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Molecular Tumor Board: Using Molecular Profiling to Improve the Care of Patients with Advanced Breast Cancer
Released December 2017

Proceedings from a roundtable discussion featuring practicing oncologists presenting cases from their practices for which molecular analysis may inform treatment decision-making to a panel of breast cancer medical oncology and pathology investigators. Featuring perspectives from Drs Sunil Badve, Sarat Chandarlapaty, Hope S Rugo, William F Symmans and Melinda L Telli. (Video Program)

CE Disclosures and Faculty Information

  • TARGET AUDIENCE
    This program is intended for medical oncologists, breast and general surgeons, radiation oncologists and other allied healthcare professionals involved in the treatment of breast cancer.

    OVERVIEW OF ACTIVITY
    Breast cancer remains the most frequently diagnosed cancer in women, and in 2017 in the United States alone the disease will culminate in an estimated 255,180 new cases and 41,070 deaths. Our improved understanding of the biologic mechanisms of breast cancer pathogenesis and advances in diagnosis have helped identify potentially actionable tumor mutations and predictive biomarkers, but the incorporation of these advances into clinical practice remains challenging to community-based oncologists. To address these concerns, a closed molecular tumor board was held featuring discussions among breast cancer clinical investigators and pathologists regarding recent research in the detection and clinical application of relevant molecular biomarkers. These video-recorded proceedings of that meeting will assist medical oncologists and other healthcare professionals in incorporating new information on molecular biomarkers into evidence-based strategies for the treatment of breast cancer.

    LEARNING OBJECTIVES

    • Foster interdisciplinary collaboration among medical oncologists, pathologists and other healthcare team members to improve the diagnosis and management of early and advanced breast cancer.
    • Recognize the clinical significance of BRCA1/2 mutations and other homologous repair deficiency biomarkers, and understand the biologic rationale for the investigation of PARP inhibition as monotherapy and in combination with other systemic approaches for the treatment of breast cancer.
    • Consider available and emerging research regarding the detection of estrogen receptor mutations, and appreciate the significance of these mutations in prognosis and treatment selection.
    • Appreciate current investigational efforts to identify biomarkers for disease prognosis and response to checkpoint inhibition (tumor mutational burden, tumor-infiltrating lymphocytes, et cetera), and consider how such markers may be used in future clinical practice.
    • Recall ongoing evaluation of novel immunotherapeutic approaches and combination approaches to the treatment of triple-negative and ER-positive breast cancer, and counsel appropriately selected patients about the availability of and participation in clinical trials.

    ACCREDITATION STATEMENT
    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CREDIT DESIGNATION STATEMENT
    Research To Practice designates this enduring material for a maximum of 2.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.75 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    Please note, this program has been specifically designed for the following ABIM specialty: medical oncology.

    Personal information and data sharing: Research To Practice aggregates deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of a video component. To receive credit, the participant should review the CME information, watch the video, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/MolecularTumorBoardBC17/CME.

    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:

    Sunil Badve, MBBS
    Joshua Edwards Professor of Pathology and Laboratory Medicine
    Indiana University School of Medicine
    Indianapolis, Indiana

    Speakers Bureau: Genentech BioOncology, Genomic Health Inc, Merck.

    Sarat Chandarlapaty, MD, PhD
    Medical Oncologist
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Consulting Agreements: Agendia Inc, AstraZeneca Pharmaceuticals LP, Chugai Pharmaceutical Co Ltd, MacroGenics Inc, Sermonix Pharmaceuticals; Contracted Research: Lilly, Novartis.

    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: Eisai Inc, Genentech BioOncology, GlaxoSmithKline, Lilly, MacroGenics Inc, Merck, Novartis, Pfizer Inc, Plexxikon Inc, Roche Laboratories Inc; Speakers Bureau: Genomic Health Inc.

    William F Symmans, MD
    Professor of Pathology
    The University of Texas MD Anderson Cancer Center
    Houston, Texas

    Contracted Research: BioNTech AG; Ownership Interest: Nuvera Biosciences Inc.

    Melinda L Telli, MD
    Assistant Professor of Medicine
    Stanford University Medical Center
    Palo Alto, California

    Advisory Committee: Tesaro Inc, Vertex Pharmaceuticals Incorporated; Consulting Agreement: AstraZeneca Pharmaceuticals LP; Contracted Research: Abbott Laboratories, Calithera Biosciences, Genentech BioOncology, Medivation Inc, a Pfizer Company, OncoSec Medical, PharmaMar, Vertex Pharmaceuticals Incorporated.

    CONSULTING MEDICAL ONCOLOGISTS — The following consulting medical 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
    Chief of Hematology and Medical Oncology
    New York Methodist Hospital
    Professor of Clinical Medicine
    Weill-Cornell Medical College
    New York, 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.

    Carolyn B Hendricks, MD
    Maryland Oncology Hematology
    Bethesda, Maryland

    No relevant conflicts of interest to disclose.

    Richard Zelkowitz, MD
    The Whittingham Cancer Center
    Norwalk, Connecticut

    Speakers Bureau: Genentech BioOncology, Pfizer 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, Acerta Pharma, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma 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, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals 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 grantor.

    This activity is supported by an educational grant from AstraZeneca Pharmaceuticals LP.

    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: December 2017
    Expiration date: December 2018

    After completing the Post-test, learners may download and review the answers here in order to identify further areas of study.

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