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Consensus or Controversy: Clinical Investigators Provide Perspectives on the Treatment of Metastatic Non-Small Cell Lung Cancer in Patients without Targetable Tumor Mutations
Released March 2017

Proceedings from Part 2 of a 2-part CME satellite series during the 2017 Multidisciplinary Thoracic Cancers Symposium. Featuring perspectives from Drs Julie R Brahmer, Corey J Langer, Naiyer Rizvi and Heather Wakelee. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity is intended for hematologists, medical oncologists and other healthcare providers involved in the treatment of non-small cell lung cancer (NSCLC).

    OVERVIEW OF ACTIVITY
    Lung cancer is a devastating disease with broad-reaching impact on public health, as it accounts for 13% of all new cancer cases in the United States and the most cancer-related deaths among both men and women. A major focus of recent lung cancer research has been the development — and subsequent approval — of a number of molecular-targeted agents and the identification of related biomarkers to help guide treatment selection for those individuals who harbor specific oncogenic alterations. Despite these groundbreaking scientific advances, the truth is that only 15% to 20% of patients harbor abnormalities that are truly “actionable” in the clinic today based on FDA approvals. Fortunately for these individuals and their caregivers, over the past several years major clinical trials in patients with advanced NSCLC without a targetable mutation have witnessed unprecedented successes that will challenge the cancer community’s collective understanding of the diagnosis and optimal management of this disease.

    These video proceedings from a CME symposium held during the 2017 Multidisciplinary Thoracic Cancers Symposium feature discussions with leading researchers with an expertise in the management of lung cancer about clinical research findings relevant to treatment for patients without a targetable tumor mutation to address existing uncertainties and help keep clinicians up to date and informed.

    LEARNING OBJECTIVES

    • Recognize available and emerging research information validating the utility of diagnostic assays designed to measure PD-L1 status, assess which testing platforms should be used and appropriately employ the results to identify potential candi­dates for front-line treatment with an anti-PD-1 antibody.
    • Review published research data documenting the safety and efficacy of available anti-PD-1 antibodies for patients with newly diagnosed metastatic NSCLC.
    • Devise an evidence-based approach to the selection of induc­tion and maintenance systemic therapy for patients with NSCLC without a targetable mutation.
    • Consider biologic and patient-related factors in the selection of second- and later-line therapy for patients with progressive NSCLC without a targetable mutation.
    • Describe available and emerging data on the efficacy and safety of tumor immunotherapy directed at the PD-1/PD-L1 pathway in lung cancer, and consider this information when counseling patients regarding protocol and nonresearch options.
    • Educate patients about the potential side effects associated with commonly employed chemotherapeutic, biologic and immuno­therapeutic agents, and provide preventive strategies to reduce or ameliorate these toxicities.
    • Describe ongoing trials evaluating novel applications of immune checkpoint inhibitors alone (eg, anti-PD-L1 antibodies) or in combination with other systemic approaches (eg, anti-PD-1/ PD-L1 with anti-CTLA-4 antibodies, anti-PD-1/PD-L1 antibodies with chemotherapy), and counsel appropriately selected patients about potential 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 1.75 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 1.75 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/ThoracicCancers17/Nontargeted/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:

    Julie R Brahmer, MD
    Director, Thoracic Oncology Program
    Interim Director
    Johns Hopkins Kimmel Cancer Center at Bayview
    Associate Professor of Oncology
    Sidney Kimmel Comprehensive Cancer Center
    Johns Hopkins School of Medicine
    Baltimore, Maryland

    Advisory Committee: Bristol-Myers Squibb Company, Merck; Consulting Agreements: Bristol-Myers Squibb Company, Celgene Corporation, Lilly, Merck; Contracted Research: AstraZeneca Pharma­ceuticals LP, Bristol-Myers Squibb Company, Merck.

    Corey J Langer, MD
    Director of Thoracic Oncology
    Abramson Cancer Center
    Professor of Medicine
    Perelman School of Medicine
    University of Pennsylvania
    Vice Chair, Radiation Therapy Oncology Group
    Philadelphia, Pennsylvania

    Advisory Committee: Abbott Laboratories, AstraZeneca Pharmaceu­ticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, EMD Serono Inc, Genentech BioOncology, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly, Merck, Novartis Pharmaceu­ticals Corporation, Pfizer Inc; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly, Merck, Novartis Pharma­ceuticals Corporation, Pfizer Inc; Contracted Research: Advantagene Inc, Celgene Corporation, GlaxoSmithKline, Merck, Inovio Pharma­ceuticals; Data and Safety Monitoring Board: Abbott Laboratories, Amgen Inc, Lilly, Peregrine Pharmaceuticals Inc, Synta Pharmaceuti­cals Corp.

    Naiyer Rizvi, MD
    Professor of Medicine
    Director of Thoracic Oncology and Phase I Immunotherapeutics
    Price Chair in Clinical Translational Research
    Columbia University Medical Center
    New York, New York

    Advisory Committee and Consulting Agreements: AstraZeneca Pharmaceuticals LP, Merck, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc; Ownership Interest: Gritstone Oncology.

    Heather Wakelee, MD
    Associate Professor of Medicine
    Division of Oncology
    Stanford University School of Medicine
    Stanford Cancer Institute
    Stanford, California

    Consulting Agreements: ACEA Biosciences Inc, Genentech BioOncology, Helsinn Group, Peregrine Pharmaceuti­cals Inc, Pfizer Inc; Contracted Research: AstraZeneca Pharmaceuti­cals LP, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Exelixis Inc, Genentech BioOncology, Gilead Sciences Inc, Lilly, Novartis Pharmaceuticals Corporation, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Roche Laboratories Inc, Xcovery; Grants: Clovis Oncology, Exelixis Inc, Gilead Sciences Inc, Pharmacyclics LLC, an AbbVie Company, Xcovery.

    MODERATOR — 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, 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, Lexicon 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 AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Lilly and Merck.

    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.

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

Module 1

  • Front-Line Treatment for Patients with Newly Diagnosed Metastatic Non-Small Cell Lung Cancer

Module 2

  • Second- and Later-Line Therapy for Patients with Metastatic Non-Small Cell Lung Cancer

Module 3

  • Toxicities Associated with and Relative Contraindications to Immune Checkpoint Inhibition

Module 4

  • Ongoing Investigation, Future Directions with Immune Checkpoint Inhibitors