TARGET AUDIENCE
This activity is intended for medical oncologists, hematology-oncology fellows and other allied healthcare professionals involved in the treatment of colorectal, gastric and pancreatic cancer.

OVERVIEW OF ACTIVITY
Cancer of the colon and rectum is the fourth 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. Although individually less frequently encountered, the collection of other noncolorectal GI cancers account for more per annum cancer-related deaths than those attributed to tumors of the colon and rectum combined. In 2014 in the United States alone it is estimated that these diseases will culminate in 136,830 new cases and 50,310 deaths.

Current therapeutic management of colorectal cancer (CRC) is dependent on tumor stage at the time of initial diagnosis, status of surgical margins, 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 introduction 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. Similarly, local and systemic treatment approaches for each of the non-CRC GI cancers are continuously evolving. Like their more prevalent tumor counterparts, the impact of novel molecular-targeted and biologic therapies on the management of non-CRC GI cancers has been profound. By providing information on the latest research developments and their potential application to routine practice, this activity is designed to assist medical oncologists, hematology-oncology fellows and other allied healthcare professionals with the formulation of up-to-date clinical management strategies for both CRC and select non-CRC GI cancers.

LEARNING OBJECTIVES

• Coordinate comprehensive biomarker analysis for patients diagnosed with advanced CRC, and use this information to guide evidence-based care for these patients.
• 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.
• Individualize local and systemic treatment for patients with metastatic CRC that is isolated to the liver.
• Effectively integrate the evidence-based use of chemotherapy and molecular-targeted agents into the individualized management of advanced pancreatic cancer.
• Use clinical and molecular biomarkers to select optimal treatment strategies for patients with locally advanced or metastatic gastric or gastroesophageal junction (GEJ) cancer.
• Appreciate the recent FDA-approved indication for ramucirumab in advanced gastric or GEJ cancer, and discern how this agent can be optimally integrated into clinical practice.
• Recall new data with investigational agents demonstrating promising activity in colorectal, gastric and pancreatic cancers.

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. To receive credit, 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:

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.

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

Nashville, Tennessee

No real or apparent conflicts of interest to disclose.

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.

Herbert I Hurwitz, MD
Professor of Medicine
Division of Medical Oncology
Clinical Director, Phase I Program
Co-Leader, GI Oncology Program
Duke University Medical Center
Durham, North Carolina

Consulting Agreements: Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, EMD Serono Inc, Genentech BioOncology, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi; Contracted Research: Abbott Laboratories, Genentech BioOncology, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Sanofi.

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: Bayer HealthCare Pharmaceuticals, Genentech BioOncology, Millennium: The Takeda Oncology Company, Pfizer Inc, Roche Laboratories Inc.

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, 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, Pharmacyclics 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, Bristol-Myers Squibb Company, Genentech BioOncology and Incyte 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: September 2014
Expiration date: September 2015