TARGET AUDIENCE
This activity is intended for medical oncologists, hematologist-oncologists and other healthcare providers involved in the treatment of breast cancer (BC).

OVERVIEW OF ACTIVITY
The current clinical management of breast cancer is multidisciplinary and includes surgical resection of local disease with or without radiation therapy and the treatment of systemic disease with cytotoxic chemotherapy, endocrine therapy, biologic therapy or combinations of these approaches. Although several factors are routinely considered in therapeutic decision-making for these patients, hormone receptor and HER2 status play perhaps the most significant roles, and this has led to the division of breast cancer into 3 primary phenotypes, ER-positive, HER2-positive and triple-negative disease. HER2 overexpression or amplification, an attribute that is generally associated with aggressive disease, is present in approximately 15% to 20% of breast cancer cases. Recent advances in the treatment of HER2-positive disease, including the use of HER2-targeted therapies, have improved outcomes but created challenges in the management of this subtype of breast cancer.

To bridge the gap between research and patient care, this issue of Breast Cancer Update uses one-on-one interviews with leading breast cancer investigators to distill the latest research developments in the management of HER2-positive breast cancer so they may be incorporated into clinical practice as appropriate. By providing access to cutting-edge data and expert perspectives, this CME program assists medical oncologists in the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

• Consider available data and relevant clinical factors in the selection of neoadjuvant therapy for patients with HER2-overexpressing early breast cancer.
• Apply emerging research evidence to individualize the use and/or selection of adjuvant systemic therapy for patients with HER2-positive early breast cancer who have and have not received prior neoadjuvant treatment.
• Implement a long-term clinical plan for the management of metastatic HER2-positive breast cancer, incorporating existing, recently approved and emerging targeted treatments.
• Develop a plan of care to recognize and manage side effects and toxicities associated with approved and investigational HER2-targeted therapies.
• Appraise ongoing trials of novel agents and approaches in breast cancer, and obtain consent and refer patients for study 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
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 THESE CME ACTIVITIES
Audio Program: This CME activity consists of an audio component.
CME credit is no longer available for this issue

Video Program: 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:

Ian E Krop, MD, PhD
Associate Chief, Division of Breast Oncology
Dana-Farber Cancer Institute
Associate Professor of Medicine, Harvard Medical School
Boston, Massachusetts

Consulting Agreements: Bristol-Myers Squibb Company, Context Therapeutics, Daiichi Sankyo Inc, Genentech, MacroGenics Inc, Pfizer Inc, Roche Laboratories Inc, Taiho Oncology Inc; Contracted Research: Daiichi Sankyo Inc, Genentech, Pfizer Inc, Roche Laboratories Inc; Data and Safety Monitoring Board/Committee: Merck, Novartis.

Sara Hurvitz, MD
Associate Professor of Medicine
David Geffen School of Medicine at UCLA
Director, Breast Cancer Clinical Research Program
Co-Director, Santa Monica-UCLA Outpatient Oncology Practice
Santa Monica, California

Grant/Support: Ambryx Inc, Amgen Inc, Bayer HealthCare Pharmaceuticals, BioMarin, Boehringer Ingelheim Pharmaceuticals Inc, Daiichi Sankyo Inc, Dignitana, Genentech, GlaxoSmithKline, Lilly, MacroGenics Inc, Medivation Inc, a Pfizer Company, Merrimack Pharmaceuticals Inc, Novartis, OBI Pharma Inc, Pfizer Inc, Pieris Pharmaceuticals Inc, Puma Biotechnology Inc, Roche Laboratories Inc, Seattle Genetics; Paid Travel: Lilly, Novartis, OBI Pharma Inc.

EDITOR — 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, EMD Serono 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, A GSK Company, 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.

These educational activities contain 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 AstraZeneca Pharmaceuticals LP, Celgene Corporation, Daiichi Sankyo Inc, Genentech, Genomic Health Inc, Lilly, Merck, Novartis, Puma Biotechnology Inc and Seattle Genetics.

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: September 2019
Expiration date: September 2020