CE Disclosures and Faculty Information

• TARGET AUDIENCE
  This activity is intended for medical oncologists and other healthcare providers involved in the treatment of breast cancer.

  OVERVIEW OF ACTIVITY
  Breast cancer (BC) remains the most frequently diagnosed cancer in women, and it is estimated that approximately 234,580 new cases will be identified in the United States in the year 2013 and 40,030 individuals will die from the disease. 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 BC has increased substantially, as has the population “at risk” for metastatic or recurrent disease. Depending on the histological subtype, the initial stage of their disease at the time of diagnosis and the subsequent treatment strategy employed, approximately 20% to 80% of these women will develop a distant metastasis within 5 years of their BC diagnosis.

  Historically, available treatment options offered little for patients with this incurable disease. However, with the introduction of more effective systemic therapies over the past 20 years, there has been a substantial improvement in clinical outcomes. While the diagnosis and treatment of this disease remains in many ways more advanced than for other solid cancers, challenging issues in the management of metastatic BC (mBC) continue to require refinement. Increasing emphasis is being placed on a “personalized medicine” approach that promises to more effectively identify specific treatments that will benefit the individual, based on specific patient and disease characteristics. In conjunction with this approach researchers are developing novel agents to target additional signaling pathways, with the aim of enhancing the efficacy of existing treatments or overcoming resistance/restoring sensitivity to endocrine therapy, chemotherapy or other biologics.

  To assist medical oncologists and other allied BC professionals in keeping informed about these approved and developmental approaches, these proceedings from a case-based CME Grand Rounds presentation introduce the perspectives of 12 renowned investigators on a number of controversial clinical and research issues in the management of mBC.

  LEARNING OBJECTIVES

  • Compare and contrast expert perspectives on breast cancer treatment recommendations, and use this information to refine or validate your existing management strategies.
  • Implement a clinical plan for the management of advanced HER2-positive breast cancer, incorporating existing and recently approved targeted treatments.
  • Assimilate new clinical trial evidence into the therapeutic algorithm for advanced ER-positive postmenopausal breast cancer.
  • Integrate recent clinical trial results into the management of metastatic breast cancer with no evidence of disease.
  • Recall the results of pivotal trials introducing effective new breast cancer therapeutics, and identify their impact on existing treatment algorithms.
  • 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. The participant should watch the video.

  
  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:

  Kimberly L Blackwell, MD
  Professor of Medicine
  Director, Breast Cancer Program
  Duke Cancer Institute
  Durham, North Carolina

  Advisory Committee: Novartis Pharmaceuticals Corporation; Consulting Agreements: Novartis Pharmaceuticals Corporation, Sandoz; Contracted Research: Celgene Corporation, Genentech BioOncology, Roche Laboratories Inc; Speakers Bureau: Genomic Health Inc.

  Adam M Brufsky, MD, PhD
  Professor of Medicine, University of Pittsburgh
  Associate Director for Clinical Investigation
  University of Pittsburgh Cancer Institute
  Co-Director
  Comprehensive Breast Cancer Center
  Associate Division Chief
  University of Pittsburgh, Department of Medicine
  Division of Hematology/Oncology
  Pittsburgh, Pennsylvania

  Advisory Committee: Roche Laboratories Inc; Consulting Agreements: Celgene Corporation, Genentech BioOncology, Genomic Health Inc, Novartis Pharmaceuticals Corporation; Speakers Bureau: Celgene Corporation, Genentech BioOncology, Novartis Pharmaceuticals Corporation.

  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

  Advisory Committee, Consulting Agreements and Speakers Bureau: Amgen Inc, Bristol-Myers Squibb Company, Genentech BioOncology, Novartis Pharmaceuticals Corporation, Pfizer Inc, Sanofi; Research Support: Genentech BioOncology, GlaxoSmithKline, Sanofi.

  William J Gradishar, MD
  Betsy Bramsen Professor of Breast Oncology
  Professor of Medicine
  Director, Maggie Daley Center
  for Women’s Cancer Care
  Robert H Lurie Comprehensive Cancer Center
  Northwestern University Feinberg School of Medicine
  Chicago, Illinois

  No real or apparent conflicts of interest to disclose.

