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Beyond the Guidelines: Clinical Investigators Provide Their Perspectives on Current Strategies and Ongoing Research in the Management of Breast Cancer
Released March 2014

Proceedings from a satellite symposium during the 36th annual San Antonio Breast Cancer Symposium. Including perspectives from Drs Sunil Verma, George W Sledge Jr, Clifford Hudis, Lisa A Carey and Hope S Rugo. (Video Program)

CE Disclosures and Faculty Information

    This activity is intended for medical oncologists, breast cancer surgeons and other healthcare providers involved in the treatment of breast cancer.

    Breast cancer remains the most frequently diagnosed cancer in women, and in 2013 in the United States alone the disease culminated in an estimated 232,340 new cases and 39,620 estimated 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. Because of this, the number of individuals living with breast cancer has increased substantially, as has the population “at risk” for recurrent disease.

    The current clinical management of breast cancer is multidisciplinary and includes surgical resection of local disease with or without radiation therapy and the treatment of systemic disease (micro- or macroscopic) with cytotoxic chemotherapy, endocrine therapy, biologic therapy or combinations of these agents. The indication and utility of these local and systemic therapeutic options are largely based on a number of prognostic and predictive risk factors present within the patient or the tumor at the time of diagnosis. In fact, as the field of oncology is challenged to improve the precision with which it therapeutically targets malignant cells, biomarker-driven treatment algorithms have become the “norm” for many tumor types, including breast cancer.

    These proceedings from a CME symposium during the 36th annual San Antonio Breast Cancer Symposium explore the most significant therapeutic advances during the previous year by using the perspectives of leading breast cancer experts and employing a unique strategy centered on actual cases from community-based oncologists to frame a relevant discussion of how this information has aided in the refinement of current routine clinical practice and ongoing research. This CME activity will help medical oncologists integrate these findings into best-practice disease management strategies.

    • Identify clinical scenarios for which relative agreement and heterogeneity exist in clinical investigator patterns of care for breast cancer, and apply these findings, where appropriate, to the individualized care of patients.
    • Recognize the evolving application of biomarkers and multigene assays in breast cancer management, and effectively use these tools to refine or individualize treatment plans for patients.
    • Implement a long-term clinical plan for the management of early and advanced HER2-positive breast cancer, incorporating existing and recently approved targeted treatments.
    • Assimilate new clinical trial evidence into the therapeutic algorithm for localized and advanced ER-positive, pre- and postmenopausal breast cancer.
    • Demonstrate knowledge of emerging research to support alternative or novel chemotherapeutic regimens in the metastatic setting, and integrate these findings into best-practice disease management strategies.
    • Counsel appropriately selected patients about participation in ongoing breast cancer clinical research.

    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:

    Sunil Verma, MD, MSEd

    Medical Oncologist
    Chair, Breast Medical Oncology
    Head, Breast Cancer Clinical Trials
    Sunnybrook Odette Cancer Centre
    Associate Professor, University of Toronto
    Toronto, Ontario, Canada

    Advisory Committee: Amgen Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Eisai Inc, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc; Speakers Bureau: Novartis Pharmaceuticals Corporation, Roche Laboratories Inc.

    George W Sledge Jr, MD
    Professor of Medicine
    Chief, Division of Oncology
    Department of Medicine
    Stanford University School of Medicine
    Stanford, California

    Consulting Agreement: Genomic Health Inc.

    Clifford Hudis, MD
    Chief, Breast Cancer Medicine Service
    Solid Tumor Division
    Department of Medicine
    Memorial Sloan-Kettering Cancer Center
    Professor of Medicine
    Weill Cornell Medical College
    New York, New York

    No real or apparent conflicts of interest to disclose.

    Lisa A Carey, MD

    Richardson and Marilyn Jacobs Preyer Distinguished Professor for Breast Cancer Research
    Chief, Division of Hematology and Oncology
    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.

    Hope S Rugo, MD
    Professor of Medicine
    Director, Breast Oncology and Clinical Trials Education
    University of California, San Francisco
    Helen Diller Family Comprehensive Cancer Center
    San Francisco, California

    Contracted Research: Agensys Inc, a subsidiary of Astellas Pharma US, Amgen Inc, Eisai Inc, Genentech BioOncology, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, MacroGenics Inc, Merck, Novartis Pharmaceuticals Corporation, Plexxikon Inc; Speakers Bureau: Genomic Health Inc.

    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 AbbVie Inc, AstraZeneca Pharmaceuticals LP, Eisai Inc, Genentech BioOncology, 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: March 2014
    Expiration date
    : March 2015

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