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Proceedings from the 13th Annual Winter Lung Cancer Conference
Released July 2016

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 Julie R Brahmer, Walter J Curran Jr, Gary Deng, Giuseppe Giaccone, David H Harpole Jr, Leora Horn, Corey J Langer, Rogerio C Lilenbaum, Renato G Martins, Suresh S Ramalingam, Gregory J Riely, Mark A Socinski, David R Spigel and Everett E Vokes. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This educational activity has been designed to meet the educational needs of medical oncologists, hematology-oncology fellows, nurse practitioners and other allied cancer professionals involved in the treatment of lung cancer.

    OVERVIEW OF ACTIVITY
    Lung cancer is a devastating disease that accounts for approximately 13% of new cancer cases and more cancer-related deaths among both men and women than any other tumor type. In the year 2016, it is estimated that 224,390 individuals will be diagnosed and 158,080 individuals will die from the disease. The plethora of available cytotoxic chemotherapies exhibiting activity in lung cancer has increased substantially over the past several years, and development of new therapeutic strategies beyond cytotoxic chemotherapy has been the focus of extensive recent research and has led to an explosion in lung cancer genetic and biologic knowledge. The advent of these next-generation treatments presents new promise of both efficacy and enhanced safety for patients with lung cancer but also challenges practicing oncologists to appropriately select individuals who may benefit from these agents and to determine how to integrate such therapies, as they become available, into standard lung cancer treatment algorithms.

    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 treatment of localized non-small cell lung cancer (NSCLC), exploring the role of (neo)adjuvant systemic therapy.
    • Employ an understanding of personalized medicine to individualize the use of available EGFR inhibitors in the treatment of NSCLC.
    • Describe mechanisms of tumor resistance to EGFR tyrosine kinase inhibitors, and identify therapeutic opportunities to circumvent this process, including the recently approved third-generation agent osimertinib.
    • Communicate the efficacy and safety of crizotinib, ceritinib, alectinib and other emerging ALK inhibitors to appropriate patients with NSCLC, considering the predictive utility of ALK and ROS1 mutation testing.
    • Devise an evidence-based approach to the selection of induction and maintenance systemic therapy for patients with NSCLC without a targetable mutation.
    • Appreciate the recent FDA approvals of nivolumab and pembrolizumab, and consider their role in the formulation of optimal treatment approaches for patients with metastatic NSCLC.
    • Describe emerging data on the efficacy and safety of tumor immunotherapy in lung cancer, and consider this information when counseling patients regarding clinical trial participation.
    • Consider biologic and patient-related factors in the selection of later-line therapy for individuals with progressive NSCLC without a targetable mutation.
    • Assess new oncogenic pathways mediating the growth of unique NSCLC tumor subsets, and recall emerging data with experimental agents exploiting these targets.
    • Formulate management strategies for small cell lung cancer, considering the contributory roles of local and systemic therapy.
    • Consider the use of multimodality therapy for appropriate patients with mesothelioma who may potentially be cured with this approach, and devise optimal treatment strategies for those with advanced disease.
    • 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.

    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 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, MedImmune Inc.

    Walter J Curran Jr, MD
    Executive Director, Winship Cancer Institute
    Lawrence W Davis Professor and Chairman
    Dept of Radiation Oncology
    Group Chairman, NRG Oncology
    Georgia Research Alliance Eminent Scholar and Chair in Cancer Research
    Emory University
    Atlanta, Georgia

    Consulting Agreements: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company.

    Gary Deng, MD, PhD
    Interim Chief, Integrative Medicine Service
    Associate Member/Attending Physician
    Memorial Sloan Kettering Cancer Center
    New York, New York

    No relevant conflicts of interest to disclose.

    Giuseppe Giaccone, MD, PhD
    Associate Director for Clinical Research
    Lombardi Comprehensive Cancer Center
    Professor of Medical Oncology and Pharmacology
    Georgetown University
    Director of Clinical Research
    MedStar Health Cancer Network’s Washington Region
    Washington, DC

    Advisory Committee: Celgene Corporation; Contracted Research: AstraZeneca Pharmaceuticals LP, Karyopharm Therapeutics.

    David H Harpole Jr, MD
    Professor of Surgery
    Associate Professor in Pathology
    Vice Chief, Division of Surgical Services
    Duke University School of Medicine
    Durham, North Carolina

    No relevant conflicts of interest to disclose.

    Leora Horn, MD, MSc
    Associate Professor of Medicine
    Assistant Director
    Educator Development Program
    Vanderbilt University Medical Center
    Nashville, Tennessee

    Advisory Committee: Bristol-Myers Squibb Company, Genentech BioOncology, Merck; Consulting Agreements: Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Xcovery; Contracted Research: AstraZeneca Pharmaceuticals LP.

    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, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc; Consulting Agreements: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly, Merck, Pfizer Inc; Contracted Research: Astellas Pharma Global Development Inc, Celgene Corporation, Genentech BioOncology, GlaxoSmithKline, Merck; Data and Safety Monitoring Board: AbbVie Inc, Amgen Inc, Lilly, Peregrine Pharmaceuticals Inc, Synta Pharmaceuticals Corp.

    Rogerio C Lilenbaum, MD (Co-Chair and Moderator)
    Professor of Medicine
    Yale School of Medicine
    Chief Medical Officer
    Smilow Cancer Hospital
    Yale Cancer Center
    New Haven, Connecticut

    Consulting Agreements: Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Genentech BioOncology.

