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Proceedings from the 14th Annual Winter Lung Cancer Conference
Released June 2017

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 Paul A Bunn Jr, Roy H Decker, Roy S Herbst, Karen Kelly, Mark G Kris, Corey J Langer, Rogerio C Lilenbaum, Barbara L McAneny, Joel W Neal, Geoffrey R Oxnard, Nathan A Pennell, Naiyer Rizvi, Alice Shaw, Mark A Socinski, Thomas E Stinchcombe and Eric Vallières. (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 and other allied cancer professionals involved in the treatment of lung cancer.

    OVERVIEW OF ACTIVITY
    Lung cancer is a devastating disease with broad-reaching impact on public health as it accounts for 14% of all new cancer cases in the United States and the most cancer-related deaths among both men and women. In the year 2017, it is estimated that more than 222,500 individuals will be diagnosed and more than 155,870 will die from the disease. Today, however, this field is seeing renewed optimism as recent research advances have led to an explosion in lung cancer genetic and biologic knowledge among scientists and clinicians working in this area of cancer medicine. Over the past several years major clinical trials in advanced lung cancer have witnessed a host of promising successes, many of which are already being operationalized in clinical practice. Even so, these achievements will doubtlessly continue to be dissected and will further challenge the collective understanding of the biology and optimal management of this disease. Several consensus- and evidence-based treatment guidelines are currently available and aim to assist clinicians with making lung cancer treatment decisions in the face of this dynamic clinical environment, but despite the existence of these tools, many areas of controversy persist within academic and community settings.

    This CME activity will use the perspectives of a multidisciplinary panel of clinical investigators on key challenges and controversies in the treatment of lung cancer to address the existing management uncertainties of clinician learners and help keep them up to date in a continuously evolving therapeutic environment.


    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.
    • Apply the results of emerging clinical research to optimize the multimodality management of Stage III NSCLC.
    • 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 investigational therapeutic opportunities to circumvent this process.
    • Communicate the efficacy and safety of crizotinib, ceritinib, alectinib, brigatinib and 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.
    • 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.
    • 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 management strategies for 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.

    CREDIT DESIGNATION STATEMENT
    Research To Practice designates this enduring material for a maximum of 10.25 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, which includes participation in the evaluation component, enables the participant to earn up to 10.25 Medical Knowledge 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/WLCC2017/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:


    Paul A Bunn Jr, MD
    Distinguished Professor and James Dudley Chair in Cancer Research
    University of Colorado Cancer Center
    Aurora, Colorado

    Advisory Committee: Genentech BioOncology, Lilly; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Celgene Corporation, EMD Serono Inc, Genentech BioOncology, Lilly, Merck, Novartis, Pfizer Inc.

    Roy H Decker, MD, PhD
    Associate Professor of Therapeutic Radiology
    Clinical Research Program Leader, Therapeutic Radiology
    Director, Residency Training Program
    Director, Thoracic/Stereotactic Body Radiotherapy Program
    Vice Chair for Clinical Research
    Yale Comprehensive Cancer Center
    Yale School of Medicine
    New Haven, Connecticut

    Contracted Research: Merck.

    Roy S Herbst, MD, PhD
    Ensign Professor of Medicine (Oncology)
    Professor of Pharmacology
    Chief of Medical Oncology
    Director, Thoracic Oncology Research Program
    Associate Director for Translational Research
    Yale Comprehensive Cancer Center
    Yale School of Medicine
    New Haven, Connecticut

    Consulting Agreements: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Kolltan Pharmaceuticals Inc, Lilly, Merck, Pfizer Inc; Contracted Research: Genentech BioOncology, Merck.

    Karen Kelly, MD
    Professor of Medicine
    Associate Director for Clinical Research
    Jennifer Rene Harmon Tegley and Elizabeth Erica Harmon
    Endowed Chair in Cancer Clinical Research
    UC Davis Comprehensive Cancer Center
    Sacramento, California

    Advisory Committee: Ariad Pharmaceuticals Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, G1 Therapeutics, Genentech BioOncology, Lilly; Contracted Research: AbbVie Inc, Celgene Corporation, EMD Serono Inc, Five Prime Therapeutics Inc, Genentech BioOncology, Gilead Sciences Inc; Data Monitoring Committee: AstraZeneca Pharmaceuticals LP, Genentech BioOncology; Other Remunerated Activities: UpToDate Inc.

