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TARGET AUDIENCE
This activity is intended for gynecologic oncologists, medical oncologists, gynecologists and other healthcare providers involved in the treatment of gynecologic cancers.

OVERVIEW OF ACTIVITY
The American Cancer Society estimates that in 2019, 22,530 new cases of ovarian cancer (OC) will be diagnosed in the United States and 13,980 deaths from the disease will occur. For this reason, significant financial and intellectual resources have been invested over the past few decades in attempts to better understand the natural history of the disease, identify genetic and other factors responsible for its proliferation and develop novel therapies with the potential to significantly improve outcomes for patients. Perhaps the largest recent advance in OC has been the introduction of PARP inhibitors into the therapeutic milieu. However, the paradigm shift brought forth by the availability of PARP inhibitors has significant ramifications for practicing clinicians who must now confront a variety of practical issues, and uncertainties with regard to the safe and efficacious use of these agents persist.

This CME program developed from the proceedings of a satellite symposium held during the Society of Gynecologic Oncology’s 2019 Annual Meeting on Women’s Cancer features video slide presentations given by leading researchers with an expertise in gynecologic cancers on the emerging considerations that drive clinical decision-making about the use of PARP inhibitors in the management of OC. By providing information on the latest research developments and their potential application to routine practice, this activity is designed to assist medical oncologists, gynecologic oncologists and other healthcare providers with the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

  • Recognize the recent FDA approval of olaparib as maintenance therapy after first-line platinum-based chemotherapy for patients with advanced OC and a deleterious or suspected deleterious BRCA germline or somatic mutation, and consider how the availability of this strategy affects current therapeutic algorithms.
  • Assess available clinical trial data with and FDA indications for the various PARP inhibitors when used as maintenance therapy for recurrent, platinum-sensitive OC, and develop strategies to identify patients for whom this approach might be appropriate.
  • Identify patients with multiregimen-refractory OC who may be appropriate candidates for a PARP inhibitor, and safely integrate these agents into nonresearch therapy.
  • Recognize the toxicities associated with PARP inhibitors commonly used in the care of patients with OC, and offer supportive management strategies to minimize and/or ameliorate these side effects.
  • Develop an understanding of the mechanisms of action of, available data with and possible clinical roles of other investigational PARP inhibitors in preparation for their potential introduction into clinical practice.
  • Recall the biologic rationale for and ongoing research efforts evaluating the role of PARP inhibitors in combination with chemotherapy, targeted therapy or immunotherapy, and refer appropriate patients for clinical trial participation.

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 1 AMA PRA Category 1 Credit. 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 1 Medical Knowledge MOC point 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/GynOnc19/PARP/Video/CME. The corresponding audio program is available at ResearchToPractice.com/GynOnc19/PARP.

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:

Robert L Coleman, MD
Professor and Executive Director
Cancer Network Research
Ann Rife Cox Chair in Gynecology
Department of Gynecologic Oncology and Reproductive Medicine
The University of Texas MD Anderson Cancer Center
Houston, Texas

Advisory Committee and Contracted Research: AbbVie Inc, Array BioPharma Inc, AstraZeneca Pharmaceuticals LP, Clovis Oncology, Eisai Inc, GamaMabs Pharma, Genentech, Genmab, ImmunoGen Inc, Janssen Biotech Inc, Merck, Novartis, Tesaro; Data and Safety Monitoring Board/Committee: AstraZeneca Pharmaceuticals LP.

Professor Jonathan A Ledermann
Professor of Medical Oncology
Clinical Director
University College London Cancer Institute
Director, Cancer Research UK and UCL Cancer Trials Centre
London, United Kingdom

Advisory Committee: Artios Pharma, AstraZeneca Pharmaceuticals LP, Clovis Oncology, Cristal Therapeutics, Merck Sharp & Dohme Corp, Pfizer Inc, Roche Laboratories Inc, Seattle Genetics; Contracted Research: AstraZeneca Pharmaceuticals LP, Merck Sharp & Dohme Corp; Data and Safety Monitoring Board/Committee: Regeneron Pharmaceuticals Inc; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Clovis Oncology.

Stephanie Lheureux, MD, PhD
Staff, Medical Oncology-Gynecology and Drug Development Program
Gynecology Site Lead at Princess Margaret Cancer Centre
Assistant Professor, University of Toronto
Toronto, Canada

No relevant conflicts of interest to disclose.

Kathleen Moore, MD
Jim and Christy Everest Endowed Chair in Cancer Research
Associate Director, Clinical Research
Director, Oklahoma TSET Phase I Program
Stephenson Cancer Center
Associate Professor, Section of Gynecologic Oncology
Director, Gynecologic Oncology Fellowship
Department of Obstetrics and Gynecology
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma

Advisory Committee: Aravive Inc, AstraZeneca Pharmaceuticals LP, Clovis Oncology, Genentech, ImmunoGen Inc, Janssen Biotech Inc, Merck, OncoMed Pharmaceuticals Inc, Pfizer Inc, Roche Laboratories Inc, Samumed, Tesaro, VBL Therapeutics; Contracted Research: Clovis Oncology, Genentech, Merck, PTC Therapeutics, Roche Laboratories Inc.

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 Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech, Genmab, 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 Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Oncopeptides, 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, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

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, Clovis Oncology and Tesaro.

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: June 2019
Expiration date: June 2020

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