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TARGET AUDIENCE
This activity is intended for medical oncologists and other healthcare providers involved in the treatment of follicular lymphoma (FL).

OVERVIEW OF ACTIVITY
FL is an indolent yet incurable form of non-Hodgkin lymphoma that can vary significantly in its clinical presentation. To date, no single standard approach to initial management has been established, and a wide range of approaches are available for treating clinicians to weigh and consider. Longstanding debate also exists regarding the contributions associated with various maintenance strategies. Furthermore, in the setting of relapsed/refractory disease, management becomes more difficult as durability and duration of response to therapy tend to diminish over time. However, a number of data sets and several FDA actions have recently ushered in an era in which additional evidence-based options must now be considered. Together, this spate of newly approved agents and promising approaches in clinical development seem poised to disrupt the management of FL, contributing to a great need for educational resources specific to the treatment of this commonly encountered disease.

This video presentation by Dr John P Leonard uses a review of recent relevant publications and presentations, ongoing clinical trials and clinical investigator treatment preferences to assist medical oncologists and other healthcare providers involved in the treatment of FL with the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

  • Compare and contrast the self-reported practice patterns of lymphoma clinical investigators, and apply this knowledge to the diagnosis and treatment of FL.
  • Evaluate published research data and clinical investigator perspectives when designing an optimal induction therapeutic approach for patients with newly diagnosed FL requiring active therapy.
  • Describe the mechanism of action of and available data with the Type II CD20-targeted antibody obinutuzumab, and consider the current clinical role of this agent for newly diagnosed and relapsed/refractory FL.
  • Appreciate available Phase III data with the use of rituximab/lenalidomide as front- or later-line treatment for FL, and optimally incorporate this novel therapeutic approach into current management algorithms.
  • Individualize the use of maintenance therapeutic approaches in the management of newly diagnosed FL.
  • Consider published research data and other clinical factors in the best-practice selection, sequencing or combining of available therapeutic agents in the nonresearch care of patients with relapsed/refractory FL.
  • Distinguish among the unique mechanisms of action, methods of administration and potential toxicities of available PI3K inhibitors to optimally integrate these agents into the care of patients with relapsed/refractory FL.
  • Develop practical strategies to prevent, recognize and ameliorate the toxicities associated with therapies routinely used in the management of FL.

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 specialties: medical oncology and hematology.

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/GrandRoundsFL19/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:

Presenting Faculty Member

John P Leonard, MD
Richard T Silver Distinguished Professor of Hematology and Medical Oncology
Associate Dean for Clinical Research
Weill Cornell Medical College
New York, New York

Consulting Agreements: ADC Therapeutics SA, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biotest Pharmaceuticals Corporation, Bristol-Myers Squibb Company, Celgene Corporation, Genentech, Gilead Sciences Inc, Juno Therapeutics, Karyopharm Therapeutics, MEI Pharma, Novartis, Pfizer Inc, Sutro Biopharma Inc, United Therapeutics.

Project Steering Committee Members

Bruce D Cheson, MD
Professor of Medicine
Deputy Chief, Division of Hematology-Oncology
Head of Hematology
Georgetown University Hospital
Lombardi Comprehensive Cancer Center
Washington, DC

Advisory Committee and Consulting Agreements: AbbVie Inc, AstraZeneca Pharmaceuticals LP, Celgene Corporation, Genentech, Gilead Sciences Inc; Contracted Research: AbbVie Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Genentech, Seattle Genetics.

Andrew M Evens, DO, MSc
Associate Director for Clinical Services
Rutgers Cancer Institute of New Jersey
Medical Director, Oncology Service Line
RWJBarnabas Health
Director, Lymphoma Program, Division of Blood Disorders
Professor of Medicine
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey

Advisory Committee: Novartis; Consulting Agreements: Merck, Pharmacyclics LLC, an AbbVie Company, Novartis, Spectrum Pharmaceuticals Inc.

Christopher R Flowers, MD, MS
Director, Lymphoma Program
Professor of Hematology and Oncology
Bone Marrow and Stem Cell Transplantation
Department of Hematology and Medical Oncology
Winship Cancer Institute
Health Science Research Building
Emory University
Atlanta, Georgia

Consulting Agreements: AbbVie Inc, Bayer HealthCare Pharmaceuticals, Denovo Biopharma, Gilead Sciences Inc, Janssen Biotech Inc, Karyopharm Therapeutics, OptumRx Inc, Pharmacyclics LLC, an AbbVie Company, Spectrum Pharmaceuticals Inc; Contracted Research: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Burroughs Wellcome Fund, Celgene Corporation, Eastern Cooperative Oncology Group, Genentech, Gilead Sciences Inc, Janssen Biotech Inc, National Cancer Institute, Roche Laboratories Inc, Takeda Oncology, TG Therapeutics Inc, The V Foundation for Cancer Research; Uncompensated Consulting: Celgene Corporation, Genentech, Roche Laboratories Inc.

Nathan H Fowler, MD
Co-Director of Clinical and Translational Research
Lead, Phase I and Indolent Research Groups
Department of Lymphoma/Myeloma
The University of Texas MD Anderson Cancer Center
Houston, Texas

Advisory Committee: AbbVie Inc, Bayer HealthCare Pharmaceuticals, Celgene Corporation, Gilead Sciences Inc, Janssen Biotech Inc, Roche Laboratories Inc, TG Therapeutics Inc; Contracted Research: AbbVie Inc, Celgene Corporation, Janssen Biotech Inc, Roche Laboratories Inc, TG Therapeutics Inc.

Ann S LaCasce, MD, MMSc
Program Director, Fellowship in Hematology/Oncology
Associate Professor of Medicine, Harvard Medical School
Institute Physician
Lymphoma Program
Dana-Farber Cancer Institute
Boston, Massachusetts

Advisory Committee: Humanigen Inc; Consulting Agreement: Seattle Genetics; Data and Safety Monitoring Board/Committee: Bristol-Myers Squibb Company; Institutional Research Funding: Celgene Corporation, Forty Seven Inc, Seattle Genetics.

Julie M Vose, MD, MBA
Neumann M and Mildred E Harris Professor
Chief, Division of Hematology/Oncology
Nebraska Medical Center
Omaha, Nebraska

Consulting Agreements: Acerta Pharma — A member of the AstraZeneca Group, Amgen Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech, Incyte Corporation, Kite Pharma Inc, Merck Sharp & Dohme Corp, Novartis, Seattle Genetics Inc; Contracted Research: AbbVie Inc, Epizyme Inc, Karyopharm Therapeutics, Legend Biotech, Nordic Nanovector, Novartis, Roche Laboratories Inc, Sandoz Inc, a Novartis Division, Vaniam Group.

Andrew D Zelenetz, MD, PhD
Medical Director, Medical Informatics
Department of Medicine
Memorial Sloan Kettering Cancer Center
New York, New York

Advisory Committee: AbbVie Inc, AstraZeneca Pharmaceuticals LP, Genentech, Gilead Sciences Inc, Lymphoma Research Foundation; Consulting Agreements: Adaptive Biotechnologies, Amgen Inc, Celgene Corporation, Genentech, Gilead Sciences Inc, Janssen Biotech Inc, Novartis, Roche Laboratories Inc; Contracted Research: BeiGene, Gilead Sciences Inc, MEI Pharma, Roche Laboratories Inc; Data and Safety Monitoring Board/Committee: BeiGene.

EDITOR — 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, EMD Serono 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, A GSK Company, 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 Bayer HealthCare Pharmaceuticals, Celgene Corporation, Genentech and Gilead Sciences Inc.

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: September 2019
Expiration date: September 2020

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