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 2013, it is estimated that 228,190 new cases will be diagnosed and 159,480 deaths will occur from the disease. In addition, only 16% of all patients with lung cancer are alive 5 years or more after diagnosis, despite currently available therapies.

Current therapeutic management of non-small cell lung cancer (NSCLC) is dependent on tumor stage and histology at the time of initial diagnosis, as well as prior treatment exposure, patient performance status and sites of metastasis for those with disease recurrence or de novo Stage IV presentation. The number of available cytotoxic chemotherapies exhibiting activity in lung cancer has increased substantially over the past several years, although platinum-based doublets continue to be the standard front-line choice in both the early- and advanced-stage disease settings. Opportunities to individualize acceptable side-effect profiles and patient thresholds for quality of life form the basis for selection of an optimal platinum partner. To bridge the gap between research and patient care, this CME activity uses the input of cancer experts to frame a relevant discussion of recent research advances in lung cancer that can be applied to routine clinical practice. This information will help medical oncologists formulate up-to-date clinical management strategies.

LEARNING OBJECTIVES

• Use biomarkers, clinical characteristics and tumor histology to select individualized front-line and subsequent treatment approaches for patients with NSCLC.
• Assess the optimal therapeutic strategy for patients with resectable or unresectable EGFR mutation-positive NSCLC.
• Explore the role of neoadjuvant and adjuvant systemic or localized therapy for early-stage NSCLC.
• Appraise the evolving role of the tyrosine kinase inhibitor erlotinib in novel neoadjuvant and adjuvant clinical settings, and identify patients who may be eligible for a clinical trial examining this treatment approach.
• Demonstrate knowledge of emerging research on EGFR exon 20 insertion mutations in NSCLC, and consider this information when developing best-practice disease management strategies.
• Compare and contrast the clinical benefits and risks associated with weekly albumin-bound paclitaxel versus solvent-based paclitaxel for patients with previously untreated advanced-stage NSCLC.
• Consider the use of appropriate combination chemotherapy regimens for patients with high-risk advanced NSCLC and poor performance status.
• Evaluate the utility of immune-directed therapy for patients with metastatic NSCLC.
• Identify patients with advanced-stage NSCLC who may experience clinical benefit from the addition of continuation maintenance therapy with biologic agents and/or chemotherapy.

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 contains text, web PowerPoint and video components. The participant should read the text portion, review the slides, and 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:

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.

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.

EDITOR — 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, 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, 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: August 2013
Expiration date: August 2014