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RTP On Demand — Breast Cancer, Part II
Released September 2015

Proceedings from a video interview with Drs Lisa A Carey and Eric P Winer on next-generation sequencing and use of chemotherapy and novel agents for ER-positive and triple-negative breast cancer, including data review, case-based discussions and downloadable slides. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity is intended for medical and radiation oncologists, breast and general surgeons, hematology-oncology fellows and other healthcare providers involved in the treatment of breast cancer.

    OVERVIEW OF ACTIVITY
    Breast cancer remains the most frequently diagnosed cancer in women, and in 2015 in the United States alone the disease will culminate in an estimated 231,840 new cases and 40,290 deaths. Advances in screening and prevention have resulted in a steady down-stage migration at the time of disease presentation, such that only 5% of women have identifiable distant metastases at primary diagnosis. Consequently, the number of individuals living with breast cancer has increased substantially, as has the population “at risk” for recurrent disease. While the diagnosis and treatment of breast cancer remain, in many ways, more advanced than in other solid cancers, challenging issues in the basic management of this disease continue to require refinement.

    Published results from ongoing trials lead to the continuing emergence of new therapeutic agents and changes in the indications for existing treatments. In order to offer optimal patient care, the practicing medical oncologist must be well informed of these advances. To bridge the gap between research and patient care, this program uses a discussion with Drs Lisa A Carey and Eric P Winer about treatment controversies and the integration of key data sets into the practical management of breast cancer.

    LEARNING OBJECTIVES

    • Recall emerging data with next-generation sequencing, and determine its clinical and/or research applications for patients with metastatic breast cancer.
    • Demonstrate knowledge of emerging research to support alternative or novel chemotherapeutic regimens in the treatment of ER/PR-negative, HER2-negative breast cancer, and integrate these findings into best-practice disease management strategies.
    • Counsel appropriately selected patients with breast cancer about participation in ongoing clinical trials investigating novel therapeutic agents and strategies.

    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

    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 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:

    Lisa A Carey, MD
    Richardson and Marilyn Jacobs Preyer Distinguished Professor for Breast Cancer Research
    Chief, Division of Hematology and Oncology
    Physician-in-Chief
    North Carolina Cancer Hospital
    Associate Director for Clinical Research
    Lineberger Comprehensive Cancer Center
    Chapel Hill, North Carolina

    No real or apparent conflicts of interest to disclose.

    Eric P Winer, MD
    Thompson Chair in Breast Cancer Research
    Chief, Division of Women's Cancers
    Dana-Farber Cancer Institute
    Professor of Medicine
    Harvard Medical School
    Boston, Massachusetts

    Contracted Research: Genentech BioOncology.

    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, Amgen Inc, Astellas Scientific and Medical Affairs Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, ImmunoGen Inc, Incyte Corporation, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics Inc, 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 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 AstraZeneca Pharmaceuticals LP, Celgene Corporation, Eisai Inc, Foundation Medicine, Genomic Health Inc and Lilly.

    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 2015
    Expiration date: September 2016

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Watch video
(WIFI is recommended for best performance):

Next-Generation Sequencing (NGS) for Identification of Genetic Mutations and Alterations
Clinical implications of NGS
HER2 tumor mutations
New trials evaluating patients with specific tumor mutations
Current limitations of trials focused on patients with specific tumor mutations
Use of NGS and other multiplex assays in patients with metastatic disease who have received all available appropriate therapies
Chemotherapy for Breast Cancer
Case scenario: A patient with a 4-cm triple-negative IDC and a palpable axillary node that is positive on biopsy
GeparSepto GBG 69: Results of a Phase III trial of neoadjuvant nab paclitaxel versus paclitaxel
Clinical use of nab paclitaxel
Novel Agents for Breast Cancer
Case scenario: Development of metastatic disease in a patient with triple-negative disease who received neoadjuvant AC → T
Immune checkpoint inhibitors in triple-negative breast cancer (TNBC)
Case presentation: A 52-year-old woman with recurrent BRCA-negative TNBC receives olaparib and a PI3K inhibitor on a clinical trial
Clinical experience with and tolerability of olaparib
OlympiA trial: Adjuvant olaparib in patients with high-risk HER2-negative BC and a germline BRCA1/2 mutation
Results of a Phase II study of enzalutamide in advanced androgen receptor-positive TNBC