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Consensus or Controversy? Clinical Investigators Provide Perspectives on Practical Issues and Ongoing Research Related to the Management of Breast Cancer
Released August 2018

Proceedings from a CME symposium held at the 2018 ASCO Annual Meeting. Featuring perspectives from Drs Harold J Burstein, Angelo Di Leo, Sara A Hurvitz, Mark Robson, Hope S Rugo and George W Sledge Jr. (Video Program)

CE Information and Faculty Disclosures

  • TARGET AUDIENCE
    This program is intended for medical oncologists, hematology-oncology fellows 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 2018 in the United States alone the disease will culminate in an estimated 268,670 new cases and 41,400 deaths. The current clinical management of breast cancer is multidisciplinary and includes surgical resection of local disease with or without radiation therapy and the treatment of systemic disease 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 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 breast cancer. 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. In conjunction with this approach researchers are actively attempting to develop novel agents and immunotherapeutic strategies, with the aim of generating additional benefit, enhancing the efficacy of existing treatments or overcoming resistance to endocrine therapy, chemotherapy or biologic therapy. As such, the pace of change in the field of breast medical oncology has been rapid, and it is expected that a plethora of new data will continuously be disseminated requiring ongoing efforts to keep medical professionals informed.

    These video proceedings from a CME symposium held during the 2018 ASCO Annual Meeting feature renowned breast cancer clinical investigators weighing in on challenging questions and cases from a panel of community-based general oncologists and reviewing relevant data. By exploring the perspectives of leading breast cancer clinical investigators regarding a number of clinical scenarios along with key data sets, this activity will assist medical oncologists, hematology-oncology fellows and other healthcare professionals in the development of evidence-based strategies for the treatment of breast cancer.

    LEARNING OBJECTIVES

    • Consider published data to guide the use of biomarkers and genomic classifiers to assess risk and customize therapy for patients with hormone receptor-positive breast cancer in the neoadjuvant, adjuvant and extended adjuvant settings.
    • Appraise available and emerging research evidence to individualize the selection and duration of neoadjuvant, adjuvant and/or extended adjuvant therapy for patients with HER2-overexpressing early breast cancer.
    • Implement a long-term clinical plan for the management of metastatic HER2-positive breast cancer, incorporating existing and investigational targeted treatments.
    • Develop an evidence-based algorithm for the treatment of advanced hormone receptor-positive pre- and postmenopausal breast cancer, including endocrine, biologic and chemotherapeutic agents.
    • Consider published research and patient preferences in the selection and sequencing of available and investigational therapeutic agents for metastatic ER/PR-negative, HER2-negative breast cancer.
    • Appreciate the recent FDA approval of olaparib for patients with HER2-negative metastatic breast cancer harboring a germline BRCA mutation, and discern how this agent can be appropriately and safely integrated into routine clinical practice.
    • Develop an understanding of the mechanisms of action, available data and potential clinical roles of investigational compounds in preparation for their potential introduction into future clinical practice.

    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
    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:

    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.

    Angelo Di Leo, MD, PhD
    Head of the Sandro Pitigliani Department of Medical Oncology
    Hospital of Prato
    Istituto Toscano Tumori
    Prato, Italy

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Daiichi Sankyo Inc, Genomic Health Inc, Lilly, Novartis, Pfizer Inc, Roche Laboratories Inc; Consulting Agreements: Amgen Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Celgene Corporation, Eisai Inc, Genentech, Genomic Health Inc, Lilly, Novartis, Pfizer Inc, Roche Laboratories Inc; Contracted Research: AstraZeneca Pharmaceuticals LP, Novartis, Pfizer Inc.

    Sara A Hurvitz, MD
    Associate Professor of Medicine
    Director, Breast Oncology Program, Division of Hematology/Oncology
    University of California, Los Angeles
    Medical Director, Jonsson Comprehensive Cancer Center Clinical Research Unit
    Los Angeles, California
    Co-Director, Santa Monica-UCLA Outpatient Oncology Practices
    Santa Monica, California

    Contracted Research: Amgen Inc, Bayer HealthCare Pharmaceuticals, BioMarin, Boehringer Ingelheim Pharmaceuticals Inc, Cascadian Therapeutics, Dignitana, Genentech, GlaxoSmithKline, Lilly, Medivation Inc, a Pfizer Company, Merrimack Pharmaceuticals Inc, Novartis, OBI Pharma Inc, Pfizer Inc, Puma Biotechnology Inc, Roche Laboratories Inc, Seattle Genetics; Paid Travel: Bayer HealthCare Pharmaceuticals, Lilly, Novartis, OBI Pharma Inc.

    Mark Robson, MD
    Clinic Director, Clinical Genetics Service
    Associate Attending Physician, Clinical Genetics and Breast Cancer Medicine
    Associate Member, Memorial Sloan Kettering Cancer Center
    Associate Professor of Medicine, Weill Medical College of Cornell University
    New York, New York

    Advisory Committee, Consulting Agreement and Contracted Research: AstraZeneca Pharmaceuticals LP.

    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, Lilly, MacroGenics Inc, Merck, Novartis, OBI Pharma Inc, Pfizer Inc, Plexxikon Inc, Roche Laboratories Inc; Paid Travel: Lilly, Mylan NV, Puma Biotechnology Inc.

    George W Sledge Jr, MD
    Professor of Medicine
    Chief, Division of Oncology
    Department of Medicine
    Stanford University School of Medicine
    Stanford, California

    Advisory Committee: Syndax Pharmaceuticals Inc, Taiho Oncology Inc; Contracted Research: Genentech.

    MODERATOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, 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, 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, Sandoz Inc, a Novartis Division, 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 CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent 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 AbbVie Inc, AstraZeneca Pharmaceuticals LP, Genentech, Genomic Health Inc, Lilly and Merck.

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
    Adobe Flash Player 27 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Release date: August 2018
    Expiration date: August 2019

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