  Julie R Gralow, MD
  Professor, Medical Oncology
  Jill Bennett Endowed Professorship in Breast Cancer
  University of Washington School of Medicine
  Director, Breast Medical Oncology
  University of Washington School of
  Medicine/Seattle Cancer Care Alliance
  Member, Clinical Research Division
  Fred Hutchinson Cancer Research Center
  Seattle, Washington

  Contracted Research: Amgen Inc, Genentech BioOncology, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc.

  Sara A Hurvitz, MD
  Assistant Clinical Professor of Medicine
  University of California, Los Angeles
  Director, Breast Oncology Program
  Medical Director, Clinical Research Unit
  Jonsson Comprehensive Cancer Center
  Los Angeles, California

  Contracted Research: Boehringer Ingelheim Pharmaceuticals Inc, Eisai Inc, Genentech BioOncology, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi; Paid Travel: Novartis Pharmaceuticals Corporation.

  Ian E Krop, MD, PhD
  Associate Physician, Dana-Farber Cancer Institute
  Assistant Professor of Medicine
  Harvard Medical School
  Boston, Massachusetts

  Advisory Committee: Seattle Genetics; Clinical Trial Support: Genentech BioOncology.

  Kathy D Miller, MD
  Co-Director, IU Simon Cancer Center
  Breast Cancer Team
  Ballvé Lantero Scholar in Oncology
  Associate Professor of Medicine
  Department of Personalized Medicine
  Division of Hematology/Oncology
  The Indiana University Melvin and
  Bren Simon Cancer Center
  Indianapolis, Indiana

  Consulting Agreements: Antigen Express, Nektar; Contracted Research: Genentech BioOncology, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company; Paid Research: Antigen Express, Clovis Oncology, EntreMed Inc, Merrimack Pharmaceuticals, Syndax Pharmaceuticals Inc, Taiho Pharmaceutical Co Ltd.

  Hyman B Muss, MD
  Professor of Medicine
  University of North Carolina
  Director of Geriatric Oncology
  Lineberger Comprehensive Cancer Center
  Chapel Hill, North Carolina

  Consulting Agreements: Pfizer Inc, Sanofi.

  Joyce O'Shaughnessy, MD
  Co-Director, Breast Cancer Research Program
  Baylor-Charles A Sammons Cancer Center
  Texas Oncology
  US Oncology
  Dallas, Texas

  Advisory Committee: Genentech BioOncology; Consulting Agreements: Arno Therapeutics Inc, Eisai Inc, GlaxoSmithKline, Johnson & Johnson Pharmaceuticals, Roche Laboratories Inc, Sanofi.

  Mark D Pegram, MD
  Susy Yuan-Huey Hung Professor of Medicine
  Director of the Breast Oncology Program
  Director, Molecular Therapeutics Program
  Stanford Cancer Institute
  Stanford University School of Medicine
  Stanford, California

  Advisory Committee: Celgene Corporation, Genentech BioOncology; Consultant (Spouse): DAVA Oncology; Consulting Agreement: Genentech BioOncology; Contracted Research: Genentech BioOncology; Expert Testimony: Novartis Pharmaceuticals Corporation.

  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.

  CONSULTING COMMUNITY ONCOLOGISTS:

  Mary Ann K Allison, MD
  Comprehensive Cancer Centers of Nevada
  Stephanie Campus
  Henderson, Nevada

  No real or apparent conflicts of interest to disclose.

  Alan B Astrow, MD
  Director, Division of Medical Oncology/Hematology
  Maimonides Cancer Center
  Brooklyn, New York

  No real or apparent conflicts of interest to disclose.

  Patricia A DeFusco, MD
  Senior Staff, Department of Medicine
  Hartford Hospital
  Assistant Clinical Professor in the Department of Medicine
  University of Connecticut School of Medicine
  Hartford, Connecticut

  No real or apparent conflicts of interest to disclose.

  EDITOR — Dr 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, Allos Therapeutics, Amgen Inc, ArQule 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, EMD Serono Inc, Exelixis Inc, Foundation Medicine Inc, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Incyte Corporation, Lilly, Medivation Inc, Merck, Millennium: The Takeda Oncology Company, Mundipharma International Limited, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc and Teva Oncology.

  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 Genentech BioOncology and Novartis Pharmaceuticals Corporation.

  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: December 2013
  Expiration date: December 2014