|Presentation Title||Faculty||Discussion Question|
|Is It Stage or Is It Biology?||Kathy S. Albain, MD, FACP||Which is more important in deciding whether a patient with ER+, node-negative breast cancer should receive adjuvant chemotherapy – standard clinico-pathologic criteria (eg, tumor size, grade) or biology? What about in node-positive disease? Do multigene assays have any utility in this setting?|
|Duration of Adjuvant Endocrine Therapy: What Have ATLAS and aTTom Taught Us?||Christy A. Russell, MD||Is 10 years of tamoxifen the new standard in adjuvant endocrine therapy for premenopausal women with ER+ breast cancer? If not, which patients should receive 5 years versus 10 years of therapy? Should data from the ATLAS and aTTom trials be extrapolated to aromatase inhibitors in postmenopausal patients?|
|ER+ BC Controversies, Lobular Breast Cancers, Therapeutic Considerations||Joseph Sparano, MD||What form of adjuvant endocrine therapy do you generally choose for a postmenopausal patient with a lobular histology? Do the data from the BIG 1-98 subset analysis influence your opinion on using aromatase inhibitors in these patients?|
|Who Benefits From PI3K/mTOR Blockade?||Hope S. Rugo, MD||In which patients with ER+ metastatic breast cancer (MBC) do you use everolimus plus exemestane? What side effects do you most commonly encounter with this regimen, and what management strategies do you employ?|
|Altered Fractionation: When Is It Appropriate?||Jennifer R. Bellon, MD||
How do hypofractionation results compare with those from conventional radiation therapy schedules with regard to efficacy? Toxicity? Cosmesis?
Which patients are suitable for accelerated partial-breast irradiation? Which patients should not be treated with this approach?
|Coordinating Radiation and Reconstruction||Alice Ho, MD|
|Sentinel Lymph Node Biopsy and Neoadjuvant Therapy||Eleftherios Mamounas, MD, MPH, FACS||For a patient with cN1 disease who is going to receive neoadjuvant chemotherapy, would you recommend sentinel lymph node biopsy before or after systemic therapy?|
|Is Systemic Therapy Effective After Locoregional Recurrence?||Irene L. Wapnir, MD||Do you offer chemotherapy to patients with previously treated ER- breast cancer who experience an ipsilateral local and/or regional recurrence? Have the CALOR results influenced your practice?|
|The New Guidelines for MBC Manangement||Hope Rugo, MD|
|Adjuvant and Neoadjuvant HER2-Targeted Therapy: Best Practices||Debu Tripathy, MD||
What is the most appropriate duration of adjuvant trastuzumab therapy? Are there any situations where you would consider longer or shorter courses of therapy?
Do you ever recommend adjuvant trastuzumab for a patient with a T1a/b N0 HER2+ tumor? What factors influence your decision?
|Data-Driven Management of HER2+ MBC||Joyce O'Shaughnessy, MD||
What first-line chemotherapy/HER2-targeted therapy combination do you recommend most frequently for your patients with HER2+ MBC? Do the overall survival results from the CLEOPATRA trial influence your decision on whether to use the triplet combination with pertuzumab? Do you believe there are sufficient data to support the substitution of paclitaxel for docetaxel? Is this regimen suitable for older patients?
What treatment do you typically recommend for a patient with HER2+ MBC that has progressed on trastuzumab and a taxane? What are the pros and cons of different options for relapsed/refractory disease?
|The Role of HER1 and HER3 in HER2+ Breast Cancer||Brent Rexer, MD, PhD|
|HER2-Targeted Vaccine Therapies||Elizabeth Mittendorf, MD, PhD|
|Ki67: The Good, the Bad, and the Clinical Utility||Torsten O. Nielsen, MD, PhD, FRCPC|
|Lessons from The Cancer Genome Atlas for ER+ Breast Cancer||Matthew Ellis, M.B., B.Chir., Ph.D.|
|Optimizing Non-Anthracycline Adjuvant Therapy||Stephen E. Jones, MD||Which do you recommend most often for patients requiring adjuvant chemotherapy, an anthracycline- or non-anthracycline-based regimen? What factors are most important when making this decision with an individual patient? In which clinical situations would you use an anthracycline-based regimen? A non-anthracycline-based regimen? Does HER2 status influence your choice?|
|Osteoclast-Targeted Therapy, Forever?||Frankie Ann Holmes, MD, FACP||
When do you typically initiate anti-osteoclast therapy in a patient with MBC – upon documented evidence of bone disease, or only when bone disease becomes symptomatic? When using a bisphosphonate in this setting, what schedule do you use? Do you ever reduce the frequency of administration?
When would you recommend anti-osteoclast therapy for the prevention of bone loss in a postmenopausal patient who is starting therapy with an aromatase inhibitor? Do you use a certain bone mineral density cutoff, and if so, what is the trigger point for you? Do you ever use online tools to estimate fracture risk?
What do you do to minimize the risk of adverse events (such as osteonecrosis of the jaw) in your patients who will be receiving anti-osteoclast therapy?
|Washington Update - Examining the Oncology Landscape Post-Healthcare Reform||Ben Jones|
|When to Consider Platinum-Based Therapy||Melinda L. Telli, MD||Do you use platinum-based chemotherapy for patients with triple-negative or BRCA1/2-mutated MBC? If so, at what point in disease progression (ie, earlier or later)? Do you ever recommend including a platinum agent for early-stage breast cancers?|
|Novel Preoperative Strategies for TNBC||Ingrid A. Mayer, MD, MSCI|
|Novel Therapies for Brain Metastases||Carey Anders, MD||Do you recommend upfront whole-brain radiation therapy to your patients who are candidates for stereotactic radiosurgery? How important is recurrence risk versus the risk of neurocognitive decline?|
|Therapeutic Advances in TNBC||Joyce A. O'Shaughnessy, MD||Which agent would you typically use first in a patient with TNBC that has progressed on anthracyclines and taxanes – capecitabine or eribulin? Does order matter?|
|Targeting the Metastatic Machinery||Lori J. Goldstein, MD|
|NCI-FDA Efforts to Accelerate Availability of Novel Agents||Jo Anne Zujewski, MD|
|Is There Clinical Utility in Genomic Profiling of MBCs?||Stefan Gluck, MD, PhD, FRCPC||
Do you believe that precision medicine (using next-generation sequencing to identify mutations and select targeted therapies) is ready for prime time in MBC?
Have you, or would you, order this type of molecular profile to identify possible therapeutic options? To identify potential clinical trial options?
|Environmental Breast Carcinogenesis||David Euhus, MD|
|SCOTUS Patent Decision and the Future of Genetic Testing||Ellen Matloff, MS|
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