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Cases from the Community: Investigators Provide Their Perspectives on the Practice Implications of Emerging Clinical Research
Released March 2017

Proceedings from a satellite symposium during the 39th annual San Antonio Breast Cancer Symposium. Featuring perspectives from Drs Harold J Burstein, Sara A Hurvitz, Joyce O’Shaughnessy, Hope S Rugo, Ian E Smith and Sandra M Swain. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity is intended for medical oncologists, breast cancer surgeons, radiation oncologists and other healthcare professionals involved in the diagnosis and treatment of breast cancer (BC).

    OVERVIEW OF ACTIVITY
    The current clinical management of BC 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 approaches. The indication and/or utility of these local and systemic treatment options is largely based on a number of prognostic and predictive risk factors present within the patient or her tumor at the time of diagnosis. Increasingly, an emphasis is being placed on a “personalized medicine” approach that promises to more effectively identify specific treatments that will benefit individuals based on specific patient- and disease-related characteristics. The pace of change in the field of breast medical oncology has been rapid, creating an important need for education about the unique mechanisms of action, toxicities and effectiveness of novel agents to properly prepare clinicians for their appropriate use (or potential use) in clinical practice. Several consensus- and evidence-based treatment guidelines are available and aim to assist clinicians with making BC management decisions in the face of this dynamic clinical and research environment, but despite the existence of these tools many areas of controversy persist within academic and community settings.

    These proceedings from a CME symposium during the San Antonio Breast Cancer Symposium explore the most significant therapeutic advances during the previous year by using the perspectives of leading BC experts on challenging cases and questions submitted by clinicians in the community 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 find answers to the individualized questions and concerns that they frequently encounter and in turn provide high-quality cancer care.

    LEARNING OBJECTIVES

    • Consider available data and the use of biomarkers and genomic assays to assess risk and individualize therapy for patients with hormone receptor-positive BC in the neoadjuvant, adjuvant and extended-adjuvant settings.
    • Individualize the selection of evidence-based neoadjuvant and adjuvant chemobiologic regimens for patients with HER2-overexpressing early BC.
    • Implement a long-term clinical plan for the management of metastatic HER2-positive BC, incorporating existing and investigational targeted treatments.
    • Recognize the FDA approval of palbociclib for patients with ER-positive metastatic BC, and discern how its availability affects the selection and sequence of therapy for these individuals.
    • Develop an understanding of the mechanisms of action, available research data and ongoing trials of investigational CDK4/6 inhibitors and other novel therapies under development for the management of advanced ER-positive BC.
    • Consider clinical data and patient preferences in the selection and sequencing of available therapeutic agents for patients with newly diagnosed and metastatic ER/PR-negative, HER2-negative BC.
    • Recall available guideline recommendations regarding the indications for BRCA mutation testing in BC, and use the results of this analysis to inform protocol and nonprotocol treatment decision-making for patients.
    • Identify ongoing trials of other investigational approaches in BC, and obtain consent and refer patients for study 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
    Research To Practice designates this enduring material for a maximum of 2.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
    Successful completion of this CME activity enables the participant to earn up to 2.75 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    Please note, this program has been specifically designed for the following ABIM specialty: medical oncology.

    Personal information and data sharing: Research To Practice aggregates deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of a video component. To receive credit, the participant should watch the video, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/SanAntonioBC16/CME.

    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:

    Harold J Burstein, MD, PhD
    Associate Professor of Medicine
    Harvard Medical School
    Breast Oncology Center
    Dana-Farber Cancer Institute
    Boston, Massachusetts

    No relevant conflicts of interest to disclose.