    Renato G Martins, MD, MPH
    Stephen H Petersdorf Endowed Chair in Cancer Care
    Associate Medical Director
    Solid Tumor Adult Oncology
    Seattle Cancer Care Alliance
    Professor, University of Washington
    Seattle, Washington

    No relevant conflicts of interest to disclose.

    Suresh S Ramalingam, MD
    Professor of Hematology and Medical Oncology
    Director, Division of Medical Oncology
    Emory University
    Winship Cancer Institute
    Atlanta, Georgia

    Consulting Agreements: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly, Merck.

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

    Consulting Agreement: Novartis Pharmaceuticals Corporation; Contracted Research: GlaxoSmithKline, Infinity Pharmaceuticals Inc, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Takeda Oncology.

    Mark A Socinski, MD (Co-Chair and Moderator)
    Executive Medical Director
    Member, Thoracic Oncology Program
    Florida Hospital Cancer Institute
    Orlando, Florida

    Advisory Committee: Bristol-Myers Squibb Company, Daiichi Sankyo Inc, Lilly; Contracted Research: Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, GlaxoSmithKline, Lilly, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Synta Pharmaceuticals Corp; Speakers Bureau: Celgene Corporation, Genentech BioOncology.

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

    Advisory Committee: Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Lilly, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc; Consulting Agreement: AstraZeneca Pharmaceuticals LP.

    Everett E Vokes, MD
    John E Ultmann Professor
    Chairman, Department of Medicine
    Physician-in-Chief
    University of Chicago Medicine and Biological Sciences
    Chicago, Illinois

    Advisory Committee: AbbVie Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Clovis Oncology, Eisai Inc, GeneCentric Diagnostics Inc, Genentech BioOncology, Lilly, Merck, Synta Pharmaceuticals Corp, Transgene, VentiRx Pharmaceuticals Inc.

    MODERATOR AND CO-CHAIRDr 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, Amgen 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, ImmunoGen Inc, Incyte Corporation, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, 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, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, 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, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Genentech BioOncology, Lilly, Natera Inc 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: July 2016
    Expiration date: July 2017

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Watch video
(WIFI is recommended for best performance):
Keynote Address
What every clinician needs to know to care for patients receiving immunotherapy Julie R Brahmer, MD
EGFR Mutation-Positive Disease
Selection of first-line EGFR tyrosine kinase inhibitors Corey J Langer, MD
Management of acquired resistance: Clinical scenarios and detection of T790M mutations in tissue and serum Gregory J Riely, MD, PhD
Third-generation tyrosine kinase inhibitors Suresh S Ramalingam, MD
Targeted therapy for CNS metastases; management of T790M-negative disease Julie R Brahmer, MD
EML4-ALK, ROS1, BRAF and Other Potentially Targetable Mutations
Optimal molecular testing in clinical practice: Multiplex testing and next-generation sequencing Leora Horn, MD, MSc
ALK assays; ceritinib, alectinib and other novel ALK inhibitors Gregory J Riely, MD, PhD
Clinical implications of BRAF, HER2 and RET mutations David R Spigel, MD
ROS1 and MET exon 14 skipping mutations; clinical relevance of MET amplification; potential targets for small cell and squamous cell cancer Renato G Martins, MD, MPH
Management of Metastatic Disease with No Identifiable Tumor Mutations
Update on monoclonal antibodies in non-small cell lung cancer (NSCLC): Bevacizumab, ramucirumab and necitumumab Corey J Langer, MD
Role of EGFR inhibitors as second- or third-line therapy for patients without targetable mutations Renato G Martins, MD, MPH
Selection of systemic treatment for adenocarcinoma and squamous cell carcinoma Mark A Socinski, MD
Caring for the elderly and frail patient Rogerio C Lilenbaum, MD
Immune Checkpoint Inhibitors
Biology of the immune system; mechanism of action of checkpoint inhibitors; correlation of PD-L1 staining with response Suresh S Ramalingam, MD
Available clinical data on immunotherapy in squamous cell carcinoma of the lung Julie R Brahmer, MD
Available clinical data on immunotherapy in nonsquamous cell NSCLC David R Spigel, MD
Checkpoint inhibitors in small cell lung cancer and CNS disease; important ongoing clinical trials Leora Horn, MD, MSc
Integrative Oncology; Burnout in Oncologists
Integrative oncology: Complementary approaches, alternative therapies, practice guidelines Gary Deng, MD, PhD
ASCO burnout survey of medical oncologists Leora Horn, MD, MSc
Adjuvant and Neoadjuvant Therapy; Management of Small Cell Lung Cancer, Mesothelioma and Thymoma
Adjuvant and neoadjuvant therapy update — ALCHEMIST, RADIANT and ECOG-E1505; recent therapeutic advances for Stage III disease Everett E Vokes, MD
Updates on treatment advances in small cell lung cancer, mesothelioma, thymoma and thymic carcinoma Giuseppe Giaccone, MD, PhD
Interdisciplinary Tumor Panel
Surgery versus stereotactic body radiation therapy in medically operable NSCLC David H Harpole Jr, MD
Current research on thoracic radiation therapy in Stage III disease Walter J Curran Jr, MD
Indications for sublobar resection for localized NSCLC David H Harpole Jr, MD
Defining oligometastatic disease; optimal management of bone and brain metastases Walter J Curran Jr, MD