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Beyond the Guidelines: Clinical Investigator Perspectives on the Management of Lung Cancer
Released July 2019

Proceedings from a CME symposium held at the 2019 ASCO Annual Meeting. Featuring perspectives from Dr D Ross Camidge, Dr Stephen V Liu, Prof Solange Peters, Dr Gregory J Riely and Dr David R Spigel. (Video Program)

CE Information and Faculty Disclosures

  • TARGET AUDIENCE
    This activity is intended for hematologists, medical oncologists and other healthcare providers involved in the treatment of lung cancer.

    OVERVIEW OF ACTIVITY
    Lung cancer is a devastating disease with broad-reaching impact on public health as it accounts for 14% of all new cancer cases in the United States and the most cancer-related deaths among both men and women. In the year 2019, it is estimated that approximately 228,150 individuals will be diagnosed and 142,670 will die from the disease. Of importance, despite the many advances over the past few decades related to surgery, radiation therapy and chemotherapy, death rates attributable to lung cancer have remained relatively unchanged. Today, however, many have renewed optimism that these trends have already started to change as recent research advances have led to an explosion in lung cancer genetic and biologic knowledge among scientists and clinicians working in this area of cancer medicine. Over the past several years major clinical trials in lung cancer have witnessed a host of promising successes, many of which are already being operationalized in clinical practice. Even so, these achievements will doubtlessly continue to be dissected in the upcoming years and will further challenge the collective understanding of the biology and optimal management of this disease.

    Several consensus- and evidence-based treatment guidelines are available and aim to assist clinicians with making management decisions in this dynamic clinical and research environment. However, in situations where multiple acceptable therapeutic options exist, such guidelines may not be particularly helpful at the time of decision-making. By exploring the perspectives of leading investigators regarding a number of clinical scenarios and reviewing key data sets, these proceedings from a CME symposium during the 2019 ASCO Annual Meeting will assist medical oncologists and other allied healthcare professionals in the development of evidence-based strategies for the treatment of lung cancer.

    LEARNING OBJECTIVES

    • Appraise the recent FDA approval of anti-PD-L1 antibody consolidation therapy for patients with unresectable Stage III non-small cell lung cancer (NSCLC) who have not experienced disease progression after standard platinum-based chemotherapy concurrent with radiation therapy, and discern how this strategy can be appropriately and safely integrated into routine clinical practice.
    • Review recent FDA approvals and other therapeutic advances related to the use of anti-PD-1/PD-L1 antibodies as monotherapy or in combination with chemotherapy or chemobiologic therapy for newly diagnosed metastatic NSCLC.
    • Consider emerging research data and available guidelines informing the use of immune checkpoint inhibitors for patients with advanced small cell lung cancer (SCLC).
    • Recall the design of ongoing clinical trials evaluating anti-PD-1/PD-L1 antibodies in combination with other systemic therapies for NSCLC and SCLC, and counsel appropriate patients about availability and participation.
    • Review published research data documenting the safety and efficacy of EGFR tyrosine kinase inhibitors for metastatic NSCLC with an EGFR tumor mutation, and discern how this information should be applied outside of a research setting.
    • Communicate the efficacy and safety of approved and investigational ALK inhibitors to appropriate patients with NSCLC.
    • Assess other oncogenic pathways mediating tumor growth in unique patient subgroups, and recall emerging data with commercially available and experimental agents exploiting these targets.

    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:

    D Ross Camidge, MD, PhD
    Professor of Medicine/Oncology
    Joyce Zeff Chair in Lung Cancer Research
    University of Colorado Anschutz Medical Campus
    Denver, Colorado

    Consulting Agreements: Arrys Therapeutics, a wholly owned subsidiary of Kyn Therapeutics, AstraZeneca Pharmaceuticals LP, Blueprint Medicines, Bristol-Myers Squibb Company, Genentech, Hengrui Therapeutics Inc, Inivata, Regeneron Pharmaceuticals Inc, Ribon Therapeutics, Roche Laboratories Inc, Takeda Oncology; Data and Safety Monitoring Board/Committee: Biothera Pharmaceuticals Inc, Daiichi Sankyo Inc, G1 Therapeutics, Hansoh Pharma.

