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Proceedings from the 10th Annual Winter Lung Cancer Conference
Released May 2013

Proceedings from a live event featuring traditional didactic faculty presentations and case-based panel discussions focused on all factors that influence multidisciplinary treatment decision-making for lung cancer. Featuring perspectives from Drs Jeffrey Bradley, Julie R Brahmer, Frank C Detterbeck, Ramaswamy Govindan, John Heymach, Bruce E Johnson, Rogerio C Lilenbaum, Thomas J Lynch Jr, Jyoti D Patel, Alice Shaw, Mark A Socinski and David R Spigel. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity has been designed to meet the educational needs of medical oncologists and other healthcare providers involved in the treatment of lung cancer.

    OVERVIEW OF ACTIVITY
    Lung cancer is a devastating disease that accounts for more cancer-related deaths among both men and women than any other tumor type. Historically, systemic therapeutic options have been limited, but recent advances in our understanding of cellular and tumor biology have resulted in the development of numerous therapies demonstrating benefit in lung cancer. Despite these advances, many clinical scenarios continue to exist in which multiple treatment options may be available but the optimal strategy is highly debatable and may depend on rapidly evolving clinical research data. This unique educational activity delivers highly applicable current clinical information delving into the personalized management of this challenging disease and provides clinicians with a concise, easy-to-understand resource to facilitate knowledge and application of optimal diagnostic and therapeutic approaches.

    LEARNING OBJECTIVES

    • Develop an evidence-based strategy for the initial staging and treatment of localized non-small cell lung cancer (NSCLC), exploring the role of adjuvant systemic therapy.
    • Apply the results of emerging clinical research to the recommendation of multimodality therapy for patients with Stage III NSCLC.
    • Compare and contrast the benefits and risks of combination chemobiologic and doublet and single-agent chemotherapy regimens when developing treatment plans for patients with advanced disease.
    • Use biomarkers, clinical characteristics and tumor histology to select individualized treatment approaches for patients with NSCLC in the adjuvant and metastatic settings.
    • Identify patients with metastatic NSCLC who may experience clinical benefit from the addition of continuation or switch maintenance biologic therapy and/or chemotherapy.
    • Differentiate among existing and emerging molecular-targeted therapies, and effectively integrate new compounds, when available, into individualized lung cancer treatment strategies.
    • Recognize the effect of NSCLC tumor-specific mutations on relative response or resistance to treatment with EGFR tyrosine kinase inhibitors, monoclonal antibodies and other emerging molecular-targeted agents.
    • Formulate management strategies for limited- or extensive-stage small cell lung cancer, considering the contributory roles of surgery, radiation therapy (local and prophylactic cranial irradiation) and chemotherapy.
    • Recall the design of ongoing clinical trials evaluating novel investigational agents in lung cancer, and counsel appropriately selected patients about availability and participation.

    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:

    Jeffrey Bradley, MD
    S Lee Kling Professor of Radiation Oncology
    Alvin J Siteman Cancer Center
    Washington University School of Medicine
    St Louis, Missouri

    Paid Research: Varian Medical Systems Inc.

    Julie R Brahmer, MD
    Associate Professor of Oncology
    The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
    Baltimore, Maryland

    Advisory Committee: Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly USA LLC, Merck; Paid Research: ArQule Inc, MedImmune Inc; Uncompensated Research: Bristol-Myers Squibb Company.

    Frank C Detterbeck, MD
    Professor and Chief, Section of Thoracic Surgery
    Yale University School of Medicine
    Director, Thoracic Oncology Program
    Yale Cancer Center
    Co-Director, Yale Lung Screening and Nodule Program
    New Haven, Connecticut

    Advisory Committee: Pfizer Inc; Speakers Bureau: Lilly USA LLC.

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

    Consulting Agreements: Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Covidien, Merck.

    John Heymach, MD, PhD
    Chief, Thoracic Medical Oncology
    Associate Professor of Thoracic/Head and Neck Medical Oncology
    The University of Texas MD Anderson Cancer Center
    Houston, Texas

    Advisory Committee: Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Genentech BioOncology, GlaxoSmithKline, Pfizer Inc; Consulting Agreements: OSI Oncology; Contracted Research: Bayer HealthCare Pharmaceuticals, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly USA LLC, Pfizer Inc.

    Bruce E Johnson, MD
    Director, Lowe Center for Thoracic Oncology
    Dana-Farber Cancer Institute
    Professor of Medicine
    Harvard Medical School
    ASCO Translational Research Professor
    Boston, Massachusetts

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Millennium: The Takeda Oncology Company, Pfizer Inc; Consulting Agreements: Chugai Pharmaceutical Co Ltd, Sanofi, Transgenomic Inc; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Genzyme Corporation, Millennium: The Takeda Oncology Company; Stock Ownership: KEW Group LLC.

    Rogerio C Lilenbaum, MD
    Chief Medical Officer
    Smilow Cancer Hospital
    Professor of Medicine
    Yale University School of Medicine
    New Haven, Connecticut

    Consulting Agreement: Genentech BioOncology.