    Sara A Hurvitz, MD
    Associate Professor of Medicine
    Director, Breast Oncology Program
    Division of Hematology/Oncology
    University of California, Los Angeles
    Medical Director
    Jonsson Comprehensive Cancer Center Clinical Research Unit
    Los Angeles, California
    Co-Director, Santa Monica-UCLA Outpatient Oncology Practices
    Santa Monica, California

    Contracted Research: Amgen Inc, Bayer HealthCare Pharmaceuticals, BioMarin Pharmaceutical Inc, Boehringer Ingelheim Pharmaceuticals Inc, Dignitana, Genentech BioOncology, GlaxoSmithKline, Lilly, Novartis Pharmaceuticals Corporation, OBI Pharma Inc, Pfizer Inc, Puma Biotechnology Inc.

    Joyce O’Shaughnessy, MD
    Chair, Breast Cancer Research Program
    Baylor Charles A Sammons Cancer Center
    Texas Oncology
    US Oncology
    Dallas, Texas

    Consulting Agreements: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Eisai Inc, Genentech BioOncology, Lilly, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Sanofi Genzyme, Takeda Oncology.

    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: Eisai Inc, Genentech BioOncology, GlaxoSmithKline, Lilly, MacroGenics Inc, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc, Plexxikon Inc, Roche Laboratories Inc; Speakers Bureau: Genomic Health Inc.

    Ian E Smith, MD
    Professor of Cancer Medicine
    The Royal Marsden Foundation Trust and Institute of Cancer Research
    London and Surrey
    United Kingdom

    Advisory Committee: Eisai Inc, Pierre Fabre, Seattle Genetics.

    Sandra M Swain, MD
    Associate Dean for Research Development
    Professor of Medicine
    Georgetown University Medical Center
    Washington, DC

    Advisory Committee: Genentech BioOncology, Lilly, Roche Laboratories Inc; Consulting Agreements: Genentech BioOncology, Lilly, Pieris Pharmaceuticals Inc, Roche Laboratories Inc; Contracted Research: Genentech BioOncology, Lilly, Merrimack Pharmaceuticals Inc, Pfizer Inc, Puma Biotechnology Inc, Roche Laboratories Inc; Travel: Genentech BioOncology, Roche Laboratories 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, Acerta Pharma, Agendia Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, 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 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, Agendia Inc, Astellas Pharma Global Development Inc/Medivation Inc, a Pfizer Company, AstraZeneca Pharmaceuticals LP, bioTheranostics Inc, Celgene Corporation, Genentech BioOncology, Genomic Health Inc, Lilly and Tesaro Inc.

    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 2017
    Expiration date: March 2018

    After completing the Post-test, learners may download and review the answers here in order to identify further areas of study.

Acknowledge and close

Watch video
(WIFI is recommended for best performance):
Topics:

Dr Love — Introduction

Dr Hurvtiz — Introduction

  • Adjuvant and Neoadjuvant Therapy for HER2-Positive Disease

Dr Hurvtiz — Presentation

  • Adjuvant and Neoadjuvant Therapy for HER2-Positive Disease

Dr Rugo — Introduction

  • Clinical Decision-Making for Patients with ER-Positive Early Breast Cancer

Dr Rugo — Presentation

  • Clinical Decision-Making for Patients with ER-Positive Early Breast Cancer

Dr Burstein — Introduction

  • Management of ER-Positive, HER2-Negative Metastatic Disease

Dr Burstein — Presentation

  • Management of ER-Positive, HER2-Negative Metastatic Disease

Dr Swain — Introduction

  • Long-Term Management of HER2-Positive Metastatic Disease

Dr Swain — Presentation

  • Long-Term Management of HER2-Positive Metastatic Disease

Dr O’Shaughnessy — Introduction

  • Indications for BRCA Testing in Breast Cancer; Ongoing Investigation of PARP Inhibition

Dr O’Shaughnessy — Presentation

  • Indications for BRCA Testing in Breast Cancer; Ongoing Investigation of PARP Inhibition

Dr Smith — Introduction

  • Current and Future Treatment of Triple-Negative Breast Cancer

Dr Smith — Presentation

  • Current and Future Treatment of Triple-Negative Breast Cancer