TARGET AUDIENCE
This activity is intended for medical oncologists, hematologist-oncologists, hematology-oncology fellows, oncology nurses, radiation oncologists, breast/general surgeons and other healthcare practitioners involved in the management of breast cancer.

OVERVIEW OF ACTIVITY
Breast cancer remains the most frequently diagnosed type of cancer in women, with an estimated 234,580 new cases and 40,030 deaths in the United States in 2013. Advances in screening and prevention have resulted in a steady down-stage migration at the time of disease presentation, and the number of individuals living with breast cancer has increased substantially, as has the population “at risk” for recurrent disease.

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 agents. The indication and utility of these local and systemic therapeutic options are based largely on a number of prognostic and predictive risk factors present within the patient or the tumor at the time of diagnosis. Despite the existence of various evidence- and/or consensus-based guidelines or algorithms that aim to assist oncologists in making treatment decisions, many areas of controversy persist within the academic and community settings.

To bridge the gap between research and patient care, this CME activity will use the perspectives of clinical investigators on key management challenges and controversies in the treatment of breast cancer to assist medical oncologists, hematologists, hematologist-oncologists, hematology-oncology fellows and other cancer clinicians in the formulation of up-to-date and appropriate treatment strategies.

LEARNING OBJECTIVES

• Compare and contrast treatment approaches favored by the faculty for postmenopausal women with ER-positive breast cancer who develop metastases after adjuvant treatment with 1 versus 3 years of an aromatase inhibitor.
• Evaluate systemic therapy approaches preferred by clinical investigators for patients with ER-positive disease who develop a recurrence in the chest wall after complete resection and who have no other evidence of disease.
• Formulate strategies to manage toxicities associated with everolimus when used in the treatment of breast cancer.

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 consists of a text component. The participant should review the treatment preference matrix.

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:

Kimberly L Blackwell, MD
Professor of Medicine
Director, Breast Cancer Program
Duke Cancer Institute
Durham, North Carolina

Advisory Committee: Novartis Pharmaceuticals Corporation; Consulting Agreements: Novartis Pharmaceuticals Corporation, Sandoz; Contracted Research: Celgene Corporation, Genentech BioOncology, Roche Laboratories Inc; Speakers Bureau: Genomic Health Inc.

Lisa A Carey, MD
Richardson and Marilyn Jacobs Preyer Distinguished Professor for Breast Cancer Research
Chief, Division of Hematology and Oncology
Physician-in-Chief
North Carolina Cancer Hospital
Associate Director for Clinical Research
Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina

No real or apparent conflicts of interest to disclose.

Julie R Gralow, MD
Professor, Medical Oncology
Jill Bennett Endowed Professorship in Breast Cancer
University of Washington School of Medicine
Director, Breast Medical Oncology
University of Washington School of Medicine/Seattle Cancer Care Alliance
Member, Clinical Research Division
Fred Hutchinson Cancer Research Center
Seattle, Washington

Contracted Research: Amgen Inc, Genentech BioOncology, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc.

Clifford Hudis, MD
Chief, Breast Cancer Medicine Service
Solid Tumor Division
Department of Medicine
Memorial Sloan-Kettering Cancer Center
Professor of Medicine
Weill Cornell Medical College
New York, New York

No real or apparent conflicts of interest to disclose.

Ian E Krop, MD, PhD
Associate Physician, Dana-Farber Cancer Institute
Assistant Professor of Medicine, Harvard Medical School
Boston, Massachusetts

Advisory Committee: Seattle Genetics; Clinical Trial Support: Genentech BioOncology.

Kathy D Miller, MD
Co-Director, IU Simon Cancer Center Breast Cancer Team
Ballvé Lantero Scholar in Oncology
Associate Professor of Medicine
Department of Personalized Medicine
Division of Hematology/Oncology
The Indiana University Melvin and Bren Simon Cancer Center
Indianapolis, Indiana

Consulting Agreements: Antigen Express, Nektar; Contracted Research: Genentech BioOncology, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company; Paid Research: Antigen Express, Clovis Oncology, EntreMed Inc, Merrimack Pharmaceuticals, Syndax Pharmaceuticals Inc, Taiho Pharmaceutical Co Ltd.

Joyce O’Shaughnessy, MD
Co-Director, Breast Cancer Research Program
Baylor-Charles A Sammons Cancer Center
Texas Oncology
US Oncology
Dallas, Texas

Advisory Committee: Genentech BioOncology; Consulting Agreements: Arno Therapeutics Inc, Eisai Inc, GlaxoSmithKline, Johnson & Johnson Pharmaceuticals, Roche Laboratories Inc, Sanofi.

Hope S Rugo, MD
Professor of Medicine
Director, Breast Oncology and Clinical Trials Education
University of California, San Francisco
Helen Diller Family Comprehensive Cancer Center
San Francisco, California

Contracted Research: Agensys Inc, a subsidiary of Astellas Pharma US, Amgen Inc, Eisai Inc, Genentech BioOncology, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, MacroGenics Inc, Merck, Novartis Pharmaceuticals Corporation, Plexxikon Inc; Speakers Bureau: Genomic Health Inc.

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, AstraZeneca Pharmaceuticals LP, 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, Exelixis Inc, Foundation Medicine Inc, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Incyte Corporation, Lilly, Medivation Inc, Merck, Millennium: The Takeda Oncology Company, Mundipharma International Limited, Novartis Pharmaceuticals Corporation, Novocure, 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 Genentech BioOncology, Genomic Health Inc and Novartis Pharmaceuticals Corporation.

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: November 2013
Expiration date: November 2014