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Accreditation/Credit Designation

Physicians' Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Physicians' Education Resource®, LLC, designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physicians' Education Resource®, LLC, is approved by the California Board of Registered Nursing, Provider #16669, for 2.0 Contact Hours.

Acknowledgment of Commercial Support

This activity is supported by educational grants from AstraZeneca, Celgene Corporation, Celldex Therapeutics Inc., Genentech, Lilly, Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Pfizer, and Syndax Pharmaceuticals, Inc.

Community Practice Connections™: 16th Annual International Congress on the Future of Breast Cancer®

Release Date: September 29, 2017
Expiration Date: September 29, 2018
Media: Internet - based

 

Activity Overview

The Community Practice Connections™: 16th Annual International Congress on the Future of Breast Cancer® serves as an update on advances in the breast cancer field, with a focus on the clinical implications of breast cancer genetic and phenotypic subtyping. Novel agents, strategies, and improved regimens are changing the future of breast cancer therapy, and these advances and their clinical impact are highlighted throughout the program. Current controversies in the field are also addressed and new data presented, along with information about how to optimally individualize breast cancer therapy. This activity provides a unique opportunity for medical, surgical, and radiation oncologists and other healthcare professionals to increase knowledge, apply new data to practice, and, ultimately, improve patient outcomes.

Acknowledgment of Commercial Support

This activity is supported by educational grants from AstraZeneca, Celgene Corporation, Celldex Therapeutics Inc., Genentech, Lilly, Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Pfizer, and Syndax Pharmaceuticals, Inc.

CME/CE Activity Table of Contents

  • Module A: Novel Therapeutic Strategies for Triple-Negative Breast Cancer, With Joyce O’Shaughnessy, MD
  • Module B: Management of HER2-Driven Breast Cancers, With Sara Hurvitz, MD
  • Module C: Integrating Targeted Therapies Into the Management of Hormone Receptor‒Positive Breast Cancer, With Richard Finn, MD
  • Module D: Utility of Molecular Signatures in Managing Early Breast Cancer, With Adam M. Brufsky, MD, PhD

Instructions for This Activity and Receiving Credit

  • You will need to login to participate in the activity.
  • Each presentation may contain an interactive question(s). You may move forward through the presentation; however, you may not go back to change answers or review videos/content until you finish the presentation.
  • At the end of the activity, “educational content/video files” will be available for your reference.
  • In order to receive a cme/ce certificate, participants must complete the activity.
  • Complete the posttest and pass with a score of 70% or higher, complete the evaluation and then click on request for credit. Participants may immediately download a cme/ce certificate upon completion of these steps.

Target Audience

This educational activity is directed toward medical, surgical, and radiation oncologists interested in the treatment of patients with breast cancer. Fellows, nurse practitioners, nurses, physician assistants, pharmacists, researchers, and other healthcare professionals interested in the treatment of breast cancer may also participate.

Learning Objectives

At the conclusion of this activity, you should be better prepared to:

  • Determine testing strategies that can be utilized to facilitate the diagnosis, ability to stratify risk, and identification of predictive markers in the care of patients with breast cancer
  • Apply personalized treatment planning to manage patients with breast cancer based on information obtained from testing strategies
  • Delineate approaches that apply local therapies, such as surgical and radiation therapies, to manage patients with breast cancer
  • Describe key evidence concerning the use of evolving strategies for the care of patients with breast cancer
  • Place recent clinical trial findings in the context of evolving treatment paradigms in the field of breast cancer management
  • Identify patients who may benefit from inclusion in a clinical trial evaluating investigational approaches in the setting of breast cancer

Faculty, Staff, and Planners' Disclosures

Co-Chairs

Joyce O'Shaughnessy, MD
Celebrating Women Chair in Breast Cancer Research
Baylor University Medical Center
Texas Oncology
Chair, Breast Cancer Research Program
The US Oncology Network
Dallas, TX

Disclosure: Consultant: Arno Therapeutics, AstraZeneca, Celgene, Corcept Therapeutics, Eisai, Genentech, GlaxoSmithKline, Lilly, J&J, Merrimack, Novartis, Pfizer, Roche, Sanofi, Takeda, Medfusion

Sara Hurvitz, MD
Director, Breast Cancer Clinical Research Program
Co-Director, Santa Monica – UCLA Outpatient Hematology/Oncology Practice
Associate Professor of Medicine, Division of Hematology/Oncology
David Geffen School of Medicine at UCLA
Santa Monica, CA

