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Striving for Consensus: The Application of Existing and Emerging Research Findings to the Practical Management of Gastrointestinal Cancers (Video Program)
Released January 2014

Video excerpts from a clinical investigator Think Tank held on September 20, 2013. Featuring perspectives from Drs Johanna C Bendell, Charles S Fuchs, Richard M Goldberg, J Randolph Hecht, Eileen M O’Reilly and Philip A Philip. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This activity has been designed to meet the educational needs of medical oncologists, including gastroenterologists, interventional radiologists and hepatologists, hematologists, hematology-oncology fellows and other healthcare providers involved in the treatment of gastrointestinal cancer.

    OVERVIEW OF ACTIVITY
    Because of the prevalent nature of the disease, extensive resources are allocated to colorectal cancer (CRC) research and education. Interestingly, however, although individually less frequently encountered, the collection of non-CRC gastrointestinal (GI) cancers accounts for more cancer-related deaths per annum than do tumors of the colon and rectum combined. Published results from ongoing trials in both of these fields continually lead to the emergence of novel biomarkers and new therapeutic targets and regimens, thereby altering existing management algorithms. In order to offer optimal patient care — including the option of clinical trial participation — the practicing medical oncologist must be well informed of these advances. This CME program uses a roundtable discussion with leading GI clinical investigators to assist practicing clinicians in formulating up-to-date and appropriate clinical management strategies.

    LEARNING OBJECTIVES

    • Effectively apply the results of practice-changing clinical research to the selection and sequencing of chemobiologic regimens for patients with metastatic CRC.
    • Summarize key findings from clinical studies of emerging and newly approved therapeutic regimens for pancreatic cancer, and use this information to guide treatment decision-making.
    • Use clinical and molecular biomarkers to optimize the selection of systemic therapy for patients with gastric or gastroesophageal cancer.
    • Educate patients with unresectable metastatic neuroendocrine tumors of the GI tract regarding approved and novel treatment approaches and their associated risks and benefits.
    • Communicate the benefits and risks of existing and emerging systemic interventions to patients with advanced hepatocellular carcinoma.
    • Counsel appropriately selected patients with GI cancer about the availability of ongoing clinical trial participation.

    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 video component. The participant should 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:

    Johanna C Bendell, MD
    Director, GI Oncology Research
    Associate Director, Drug Development Unit
    Sarah Cannon Research Institute
    Nashville, Tennessee

    No financial interests or affiliations to disclose.

    Charles S Fuchs, MD, MPH
    Director, Center for Gastrointestinal Cancer
    Dana-Farber/Harvard Cancer Center
    Professor of Medicine
    Harvard Medical School
    Boston, Massachusetts

    Advisory Committee: Celgene Corporation, Genentech BioOncology, Lilly, Metamark Genetics Inc, Sanofi, Takeda Pharmaceuticals North America Inc; Consulting Agreements: ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly.

    Richard M Goldberg, MD
    Professor of Medicine
    Physician-in-Chief
    OSUCCC-­James Cancer Hospital and Richard J Solove Research Institute
    Klotz Family Chair in Cancer Research
    The Ohio State University
    Columbus, Ohio

    Advisory Committee: Sanofi; Consulting Agreements: Lilly, Pfizer Inc; Contracted Research: Bayer HealthCare Pharmaceuticals, Sanofi; Speakers Bureau: Fresenius Kabi AG, Yakult Pharmaceutical Industry CO LTD.

    J Randolph Hecht, MD
    Professor of Clinical Medicine
    Carol and Saul Rosenzweig Chair in Cancer Therapies Development
    Director, UCLA GI Oncology Program
    Santa Monica, California

    No financial interests or affiliations to disclose.

    Eileen M O’Reilly, MD
    Associate Attending
    GI Medical Oncology Service
    Memorial Sloan-Kettering Cancer Center
    Associate Professor of Medicine
    Weill Medical College of Cornell University
    New York, New York

    Consulting Agreements: Abbott Laboratories, Aduro Biotech, Amgen Inc, Astellas, Celgene Corporation, Celsion Corporation, Chugai Pharmaceutical Co Ltd, EntreMed Inc, Exelixis Inc, Genentech BioOncology, Gilead Sciences Inc, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, IntegraGen, Jennerex Inc, Lilly, MedImmune Inc, Momenta Pharmaceuticals Inc, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi, Vicus Therapeutics; Contracted Research: Abbott Laboratories, Amgen Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Genentech BioOncology, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, MMGroup, Novartis Pharmaceuticals Corporation, OncoMed Pharmaceuticals Inc, Onyx Pharmaceuticals Inc, Polaris Group, Roche Laboratories Inc.

    Philip A Philip, MD, PhD
    Professor of Oncology and Medicine
    Director of GI and Neuroendocrine Tumors
    Vice President of Medical Affairs
    Karmanos Cancer Institute
    Wayne State University
    Detroit, Michigan

    Advisory Committee: Amgen Inc, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Genomic Health Inc, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi; Contracted Research: Amgen Inc, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly, Onyx Pharmaceuticals Inc; Speakers Bureau: Amgen Inc, Bayer HealthCare Pharmaceuticals, Genentech BioOncology, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals Inc, Roche Laboratories Inc, Sanofi.

    MODERATOR — 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 Amgen Inc, Daiichi Sankyo Inc, Genentech BioOncology, Lilly 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: January 2014
    Expiration date: January 2015

Acknowledge and close

Watch video
(WIFI is recommended for best performance):

Colorectal cancer
TRIBE trial: FOLFOXIRI/bevacizumab (bev) in metastatic colorectal cancer (mCRC)
Revised approach to RAS mutation testing in mCRC
Phase III trial of calcium/magnesium for patients receiving oxaliplatin
Case presentation: 30-year-old woman with mCRC and BRAF V600E tumor mutation
Case presentation: 70-year-old woman with disease progression while receiving capecitabine/bev maintenance 11 months after starting CAPOX/bev
Case presentation: 42-year-old woman with mCRC and profound fatigue while receiving regorafenib 160 mg per day
Gastric cancer
The anti-VEGFR2 antibody ramucirumab in metastatic gastric cancer (mGC)
Ongoing trials of pertuzumab or T-DM1 in HER2-positive mGC
RILOMET-1: Phase III trial of first-line ECX (epirubicin/cisplatin/ capecitabine) with placebo or rilotumumab in advanced MET-positive GC or gastroesophageal junction adenocarcinoma
Case presentation: 57-year-old man with response and then disease progression while receiving FOLFOX/trastuzumab
Pancreatic cancer
First-line treatment of metastatic pancreatic cancer — FOLFIRINOX or gemcitabine/nab paclitaxel
Case presentation: 71-year-old man with a pancreatic mass, multiple liver metastases, fatigue and weight loss
Hepatocellular carcinoma
Management of surgically incurable hepatocellular carcinoma (HCC) — Integration of local and systemic treatments
Case presentation: 58-year-old man with prior hepatitis C, Child Pugh B7 cirrhosis and unresectable HCC confined to the liver
Gastrointestinal neuroendocrine tumors
Dosing of octreotide LAR for patients with neuroendocrine GI tumors in NCCN institutions
Case presentation: 60-year-old man with a gastric carcinoid tumor and extensive liver metastases
Case presentation: 52-year-old woman receiving the mTOR inhibitor everolimus for a well-differentiated pancreatic neuroendocrine tumor metastatic to the liver
Gastrointestinal stromal tumors
Phase III adjuvant trial of 2 years of imatinib for gastrointestinal stromal tumor (GIST)
Case presentation: 49-year-old man after surgical removal of a 4-cm GIST in the distal ileum