CE Information and Faculty Disclosures

• TARGET AUDIENCE
  This activity is intended for medical oncologists, breast cancer surgeons, radiation oncologists and other healthcare professionals involved in the diagnosis and treatment of breast cancer (BC).
  
  OVERVIEW OF ACTIVITY
  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 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. In conjunction with this approach, researchers are developing novel agents and immunotherapeutic strategies with the aim of enhancing the efficacy of existing treatments or overcoming resistance to endocrine therapy, chemotherapy or biologic agents. The pace of change in the field of breast medical oncology has been rapid, creating an important need for education about the unique mechanisms of action, toxicities and effectiveness of novel agents to properly prepare clinicians for their appropriate use in clinical practice. Several consensus- and evidence-based treatment guidelines are available and aim to assist clinicians with making breast cancer 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.
  
  These proceedings from a CME symposium during the San Antonio Breast Cancer Symposium explore significant therapeutic advances by using the perspectives of leading breast cancer 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 and other healthcare professionals find answers to the individualized questions and concerns that they frequently encounter and in turn provide high-quality cancer care.
  
  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 BC in the 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 BC.
  • Develop an evidence-based algorithm for the treatment of advanced hormone receptor-positive pre- and postmenopausal BC, including the use of endocrine, biologic and chemotherapeutic agents.
  • Implement a long-term clinical plan for the care of patients with metastatic HER2-positive BC, incorporating existing and investigational targeted treatments.
  • Appreciate the biologic rationale for, available data with and ongoing evaluation of novel immunotherapeutic approaches in preparation for their potential introduction into BC clinical practice.
  • Appraise published efficacy and safety data with the use of PARP inhibitors in patients with metastatic BC harboring a BRCA1/2 mutation, and consider the diagnostic and therapeutic implications of these findings on clinical care.
  • Develop an understanding of the mechanisms of action of, available data with and potential clinical roles of other investigational compounds to facilitate referral for clinical trial opportunities or participation in expanded access programs.

  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.
  
  William J Gradishar, MD
  Betsy Bramsen Professor of Breast Oncology and Professor of Medicine
  Deputy Director, Clinical Network
  Robert H Lurie Comprehensive Cancer Center of Northwestern University
  Director, Maggie Daley Center for Women’s Cancer Care
  Interim Chief, Division of Hematology/Oncology
  Northwestern University Feinberg School of Medicine
  Chicago, Illinois
  
  Advisory Committee: AstraZeneca Pharmaceuticals LP, Pfizer Inc; Data and Safety Monitoring Board: Genentech, Seattle Genetics.
  
  Joyce O’Shaughnessy, MD
  Chair, Breast Cancer Research Program
  Baylor Charles A Sammons Cancer Center
  Celebrating Women Chair in Breast Cancer Research
  Texas Oncology
  US Oncology
  Dallas, Texas
  
  Advisory Committee: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Daiichi Sankyo Inc, Eisai Inc, Lilly, Merck, Novartis, Pfizer Inc, Roche Laboratories Inc, Sanofi Genzyme; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Daiichi Sankyo Inc, Eisai Inc, Genomic Health Inc, Lilly, Merck, Novartis, Pfizer Inc, Roche Laboratories Inc, Sanofi Genzyme; Contracted Research: Takeda Oncology.
  
  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.
  
  Professor Peter Schmid, MD, PhD
  Centre Lead
  Centre for Experimental Cancer Medicine
  Barts Cancer Institute
  London, United Kingdom
  
  Advisory Committee: Astra Zeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Genentech, Lilly, Merck, Novartis, Pfizer Inc, Puma Biotechnology Inc, Roche Laboratories Inc, Seattle Genetics; Consulting Agreements: Astra Zeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Eisai Inc, Genentech, Lilly, Merck, Novartis, Pfizer Inc, Puma Biotechnology Inc, Roche Laboratories Inc, Seattle Genetics; Contracted Research: Astellas Pharma Global Development Inc, Astra Zeneca Pharmaceuticals LP, Genentech, Medivation Inc, a Pfizer Company, Novartis, OncoGenex Pharmaceuticals Inc, Roche Laboratories Inc; Employment (Spouse): Genentech, Roche Laboratories Inc.
  
  Debu Tripathy, MD
  Professor and Chair
  Department of Breast Medical Oncology
  The University of Texas
  MD Anderson Cancer Center
  Houston, Texas
  
  Advisory Committee: Puma Biotechnology Inc; Consulting Agreements: Novartis, Pfizer Inc; Contracted Research: Novartis.
  
  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:
  
  Laila Agrawal, MD
  Norton Healthcare
  Louisville, Kentucky
  
  No relevant conflicts of interest to disclose.
  
  Alan Astrow, MD
  NewYork-Presbyterian Brooklyn Methodist Hospital
  Professor of Clinical Medicine
  Weill Cornell Medical College
  Brooklyn, New York
  
  No relevant conflicts of interest to disclose.
  
  Evelyn Brosnan, MD, MBA
  Chief Hematology/Oncology Fellow
  University of North Carolina
  Chapel Hill, North Carolina
  
  No relevant conflicts of interest to disclose.
  
  Lowell Hart, MD
  Scientific Director of Research
  Florida Cancer Specialists
  Associate Professor of Medicine
  Wake Forest Baptist Health
  Fort Myers, Florida
  
  Speakers Bureau: Boehringer Ingelheim Pharmaceuticals Inc, Lilly, Pfizer Inc.
  
  Namrata Peswani, MD
  Advocate Health Care
  Hematology/Oncology
  Orland Park, Illinois
  
  No relevant conflicts of interest to disclose.
  
  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, 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 Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech, Genomic Health Inc, Gilead Sciences Inc, Guardant Health, 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, Loxo Oncology, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, 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, 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 AstraZeneca Pharmaceuticals LP, Genentech, Genomic Health Inc, Lilly, Merck, Puma Biotechnology Inc and Seattle Genetics.
  
  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: January 2019
  Expiration date: January 2020