
    Professor of Oncology
    Clinical Research Leader, GU Oncology
    Stanford University
    Stanford, California

    Advisory Committee: Bayer HealthCare Pharmaceuticals, Janssen Biotech Inc, Merck, Novartis; Contracted Research: Bayer HealthCare Pharmaceuticals, Merck, Novartis; Data and Safety Monitoring Board/Committee: Pfizer Inc.

    MODERATORS

    Suzanne R Fanning, DO
    Director, Blood and Marrow Transplant Program
    Prisma Health Cancer Institute
    Associate Professor, University of South Carolina
    Greenville, South Carolina

    No relevant conflicts of interest to disclose.

    Justin Peter Favaro, MD, PhD
    Oncology Specialists of Charlotte
    Charlotte, North Carolina

    Advisory Board: Genzyme Corporation, Fresenius, Labcorp

    Kellie E Schneider, MD
    Gynecologic Oncology
    Novant Health Cancer Institute - Elizabeth (Gynecologic Oncology)
    Charlotte, North Carolina

    No relevant conflicts of interest to disclose.

    Nasfat Shehadeh, MD
    Medical Oncologist
    Oncology Specialists of Charlotte
    Charlotte, North Carolina

    No relevant conflicts of interest to disclose.

    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 grantors.

    This activity is supported by educational grants from AbbVie Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bristol Myers Squibb, Daiichi Sankyo Inc, Eisai Inc, Genmab US Inc, Gilead Sciences Inc, ImmunoGen Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Karyopharm Therapeutics, Lilly, Merck, Mersana Therapeutics Inc, Novartis, Pharmacyclics LLC, an AbbVie Company and Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Puma Biotechnology Inc, and Seagen Inc.

    Release date: March 2023
    Expiration date: March 2024

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