This activity is intended for medical oncologists and other healthcare providers involved in the treatment of breast cancer (BC).
OVERVIEW OF ACTIVITY
BC remains the most frequently diagnosed cancer in women, and in 2015 it is estimated that the disease culminated in 234,190 new cases and 40,730 deaths in the United States alone. Advances in screening and prevention have resulted in a steady down-stage migration at the time of disease presentation, such that only 5% of women have identifiable distant metastases at primary diagnosis. Consequently, the number of individuals living with BC has increased substantially, as has the population “at risk” for recurrent disease.
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/or utility of these local and systemic treatment options is largely based on a number of prognostic and predictive risk factors present within the patient or her tumor at the time of diagnosis. In fact, as the field of oncology is challenged to improve the precision with which it therapeutically targets malignant cells, biomarker-driven treatment algorithms have become the “norm” for many tumor types, particularly BC.
These proceedings from a CME symposium during the 38th annual San Antonio Breast Cancer Symposium explore the most significant therapeutic advances during the previous year by using the perspectives of leading BC experts on challenging cases and questions submitted by clinicians in the community to frame a relevant discussion of how this information has aided in the refinement of current routine clinical practice and ongoing research. This CME activity will help medical oncologists integrate these findings into best-practice disease management strategies.
LEARNING OBJECTIVES
- Appreciate the similarities and differences between existing genomic assays, and use this information to select an appropriate platform or platforms to assess risk and individualize therapy for patients with invasive early BC.
- Individualize the selection of evidence-based neoadjuvant and adjuvant chemobiologic regimens for patients with HER2-overexpressing early BC.
- Implement a long-term clinical plan for the management of metastatic HER2-positive BC, incorporating existing, recently approved and investigational targeted treatments.
- Apply the results of emerging research to the initial and long-term care of localized, hormone receptor-positive pre- and postmenopausal BC.
- Develop an evidence-based algorithm for the treatment of hormone-sensitive advanced BC, including the use of endocrine, biologic and chemotherapeutic agents.
- Recognize the recent FDA approval of palbociclib for patients with ER-positive metastatic BC (mBC), and discern how this agent can be optimally integrated into clinical practice.
- Consider clinical data and patient preferences in the selection and sequencing of available therapeutic agents for patients with ER/PR-negative, HER2-negative mBC, including the option of clinical trial participation.
- Appraise the rationale for and clinical data with investigational anti-PD-1 and/or anti-PD-L1 antibodies in patients with mBC.
- Counsel appropriately selected patients with BC about participation in ongoing clinical trials investigating novel therapeutic agents and strategies.
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
AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
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 conflicts of interest with faculty, planners and managers of CME activities. 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 relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:
Kimberly L Blackwell, MD
Professor of Medicine
Director, Breast Cancer Program
Duke Cancer Institute
Durham, North Carolina
Consulting Agreements: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Sandoz; Contracted Research: Celgene Corporation, Genentech BioOncology, Pfizer Inc.
Harold J Burstein, MD, PhD
Associate Professor of Medicine
Harvard Medical School
Breast Oncology Center
Dana-Farber Cancer Institute
Boston, Massachusetts
No relevant conflicts of interest to disclose.
Lisa A Carey, MD
Jacobs Preyer Distinguished Professor for Breast Cancer Research
Chief, Division of Hematology and Oncology
University of North Carolina
Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina
No relevant conflicts of interest to disclose.
Luca Gianni, MD
Director, Department of Medical Oncology
Ospedale San Raffaele
Scientific Institute
Milan, Italy
Consulting Agreements: Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Celgene Corporation, Genentech BioOncology, Genomic Health Inc, Lilly, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc.
Clifford Hudis, MD
Chief, Breast Medicine Service
Solid Tumor Division
Department of Medicine
Memorial Sloan Kettering Cancer Center
Professor of Medicine
Weill Cornell Medical College
New York, New York
Advisory Committee: Genentech BioOncology.
CONSULTING ONCOLOGISTS — The following consulting oncologists (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:
Alan B Astrow, MD
Director, Hematology/Medical Oncology
Maimonides Cancer Center
Brooklyn, New York
No relevant conflicts of interest to disclose.
Patricia A DeFusco, MD
Clinical Assistant Professor of Medicine
University of Connecticut School of Medicine
Director, Hartford Hospital Breast Program
Physician Leader
Hartford Healthcare Cancer Institute Breast Disease Management Team
Hartford, Connecticut
No relevant conflicts of interest to disclose.
Bonni L Guerin, MD
Director of Breast Cancer Treatment and Prevention
Overlook Medical Center
Summit, New Jersey
No relevant conflicts of interest to disclose.
Carolyn B Hendricks, MD
Maryland Oncology Hematology
Bethesda, Maryland
No relevant conflicts of interest to disclose.
Andrea Stebel, MD
Newport Breast Care
Newport Beach, California
Speakers Bureau: Celgene Corporation.
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 Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, 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, Natera Inc, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, 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 relevant 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 Astellas Pharma Global Development Inc/Medivation Inc, AstraZeneca Pharmaceuticals LP, bioTheranostics Inc, Celgene Corporation, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Lilly and Myriad Genetic Laboratories 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: April 2016
Expiration date: April 2017