    Mark G Kris, MD
    William and Joy Ruane Chair in Thoracic Oncology
    Attending Physician, Thoracic Oncology Service
    Memorial Sloan Kettering Cancer Center
    New York, New York

    No relevant conflicts of interest to disclose.

    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, 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, Pfizer Inc; Contracted Research: Advantagene Inc, Celgene Corporation, GlaxoSmithKline, Merck, Inovio Pharmaceuticals Inc; Data and Safety Monitoring Board: Abbott Laboratories, 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

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Genentech BioOncology; Consulting Agreement: Roche Laboratories Inc; Contracted Research: Celgene Corporation.

    Barbara L McAneny, MD
    Member, Board of Trustees
    American Medical Association
    CEO of New Mexico Oncology Hematology Consultants Ltd
    Albuquerque, New Mexico

    No relevant conflicts of interest to disclose.

    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/Physician Resource Management, Clovis Oncology, Nektar; Contracted Research: Ariad Pharmaceuticals Inc, ArQule Inc, Boehringer Ingelheim Pharmaceuticals Inc, Exelixis Inc, Genentech BioOncology, Merck, Nektar, Novartis, Roche Laboratories Inc.

    Geoffrey R Oxnard, MD
    Lowe Center for Thoracic Oncology
    Dana-Farber Cancer Institute
    Assistant Professor of Medicine
    Harvard Medical School
    Boston, Massachusetts

    Advisory Committee: Ariad Pharmaceuticals Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Genentech BioOncology, Inivata, Takeda Oncology; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc.

    Nathan A Pennell, MD, PhD
    Associate Professor, Hematology and Medical Oncology
    Cleveland Clinic Lerner College of Medicine
    of Case Western Reserve University
    Director, Cleveland Clinic Lung Cancer Medical Oncology Program
    Cleveland, Ohio

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc; Contracted Research: AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Celgene Corporation, Genentech BioOncology, Merck, Pfizer Inc.

    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, Roche Laboratories Inc; Ownership Interest: Gritstone Oncology.

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

    Advisory Committee: EMD Serono Inc, Genentech BioOncology, Novartis, Pfizer Inc, Roche Laboratories Inc; Consulting Agreements: Blueprint Medicines, Daiichi Sankyo Inc, EMD Serono Inc, Ignyta Inc, Novartis, Pfizer Inc, Roche Laboratories Inc, Taiho Oncology Inc.

    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, Takeda Oncology; Contracted Research: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, GlaxoSmithKline, Lilly, Pfizer Inc; Speakers Bureau: Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology.

    Thomas E Stinchcombe, MD
    Co-Director, Multidisciplinary Thoracic Oncology Program
    Duke University School of Medicine
    Durham, North Carolina

    Consulting Agreements: Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Lilly; Contracted Research: Bristol-Myers Squibb Company, EMD Serono Inc, Genentech BioOncology.

    Eric Vallières, MD
    Surgical Director, Lung Cancer Program
    Medical Director, Division of Thoracic Surgery
    Swedish Cancer Institute
    Seattle, Washington

    Consulting Agreements: Genentech BioOncology, GlaxoSmithKline, Spiration 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, Acerta Pharma, Adaptive Biotechnologies, 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, 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, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, 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 and Tokai Pharmaceuticals 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 AbbVie Inc, Ariad Pharmaceuticals, Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Lilly, Merck, Myriad Genetic Laboratories Inc, Novartis and Regeneron Pharmaceuticals Inc.

