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

OVERVIEW OF ACTIVITY
Breast cancer remains the most frequently diagnosed cancer in women, and in 2019 in the United States alone the disease will culminate in an estimated 271,270 new cases and 42,260 deaths. Estrogen receptor (ER)-positive disease, which represents approximately 65% of all cases, is perhaps the most nuanced subset in regard to therapeutic decision-making in the advanced setting. In recent years several ground-breaking clinical data sets and related FDA actions have significantly and unprecedentedly altered the treatment algorithm for patients with ER-positive breast cancer. With these exciting advances, many areas of controversy, vexing questions and clinical challenges are emerging. To provide clinicians with therapeutic strategies to address the disparate needs of patients with ER-positive breast cancer, this program will feature one-on-one discussions with leading breast cancer investigators. By providing information on the latest clinical developments in the context of expert perspectives, this activity will assist medical oncologists with the formulation of evidence-based and current therapeutic strategies, which will in turn facilitate optimal patient care.

LEARNING OBJECTIVES

• Implement a clinical plan for the management of ER-positive metastatic breast cancer, considering available data and patient and disease characteristics.
• Appraise published efficacy and safety data with the FDA-approved CDK4/6 inhibitors abemaciclib, palbociclib and ribociclib, and determine how they can be optimally integrated into the management of ER-positive advanced breast cancer.
• Consider the recent FDA approval of and available Phase III data with alpelisib in combination with fulvestrant for patients with ER-positive advanced breast cancer with a PIK3CA mutation, and determine how this regimen can be incorporated into clinical practice.
• Recognize the evolving application of biomarkers and multigene assays in breast cancer management, and effectively use these tools to refine or individualize treatment plans for patients with localized disease.
• Appreciate the role of adjuvant endocrine therapy versus chemoendocrine therapy for women with ER-positive, HER2-negative, node-negative breast cancer and an intermediate 21-gene Recurrence Score^®.
• Develop an understanding of the mechanisms of action of, available data with and potential clinical roles of novel agents and approaches in the management of ER-positive breast cancer to facilitate referral for clinical trial opportunities.

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
Audio Program: Research To Practice designates this enduring material for a maximum of 2.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Video Program: Research To Practice designates this enduring material for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CME credit is no longer available for this issue

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
Successful completion of these CME activities, which includes participation in the evaluation components, enables the participant to earn up to 2.75 (audio) and 3 (video) 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 each 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, these programs have been specifically designed for the following ABIM specialty: medical oncology.
CME credit is no longer available for this issue

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 THESE CME ACTIVITIES
Audio Program: This CME activity consists of an audio component. To receive credit, the participant should review the CME information, listen to the MP3s, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form. The corresponding video program is available as an alternative at ResearchToPractice.com/BCU319/Video.
CME credit is no longer available for this issue

Video Program: This CME activity consists of a video component. To receive credit, the participant should review the CME information, watch the video, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form. The corresponding audio program is available as an alternative at ResearchToPractice.com/BCU319
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:

Matthew Goetz, MD
Professor of Oncology and Pharmacology
Mayo Clinic
Rochester, Minnesota

Advisory Committee: bioTheranostics Inc, Biovica, Context Therapeutics, Lilly, Novartis, Pfizer Inc, Sermonix Pharmaceuticals.

Virginia Kaklamani, MD, DSc
Professor of Medicine
Ruth McLean Bowman Bowers Chair in Breast Cancer Research and Treatment
AB Alexander Distinguished Chair in Oncology
Associate Director for Clinical Research
Leader of the Breast Cancer Program
UT Health San Antonio
The University of Texas MD Anderson Cancer Center
San Antonio, Texas

Consulting Agreements: Amgen Inc, AstraZeneca Pharmaceuticals LP, Athenex, Celldex Therapeutics, Eisai Inc, Puma Biotechnology Inc; Contracted Research: Eisai Inc; Speakers Bureau: Celgene Corporation, Eisai Inc, Genentech, Genomic Health Inc, Novartis, Pfizer Inc, Puma Biotechnology 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, 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: October 2019
Expiration date: October 2020