    Stephen V Liu, MD, PhD
    Associate Professor of Medicine
    Georgetown University Hospital
    Washington, DC

    Advisory Committee: Apollomics Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, G1 Therapeutics, Genentech, Heron Therapeutics, Ignyta Inc, Janssen Biotech Inc, Lilly, Regeneron Pharmaceuticals Inc, Roche Laboratories Inc, Takeda Oncology; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Genentech, Merck, Merck Sharp & Dohme Corp, Roche Laboratories Inc, Takeda Oncology; Contracted Research: AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Blueprint Medicines, Bristol-Myers Squibb Company, Clovis Oncology, Corvus Pharmaceuticals, Esanex Inc, Genentech, Ignyta Inc, Lilly, Lycera, Merck, Molecular Partners, OncoMed Pharmaceuticals Inc, Pfizer Inc, Rain Therapeutics, Roche Laboratories Inc, Threshold Pharmaceuticals; Data and Safety Monitoring Board/Committee: Taiho Oncology Inc.

    Professor Solange Peters, MD, PhD
    Head, Medical Oncology
    Chair, Thoracic Malignancies
    Oncology Department
    Lausanne University Hospital (CHUV)
    Lausanne, Switzerland

    Advisory Committee and Consulting Agreements: AbbVie Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biocartis, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Clovis Oncology, Daiichi Sankyo Inc, Debiopharm Group, F Hoffmann-La Roche Ltd, Foundation Medicine, Illumina Inc, Janssen Biotech Inc, Lilly, Merck Serono, Merck Sharp & Dohme Corp, Merrimack Pharmaceuticals Inc, Novartis, Pfizer Inc, PharmaMar, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Takeda Oncology; Contracted Research: Amgen Inc, AstraZeneca Pharmaceuticals LP, Biodesix Inc, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, F Hoffmann-La Roche Ltd, Illumina Inc, Merck Serono, Merck Sharp & Dohme Corp, Novartis, Pfizer Inc.

    Gregory J Riely, MD, PhD
    Associate Attending
    Memorial Sloan Kettering Cancer Center
    New York, New York

    Contracted Research: Merck, Mirati Therapeutics, Novartis, Pfizer Inc, Roche Laboratories Inc, Takeda Oncology.

    David R Spigel, MD
    Chief Scientific Officer
    Program Director, Lung Cancer Research
    Sarah Cannon Research Institute
    Nashville, Tennessee

    Advisory Committee and Consulting Agreements: AbbVie Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Evelo Biosciences, Foundation Medicine, Genentech, GlaxoSmithKline, Illumina Inc, Lilly, Merck, Moderna Therapeutics, Nektar, Novartis, Pfizer Inc, PharmaMar, Precision Oncology LLC, Roche Laboratories Inc, Takeda Oncology, TRM Oncology; Contracted Research: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Aeglea BioTherapeutics, Amgen Inc, ARMO Biosciences, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Celldex Therapeutics, Clovis Oncology, Daiichi Sankyo Inc, EMD Serono Inc, Foundation Medicine, G1 Therapeutics, Genentech, GlaxoSmithKline, GRAIL, Ipsen Biopharmaceuticals Inc, Lilly, Merck, Nektar, Neon Therapeutics, Novartis, OncoGenex Pharmaceuticals Inc, Pfizer Inc, Roche Laboratories Inc, Takeda Oncology, Tesaro, Transgene, University of Texas Southwestern Medical Center Simmons Comprehensive Cancer Center.

    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 AstraZeneca Pharmaceuticals LP, Genentech, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, 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: July 2019
    Expiration date: July 2020

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