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TARGET AUDIENCE
This activity is intended for medical oncologists, hematology-oncology fellows, surgeons and other healthcare providers involved in the treatment of gastrointestinal cancers.

OVERVIEW OF ACTIVITY
Cancer of the colon and rectum is the third most frequently diagnosed cancer and the second most common cause of death among all neoplasms in the United States, accounting for approximately 9% of all cancer deaths. In the year 2014 it is estimated that 96,830 new cases of colon cancer and 40,000 new cases of rectal cancer will be documented in the United States, representing a continued decline over the past 2 decades thought to be related to improvements in detection and treatment. Current therapeutic management of colorectal cancer (CRC) is dependent on tumor stage at the time of initial diagnosis, status of surgical margins (R0, R1, R2) and patient performance status, age, prior treatment exposure and sites of metastasis for those with disease recurrence or de novo advanced cancer. Although these variables are helpful in guiding selection of treatment, the recent rapid expansion of novel biomarkers, multigene signatures and molecular-targeted systemic agents has significantly refined the clinical algorithm such that individualized therapeutic approaches have become the standard. This rapid paradigm shift presents a challenge to practicing oncologists who must grapple with the presentation of ambiguous data sets and their immediate impact on treatment decisions.

By providing information on the latest research developments and their potential application to routine practice, this activity is designed to assist medical oncologists, surgeons and other healthcare providers with the formulation of up-to-date clinical management strategies for CRC.

LEARNING OBJECTIVES

Upon completion of this activity, participants should be able to:
  • Apply the results of emerging clinical research to the best-practice management of early and advanced CRC.
  • Assess the utility of available tissue-based assays in determining the risk of recurrence and the potential benefits of adjuvant therapy for patients with Stage II and Stage III colon cancer.
  • Communicate the benefits and risks of anti-VEGF, anti-EGFR and other targeted biologic therapies to patients with metastatic CRC, and develop an evidence-based algorithm to sequence available therapeutic options.
  • Counsel patients with advanced CRC regarding the efficacy and toxicities associated with regorafenib, and employ strategies to safely and effectively integrate this agent into clinical practice.
  • Use clinical and/or biological factors to individualize the selection of chemobiologic therapy for patients with metastatic CRC who have experienced disease progression after first-line therapy.
  • Counsel patients with CRC about participation in ongoing clinical trials.

ACCREDITATION STATEMENT

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.

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:

John L Marshall, MD
Chief, Hematology and Oncology
Director, Ruesch Center for the Cure of GI Cancers
Lombardi Comprehensive Cancer Center
Georgetown University
Washington, DC

Contracted Research and Speakers Bureau: Amgen Inc, Bayer HealthCare Pharmaceuticals, Genentech BioOncology, Onyx Pharmaceuticals Inc.

Wells A Messersmith, MD
Professor and Director
GI Medical Oncology Program
Co-Leader, Developmental Therapeutics Program
University of Colorado Cancer Center
Aurora, Colorado

Contracted Research: Genentech BioOncology, GlaxoSmithKline, Millennium: The Takeda Oncology Company, Pfizer Inc, Roche Laboratories Inc; Data and Safety Monitoring Committee: GlaxoSmithKline, Morphotek Inc.

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 and Contracted Research: Bayer HealthCare Pharmaceuticals, Sanofi; Consulting Agreements: Lilly, Pfizer Inc.

Eric Van Cutsem, MD, PhD
Professor of Medicine
Digestive Oncology
University Hospital Gasthuisberg/Leuven
Leuven, Belgium

Contracted Research: Amgen Inc, Bayer HealthCare Pharmaceuticals, Merck, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi.

Scott Kopetz, MD, PhD
Assistant Professor
Department of Gastrointestinal Medical Oncology
Division of Cancer Medicine
The University of Texas MD Anderson Cancer Center
Houston, Texas

Consulting Agreements: Agendia, Amgen Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, GlaxoSmithKline, Janssen Pharmaceuticals Inc, MedImmune Inc, Onyx Pharmaceuticals Inc, Plexxikon Inc, Roche Laboratories Inc, Sanofi.

MODERATORDr 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, Amgen 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, Exelixis Inc, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Incyte Corporation, Lilly, Medivation Inc, Merck, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc, Teva Oncology and VisionGate Inc.

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 Bayer HealthCare Pharmaceuticals, Genentech BioOncology, Genomic Health Inc, Incyte Corporation, Lilly, Regeneron Pharmaceuticals and Sanofi.

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: April 2014
Expiration date: April 2015