TARGET AUDIENCE
This activity is intended for medical oncologists, hematologists and other healthcare providers involved in the treatment of chronic lymphocytic leukemia (CLL).

OVERVIEW OF ACTIVITY
CLL is a lymphoid neoplasm in the family of the non-Hodgkin lymphomas. In the United States, an estimated 14,620 new cases of CLL will be diagnosed in 2015, with 4,650 deaths attributed to the disease. The clinical course and outcomes of patients vary widely, largely based on the presence of individual predictive and other risk factors. In recent years, the identification of cytogenetic abnormalities and their subsequent incorporation into traditional clinical staging systems has further refined clinicians’ ability to determine patient prognosis. Of significance, although risk stratification plays an important role in treatment decision-making, the disease remains incurable. Despite the availability of numerous effective agents and regimens, the inevitable mortality associated with CLL has led many to seek new and better management approaches. To this end, and based on an improved understanding of the biology of CLL, in recent years a number of novel agents and strategies have been investigated in the disease, and a number of these efforts have proven successful and have yielded therapeutic options that are already available for use in the clinic.

This is a watershed moment in the management of CLL, but with the many exciting advances that are rapidly occurring, a number of vexing questions and clinical challenges are simultaneously emerging as well. To bridge the gap between research and patient care, this video presentation by Dr John P Leonard uses a review of recent relevant publications and presentations, ongoing clinical trials and clinical investigator treatment preferences to assist medical oncologists, hematologists and other healthcare providers involved in the treatment of CLL with the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

• Appraise recent data on therapeutic advances and changing practice standards in CLL, and integrate this information, as appropriate, into current clinical care.
• Develop an algorithm for the evaluation and treatment of newly diagnosed and relapsed/refractory CLL, taking into consideration the availability of novel agents and innovative research protocols.
• Appreciate the recent FDA approval of obinutuzumab, and develop strategies to appropriately incorporate this agent into the management of CLL.
• Communicate the efficacy and safety of ibrutinib in patients with CLL, and consider its potential integration into nonprotocol management.
• Describe recently presented Phase III data illustrating the efficacy and safety of idelalisib in patients with CLL.
• Consider the biologic rationale for targeting Bcl-2 in CLL, and recognize the similarities and differences between ABT-199 and first-generation Bcl-2 inhibitors.
• Identify ongoing clinical trials evaluating innovative investigational approaches for CLL, and obtain consent from appropriate patients for study 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.

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:

Presenting Faculty Member

John P Leonard, MD
Richard T Silver Distinguished Professor of Hematology and Medical Oncology
Associate Dean for Clinical Research
Weill Cornell Medical College
New York, New York

Consulting Agreements: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Genentech BioOncology, Spectrum Pharmaceuticals Inc.

Project Steering Committee Members

Jennifer R Brown, MD, PhD
Director, Chronic Lymphocytic Leukemia Center
Dana-Farber Cancer Institute
Associate Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Advisory Committee: Celgene Corporation, Emergent BioSolutions Inc, Gilead Sciences Inc, Janssen Biotech Inc, MorphoSys, Pharmacyclics Inc, ProNAi Therapeutics Inc; Consulting Agreements: Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Emergent BioSolutions Inc, Genentech BioOncology, Gilead Sciences Inc, GlaxoSmithKline, Janssen Biotech Inc, MorphoSys, Pharmacyclics Inc, ProNAi Therapeutics Inc, Roche Laboratories Inc.

Andrew M Evens, DO
Chan Soon-Shiong Endowed
Chair in Precision Medicine
Professor of Medicine
Division of Hematology/Oncology
Tufts University School of Medicine
Director, Tufts Cancer Center
Tufts Medical Center
Boston, Massachusetts

Advisory Committee and Consulting Agreements: Celgene Corporation, Genentech BioOncology, Takeda Oncology; Contracted Research: Takeda Oncology; Speakers Bureau: Celgene Corporation.

Ian W Flinn, MD, PhD
Director of Blood Cancer Research
Sarah Cannon Research Institute
Tennessee Oncology
Nashville, Tennessee

Contracted Research: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Cephalon Inc, Genentech BioOncology, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Takeda Oncology.

Jeff Sharman, MD
Director of Research
Willamette Valley Cancer Institute
Medical Director of Hematology Research
The US Oncology Network
Eugene, Oregon

Advisory Committee: Celgene Corporation, Gilead Sciences Inc, Pharmacyclics Inc; Consulting Agreement: Celgene Corporation; Contracted Research: Celgene Corporation, Cephalon Inc, Genentech BioOncology, Gilead Sciences Inc, Novartis Pharmaceuticals Corporation, Pharmacyclics Inc, Takeda Oncology.

Mitchell R Smith, MD, PhD
Director of Lymphoid Malignancies Program at Taussig Cancer Institute
Cleveland Clinic
Cleveland, Ohio

Consulting Agreements: Celgene Corporation, Spectrum Pharmaceuticals Inc, Takeda Oncology; Contracted Research: Abbott Laboratories.

Sonali M Smith, MD
Associate Professor
Section of Hematology/Oncology
Director, Lymphoma Program
The University of Chicago
Chicago, Illinois

Consulting Agreements: Celgene Corporation, Genentech BioOncology, Gilead Sciences Inc, ImmunogeniX Research LLC, Pharmacyclics Inc, TG Therapeutics Inc; Data and Safety Monitoring Board: Genentech BioOncology.

Michael E Williams, MD, ScM
Byrd S Leavell Professor of Medicine
Chief, Hematology/Oncology Division
University of Virginia School of Medicine
Charlottesville, Virginia

Advisory Committee: Celgene Corporation, Takeda Oncology, TG Therapeutics Inc; Consulting Agreements: Bristol-Myers Squibb Company, Celgene Corporation, Takeda Oncology, TG Therapeutics Inc; Contracted Research: Allos Therapeutics, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, Gilead Sciences Inc, Janssen Biotech Inc, Pharmacyclics Inc, Novartis Pharmaceuticals Corporation, Takeda Oncology.

PROJECT CHAIR — 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 AbbVie Inc, Genentech BioOncology, Gilead Sciences Inc and Pharmacyclics Inc.

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 2015
Expiration date: November 2016