TARGET AUDIENCE
This activity is intended for gynecologic oncologists, medical oncologists, gynecologists and other healthcare providers involved in the treatment of gynecologic cancers.

OVERVIEW OF ACTIVITY
Sarcomas of the female genital tract are uncommon neoplasms with an estimated incidence ranging between 1% and 7% of all gynecologic cancers. Although sarcomas may occur in any organ of the female genitalia (uterine corpus, cervix, ovary, fallopian tubes, vulva and vagina), the highest occurrence is in the uterine corpus. It is estimated that 61,880 new cases of cancer of the uterine corpus will be diagnosed in 2019 and 12,160 will die of this disease. Based on the cell of origin, uterine sarcomas can be further divided into leiomyosarcoma, endometrial stromal sarcoma and mixed mesodermal tumors. The most common of these is uterine leiomyosarcoma (uLMS), an aggressive cancer characterized by poor prognosis and high recurrence rates. As with the treatment paradigm for many other solid tumors, surgery remains a critical component in the primary management of localized disease (Stage I and II).

As a group gynecologic sarcomas are relatively rare, and given their heterogeneity, specific histologic subtypes present even less frequently in clinical practice. Therefore, gynecologic and medical oncologists may lack experience caring for patients with any given uterine sarcoma, including uLMS. And although conventional treatment options for sarcomas of the female genital tract remained unchanged for several years, recent research has led to a number of FDA-approved therapies that have begun to disrupt established practices.

This CME program, developed from the proceedings of a satellite symposium held during the 2019 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer, features discussions with leading researchers with expertise in gynecologic cancers regarding actual cases from their practices and the published data that drive clinical decision-making. By providing information on emerging research developments and their potential application to routine practice, this activity is designed to assist medical oncologists, gynecologic oncologists and other healthcare providers with the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

• Appreciate the importance of multidisciplinary collaboration in the diagnosis and management of gynecologic sarcomas, and use this information to design a process to optimize tissue procurement, accurate histologic assessment, tertiary care referral and treatment outcome.
• Develop an evidence-based strategy for the treatment of Stage I to III uterine sarcoma, considering the potential contributions of surgery, radiation therapy and cytotoxic therapy.
• Employ guideline-endorsed monitoring protocols and techniques to effectively screen patients with localized uLMS for the development of metastases.
• Appraise available safety and efficacy data with approved targeted and cytotoxic therapies used in the treatment of advanced gynecologic sarcomas, and consider how these agents can be optimally incorporated into clinical management algorithms.
• Recognize the toxicities and adverse events associated with novel agents in the management of soft-tissue sarcomas, and formulate strategies to minimize and manage these side effects.
• Recall new data with other investigational agents demonstrating promising activity in uterine and other gynecologic sarcomas, and discuss ongoing trial opportunities with eligible patients.

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
CME credit is no longer available for this issue

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
This CME activity consists of an audio 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:

Amanda Nickles Fader, MD
Associate Professor and Director
The Kelly Gynecologic Oncology Service
Director, Center for Rare Gynecologic Cancers
Johns Hopkins School of Medicine
Baltimore, Maryland

Advisory Committee: Clovis Oncology, Merck.

Mario M Leitao Jr, MD
Attending Surgeon and Member, Division of Gynecology
Professor, Weill Cornell Medical College
Director, Gynecologic Oncology Fellowship Program
Director, Minimal Access and Robotic Surgery Program
Department of Surgery
Memorial Sloan Kettering Cancer Center
New York, New York

No relevant conflicts of interest to disclose.

Angeles Alvarez Secord, MD, MHSc
Professor, Duke Cancer Institute
Duke University Health System
Durham, North Carolina

Advisory Committee: AstraZeneca Pharmaceuticals LP, Clovis Oncology, Genentech, Janssen Biotech Inc, Merck, Roche Laboratories Inc; Contracted Research: AbbVie Inc, Amgen Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Clovis Oncology, Eisai Inc, Exelixis Inc, Genentech, Immutep Ltd, Incyte Corporation, Merck, Roche Laboratories Inc, Seattle Genetics, Tesaro.

Brian A Van Tine, MD, PhD
Medical Oncology
Associate Professor of Medicine
Sarcoma Program Director
Washington University in St Louis
Siteman Cancer Center
St Louis, Missouri

Advisory Committee and Consulting Agreements: Adaptimmune, CytRx Corporation, Daiichi Sankyo Inc, Epizyme Inc, Immune Design, Janssen Biotech Inc, Lilly, Pfizer Inc; Contracted Research: Merck, Pfizer Inc, TRACON Pharmaceuticals Inc; Speakers Bureau: Adaptimmune, Caris Life Sciences, Janssen Biotech Inc, Lilly; Other Remunerated Activities: Merck, Pfizer Inc, TRACON Pharmaceuticals Inc.

MODERATOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech, Genmab, Genomic Health Inc, Gilead Sciences Inc, Guardant Health, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Oncopeptides, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, a Novartis Division, Sanofi Genzyme, Seattle Genetics, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent 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 grantor.

This activity is supported by an educational grant from Lilly.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
Adobe Flash Player 27 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Release date: June 2019
Expiration date: June 2020