TARGET AUDIENCE
This program is intended for medical oncologists, hematology-oncology fellows and other allied healthcare professionals involved in the treatment of breast cancer (BC).

OVERVIEW OF ACTIVITY
BC remains the most frequently diagnosed cancer in women, and in 2015 in the United States alone the disease will culminate in an estimated 234,190 new cases and 40,730 deaths. The current clinical management of BC is multidisciplinary and includes surgical resection of local disease with or without radiation therapy and the treatment of systemic disease (micro- or macroscopic) with cytotoxic chemotherapy, endocrine therapy, biologic therapy or combinations of these approaches. The indication and utility of these local and systemic treatment options are largely based on a number of prognostic and predictive risk factors present within the patient or her tumor at the time of diagnosis. Increasingly, an emphasis is being placed on a “personalized medicine” approach that promises to more effectively identify specific treatments that will benefit individuals based on specific patient- and disease-related characteristics.

Several consensus- and evidence-based treatment guidelines are available and aim to assist clinicians with making BC management decisions in the face of this dynamic clinical and research environment, but despite the existence of these tools many areas of controversy persist within academic and community settings. By using the perspectives of leading BC clinical investigators regarding a number of cases presented by a panel of community-based oncologists as well as a review of key data sets that support this case-based discussion, this activity will assist the practicing oncologist in the development of evidence-based strategies for the treatment of BC.

LEARNING OBJECTIVES

• Appreciate the similarities and differences among existing genomic assays, and use this information to select appropriate platform(s) to assess risk and individualize therapy for patients with early BC (EBC).
• Individualize the selection of evidence-based neoadjuvant and adjuvant chemobiologic regimens for patients with HER2-overexpressing EBC.
• Implement a long-term clinical plan for the management of metastatic HER2-positive BC, incorporating existing, recently approved and investigational targeted treatments.
• Develop an evidence-based algorithm for the initial and long-term treatment of localized hormone receptor-positive pre- and postmenopausal BC.
• Establish an evidence-based algorithm for the treatment of hormone-sensitive advanced BC, including the use of endocrine, biologic and chemotherapeutic agents.
• Consider clinical data and patient preferences in the selection and sequencing of available chemotherapeutic agents in patients with HER2-negative metastatic BC (mBC), including the option of clinical trial participation.
• Recognize clinical investigator perspectives regarding the indications for BRCA mutation testing, and use this information to appropriately select patients with BC for this analysis.
• Appraise the rationale for and clinical data with investigational anti-PD-1 and/or anti-PD-L1 antibodies in patients with mBC.

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.

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:

William J Gradishar, MD
Betsy Bramsen Professor of Breast Oncology
Professor of Medicine
Director, Maggie Daley Center for Women’s Cancer Care
Robert H Lurie Comprehensive Cancer Center
Northwestern University Feinberg School of Medicine
Northwestern Memorial Hospital
Chicago, Illinois

No real or apparent conflicts of interest to disclose.

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

Consulting Agreements: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Celgene Corporation, Eisai Inc, Genentech BioOncology, GlaxoSmithKline, Lilly, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Sanofi, Takeda Oncology.

Ann H Partridge, MD, MPH
Director, Adult Survivorship Program
Founder and Director
Program for Young Women with Breast Cancer
Dana-Farber Cancer Institute
Associate Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Advisory Committee: Pfizer Inc.

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: Amgen Inc, Eisai Inc, Genentech BioOncology, GlaxoSmithKline, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc; Speakers Bureau: Genomic Health Inc.

Ian E Smith, MD
Professor of Cancer Medicine
Head of the Breast Unit
The Royal Marsden Hospital and Institute of Cancer Research
London, United Kingdom

Advisory Committee: Pfizer Inc; Speakers Bureau: Eisai Inc.

CONSULTING ONCOLOGISTS — The following consulting oncologists (and their spouses/partners) reported real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process:

Patricia J Madej, MD
Illinois Cancer Specialists
Medical Director
Breast Care Center
Adventist Hinsdale and Adventist LaGrange Hospitals
Hinsdale, Illinois

No real or apparent conflicts of interest to disclose.

Steven W Papish, MD
Medical Director
Carol G Simon Cancer Center
Morristown Medical Center
Morristown, New Jersey

Speakers Bureau: bioTheranostics Inc, Genentech BioOncology, Genomic Health Inc, Novartis Pharmaceuticals Corporation, Pfizer Inc.

Estelamari Rodriguez, MD, MPH
Hematology-Oncology Attending
Mount Sinai Comprehensive Cancer Center
Miami Beach, Florida

Advisory Committee: Clovis Oncology.

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 Scientific and Medical Affairs Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, ImmunoGen Inc, Incyte Corporation, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Teva Oncology, Tokai Pharmaceuticals Inc 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 AstraZeneca Pharmaceuticals LP, Celgene Corporation, Genentech BioOncology, Genomic Health Inc and NanoString Technologies.

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: October 2015
Expiration date: October 2016