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Consensus or Controversy: Clinical Investigators Provide Perspectives on Targeted Treatment of Metastatic Non-Small Cell Lung Cancer
Released March 2017

Proceedings from Part 1 of a 2-part CME satellite series during the 2017 Multidisciplinary Thoracic Cancers Symposium. Featuring perspectives from Drs Ramaswamy Govindan, Joel W Neal and Gregory J Riely. (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. Despite the many advances over the past few decades related to surgery, radiation therapy and chemotherapy, death rates attributable to lung cancer have remained relatively unchanged. Today, however, scientists and clinicians working in this area of cancer medicine have renewed optimism that these trends have started to change as recent research advances have led to an explosion in lung cancer genetic and biologic knowledge. 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. This has created a paradigm shift in the way patients with advanced NSCLC are initially stratified and counseled, moving from a “one-size-fits-all” approach to a customized, biomarker-driven treatment algorithm. Significantly, this has also created an imperative for clinicians to appropriately and actively attempt to identify and subsequently treat specific patients.

    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 with targetable tumor mutations to address existing uncertainties and help keep clinicians up to date and informed on the targeted treatment of NSCLC.

    LEARNING OBJECTIVES

    • Discriminate among molecular determinants that may be used to refine NSCLC prognosis and/or predict therapeutic response to an individual treatment, and apply available clinical guide­lines to appropriately select patients for biomarker assessment.
    • Recognize available and emerging research information validating the utility of blood-based diagnostic assays to identify/measure lung cancer biomarkers, and assess how, if at all, these testing platforms can be used by practicing oncologists outside of a research setting.
    • Recognize the abilities and limitations of multiplex and next-generation sequencing platforms, and determine their clinical and/or research application for patients with NSCLC.
    • Employ an understanding of personalized medicine to individu­alize the use of available EGFR tyrosine kinase inhibitors (TKIs) in the long-term management of EGFR mutation-positive NSCLC.
    • Describe mechanisms of tumor resistance to EGFR TKIs and the clinical significance of T790M mutations, and discern how avail­able and investigational therapies can be optimally employed in the protocol and nonresearch care of patients with progressive EGFR mutation-positive disease.
    • Communicate the efficacy and safety of approved and other emerging ALK inhibitors to appropriate patients with NSCLC, considering the predictive utility of ALK mutation testing.
    • Assess newly recognized oncogenic pathways mediating the growth of unique NSCLC tumor subsets, and recall emerging data with experimental agents exploiting these targets.

    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/Targeted/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:

    Ramaswamy Govindan, MD
    Professor of Medicine
    Co-Director, Section of Medical Oncology
    Division of Oncology
    Washington University School of Medicine
    St Louis, Missouri

    Advisory Committee: AbbVie Inc, Ariad Pharma­ceuticals Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, INC Research, Roche Laboratories Inc; Consulting Agreements: AbbVie Inc, Ariad Pharmaceuticals Inc, Astellas Pharma Global Development Inc, Baxalta Inc, Bristol-Myers Squibb Company, Genentech BioOncology, INC Research; Contracted Research and Speakers Bureau: AbbVie Inc, Ariad Pharmaceuticals Inc, Baxalta Inc, INC Research.

    Joel W Neal, MD, PhD
    Assistant Professor of Medicine
    Division of Oncology
    Stanford Cancer Institute
    Stanford University
    Palo Alto, California

    Consulting Agreements: Ariad Pharmaceuticals Inc, ARMO BioSciences, Boehringer Ingelheim Pharmaceuticals Inc, CARET/Physicians Resource Management, Clovis Oncology, Nektar; Contracted Research: Ariad Pharmaceuticals Inc, ArQule Inc, Boehringer Ingelheim Pharmaceuticals Inc, Exelixis Inc, Genentech BioOncology, Merck, Nektar, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc.

    Gregory J Riely, MD, PhD
    Associate Attending
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Consulting Agreement: Genentech BioOncology; Contracted Research: Ariad Pharmaceuticals Inc, Astellas Pharma Global Development Inc, Novartis Pharmaceu­ticals Corporation, Pfizer Inc.

    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 Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, 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: 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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Topics:

Module 1

  • Optimal Testing Algorithms; Treatment for Patients with Non-Small Cell Lung Cancer and an EGFR Mutation

Module 2

  • Existing and Emerging Therapeutic Options for Patients with ALK- and ROS1-Positive Disease

Module 3

  • Identification of Other Potentially Targetable Tumor Mutations (BRAF V600E, HER2, RET, et cetera) and Implications for Clinical Practice and Ongoing Research