    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: June 2017
    Expiration date: June 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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Keynote Address
  • History, major findings and lessons learned from the Lung Cancer Mutation Consortium
    Paul A Bunn Jr, MD
Current and Future Application of Immunotherapy in Non-Small Cell Lung Cancer (NSCLC)
  • Emerging research information with the use of anti-PD-1/PD-L1 antibodies in patients with previously untreated metastatic NSCLC
    Roy S Herbst, MD, PhD
  • Practical assessment of PD-L1 status and integration of PD-L1 assays into clinical practice
    Joel W Neal, MD, PhD
  • Current role of anti-PD-1/PD-L1 antibodies in patients with EGFR- or ALK-positive disease
    Naiyer Rizvi, MD
  • Novel immunotherapeutic approaches; combination strategies with chemotherapy
    Nathan A Pennell, MD, PhD
EGFR Mutation-Positive NSCLC
  • Molecular testing in clinical practice and the role of multiplex testing/next-generation sequencing (NGS)
    Paul A Bunn Jr, MD
  • Effect of EGFR variant on the selection of first-line systemic therapy
    Alice Shaw, MD, PhD
  • Identification of acquired resistance: Detection of T790M and other secondary mutations in tissue, plasma and urine
    Geoffrey R Oxnard, MD
  • Available efficacy and safety data with osimertinib; ongoing evaluation in the first-line setting; effectiveness in patients with CNS metastases
    Roy S Herbst, MD, PhD
EML4-ALK, ROS1, BRAF and Other Potentially Targetable Mutations
  • Optimal approach to ALK assessment; selection of first-line therapy for patients with ALK-rearranged or ROS1-positive NSCLC
    Alice Shaw, MD, PhD
  • Approved and investigational TKIs for patients with ALK-positive disease progressing on first-line TKI therapy
    Geoffrey R Oxnard, MD
  • Identification of and treatment for patients with BRAF-V600E tumor mutations
    Paul A Bunn Jr, MD
  • Potential clinical benefits of and investigational opportunities associated with the identification of other oncogenic drivers (eg, HER2 and MET exon 14 skipping mutations, RET rearrangements)
    Thomas E Stinchcombe, MD
Management of Small Cell Lung Cancer, Mesothelioma and NSCLC with No Identified Targetable Mutation
  • Emerging role of immune checkpoint inhibitors and ongoing clinical trials in malignant pleural mesothelioma (MPM)
    Naiyer Rizvi, MD
  • Current management and ongoing clinical trials in small cell lung cancer (SCLC)
    Thomas E Stinchcombe, MD
  • Sequencing of systemic therapies and clinical trial options for patients with metastatic squamous cell carcinoma (SCC)
    Mark A Socinski, MD
  • Sequencing of systemic therapies and clinical trial options for patients with metastatic nonsquamous cell lung cancer
    Joel W Neal, MD, PhD
  • Is there a role for targeted therapy in the adjuvant or neoadjuvant setting?
    Nathan A Pennell, MD, PhD
Quality and Value in the Management of Lung Cancer
  • The oncology home: Implications for the care of patients with lung cancer
    Barbara L McAneny, MD
  • What clinicians can do about the cost of cancer care
    Rogerio C Lilenbaum, MD
Lung Cancer Interdisciplinary Tumor Board
  • Prognostic molecular models in early-stage lung cancer
    Eric Vallières, MD
  • Radiation therapy: Challenging clinical scenarios and related management issues
    Roy H Decker, MD, PhD
  • Adjuvant and neoadjuvant therapy
    Karen Kelly, MD
  • Controversies in the surgical management of lung cancer
    Eric Vallières, MD
  • Recent therapeutic advances and novel trial concepts for patients with locally advanced NSCLC
    Roy H Decker, MD, PhD
  • Optimal management of oligometastatic disease
    Mark G Kris, MD
Practical Challenges in the Use of Immunotherapy
  • Clinical complications associated with immunotherapy; immunotherapy in patients with a history of autoimmune disease
    Corey J Langer, MD
  • Clinically relevant endpoints for checkpoint inhibitor trials; management approach for patients with prolonged progression-free survival: Is there a role for stopping therapy?
    Mark G Kris, MD
  • Clinical trials integrating immunotherapy and radiation therapy
    Karen Kelly, MD
  • Immunotherapy in elderly patients and those with significant comorbidities
    Corey J Langer, MD