    Thomas J Lynch Jr, MD
    Director, Yale Cancer Center
    Physician-in-Chief, Smilow Cancer Hospital at Yale-New Haven
    Richard and Jonathan Sackler Professor of Internal Medicine
    New Haven, Connecticut

    Advisory Committee: Boehringer Ingelheim Pharmaceuticals Inc, Genentech BioOncology, Merck; Board of Directors: Infinity Pharmaceuticals Inc; Consulting Agreements: Boehringer Ingelheim Pharmaceuticals Inc, Genentech BioOncology, Merck; Other Remunerated Activities: Partners HealthCare.

    Jyoti D Patel, MD
    Associate Professor of Medicine
    Northwestern University
    Feinberg School of Medicine
    Division of Hematology/Oncology
    Chicago, Illinois

    Contracted Research: Lilly USA LLC.

    Alice Shaw, MD, PhD
    Assistant Professor of Medicine
    Harvard Medical School
    Center for Thoracic Cancers
    Massachusetts General Hospital
    Boston, Massachusetts

    Advisory Committee and Consulting Agreements: ARIAD Pharmaceuticals Inc, Chugai Pharmaceutical Co Ltd, Novartis Pharmaceuticals Corporation, Pfizer Inc.

    Mark A Socinski, MD
    Professor of Medicine and Thoracic Surgery
    Director, Lung Cancer Section
    Division of Hematology/Oncology
    Co-Director, UPMC Lung Cancer Center of Excellence
    Co-Director, Lung and Thoracic Malignancies Program
    University of Pittsburgh
    UPMC Cancer Pavilion
    Pittsburgh, Pennsylvania

    Contracted Research: Celgene Corporation, Genentech BioOncology, GlaxoSmithKline, Lilly USA LLC, Pfizer Inc, Synta Pharmaceuticals Corp; Data and Safety Monitoring Board: Abbott Laboratories; Speakers Bureau: Celgene Corporation, Genentech BioOncology, Lilly USA LLC.

    David R Spigel, MD
    Program Director
    Lung Cancer Research
    Sarah Cannon Research Institute
    Nashville, Tennessee

    Advisory Committee: Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly USA LLC, Novartis Pharmaceuticals Corporation, Pfizer Inc, Sanofi.

    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, Allos Therapeutics, Amgen Inc, ArQule Inc, Astellas, 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, Foundation Medicine Inc, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Incyte Corporation, Lilly USA LLC, Medivation Inc, Merck, Millennium: The Takeda Oncology Company, Mundipharma International Limited, Novartis Pharmaceuticals Corporation, 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 Astellas, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology and Lilly USA LLC.

    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: May 2013
    Expiration date:
    May 2014

Acknowledge and close

Watch video
(WIFI is recommended for best performance):

Keynote Address
Personalized Medicine in Lung Cancer: Ready for Prime Time? Bruce E Johnson, MD

Mutations and Genomic Alterations in Non-Small Cell Lung Cancer (NSCLC)
Introduction Neil Love, MD
Driver mutations in NSCLC Thomas J Lynch Jr, MD
Novel strategies for overcoming acquired resistance to EGFR TKIs Bruce E Johnson, MD
EML4-ALK and ROS1 translocations and crizotinib Alice Shaw, MD, PhD
Targeting MET in NSCLC Jyoti D Patel, MD
Faculty Case Discussion 1

Systemic Management of Pan-Wild-Type (PWT) Metastatic NSCLC
First-line chemobiologic treatment of advanced PWT adenocarcinoma Jyoti D Patel, MD
Chemobiologic treatment of advanced squamous cell carcinoma of the lung Ramaswamy Govindan, MD
Available research data and potential integration of nab paclitaxel into the management of NSCLC Mark A Socinski, MD
Role of EGFR TKIs and monoclonal antibodies in the management of PWT adenocarcinoma Thomas J Lynch Jr, MD
Faculty Case Discussion 2

Ongoing Clinical Trials Review
Critique of ongoing and maturing major cooperative group trials Mark A Socinski, MD

Current Controversies in the Multidisciplinary Management of Lung Cancer
Introduction Neil Love, MD
Adjuvant systemic treatment of NSCLC David R Spigel, MD
Controversies in the surgical management of lung cancer Frank C Detterbeck, MD
Multimodality treatment of locally advanced disease Jeffrey Bradley, MD
Management of lung cancer in the elderly and/or patients with poor performance status Rogerio C Lilenbaum, MD
Optimal staging of the mediastinum for patients with localized NSCLC Frank C Detterbeck, MD
Role of radiation therapy in localized and extensive small cell lung cancer Jeffrey Bradley, MD

New Agents and Research Strategies
Immune tumor biology and related interventions Julie R Brahmer, MD
New agents and targets in NSCLC David R Spigel, MD
Next-generation VEGF and EGFR antibodies and multikinase inhibitors John Heymach, MD, PhD
Faculty Case Discussion 3

Highlights of the 10th Winter Lung Cancer Conference
Predictions for 2014 Rogerio C Lilenbaum, MD