Disclosure: Grant/Research Support: Amgen, Bayer, Boehringer Ingelheim, Genentech, GlaxoSmithKline, Pfizer, Roche, BioMarin, Merrimack, OBI Pharma, Puma Biotechnology, Dignitana, Medivation, Lilly, Novartis, OBI Pharma, Other: Lilly, Novartis, OBI Pharma: travel

Faculty

Adam M. Brufsky, MD, PhD
Professor of Medicine
Associate Chief, Division of Hematology/Oncology
Co-Director, Comprehensive Breast Cancer Center
Associate Director, Clinical Investigation
University of Pittsburgh School of Medicine
Pittsburgh, PA

Disclosure: Consultant: Novartis, Roche, Eisai, Celgene, Lilly, Pfizer, Agendia, Genomic Health, NanoString Technologies, Biotheranostics

Richard S. Finn, MD
Associate Professor of Medicine
Department of Medicine, Division of Hematology/ Oncology
David Geffen School of Medicine
University of California, Los Angeles
Santa Monica, CA

Disclosure: Consultant: Pfizer, Bayer, Novartis, Bristol-Myers Squibb, Eisai

The staff of PER® have no relevant financial relationships with commercial interests to disclose.

Disclosure Policy and Resolution of Conflicts of Interest (COI)

As a sponsor accredited by the ACCME, it is the policy of PER® to ensure fair balance, independence, objectivity, and scientific rigor in all of its CME/CE activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME/CE activity to disclose all relevant financial relationships with commercial interests. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that creates a COI.

Additionally, PER® is required by ACCME to resolve all COI. PER® has identified and resolved all COI prior to the start of this activity by using a multistep process.

Off-Label Disclosure and Disclaimer

This CME/CE activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME/CE activity is for continuing medical and nursing education purposes only, and is not meant to substitute for the independent clinical judgment of a physician relative to diagnostic, treatment, or management options for a specific patient’s medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER®.




PER Pulse™ Recap (1 of 3)
Novel Therapeutic Strategies for Triple-Negative Breast Cancer

Community Practice Connections™: 16th Annual International Congress on the Future of Breast Cancer®, features a review of key data and evolving treatment paradigms highlighted at the live conference. Interviews with distinguished breast cancer experts, including Joyce O’Shaughnessy, MD; Sara Hurvitz, MD; Richard S. Finn, MD; and Adam M. Brufsky, MD, PhD, provide perspective on the clinical implications and patient management applications of emerging evidence and state-of-the-art approaches to the management of patients with breast cancer. This first of 3 PER Pulse™ Recaps focuses on novel targeted therapies in development for the treatment of triple-negative breast cancer (TNBC).

  • Results from the phase III OlympiAD trial demonstrated that treatment with the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib significantly improved progression-free survival (PFS) compared with physician’s choice of chemotherapy in patients with BRCA-mutated anthracycline- and taxane-pretreated metastatic breast cancer (MBC). Another PARP inhibitor, talazoparib, has also demonstrated activity in BRCA-mutated MBC in a phase II study, and is now being evaluated in the phase III EMBRACA trial.
  • Immune checkpoint inhibitors are also being investigated for TNBC. In the metastatic setting, the anti–PD-1 antibodies atezolizumab and pembrolizumab as single agents have produced objective response rates (ORRs) in the range of 20% to25% in the first-line setting, but ORRs were <10% when these agents are used as later-line therapies. These agents have also exhibited promising activity when used in combination with cytotoxic agents, such as nab-paclitaxel and eribulin. In the preoperative setting, the addition of pembrolizumab to standard neoadjuvant chemotherapy tripled pathologic complete response rates in the I-SPY-2 trial in both triple-negative and hormone receptor-positive/HER2-negative patient populations.
  • In the phase II LOTUS trial, an inhibitor of PI3K, ipatasertib, significantly improved PFS when added to paclitaxel as a first-line treatment, and the magnitude of benefit appeared greatest in patients who had an alteration in PIK3CA, AKT1, or PTEN.

For additional commentary about this topic and others, please visit www.gotoper.com.




PER Pulse™ Recap (2 of 3)
Management of HER2-Driven Breast Cancers

Community Practice Connections™: 16th Annual International Congress on the Future of Breast Cancer®, features a review of key data and evolving treatment paradigms highlighted at the live conference. Interviews with distinguished breast cancer experts, including Joyce O’Shaughnessy, MD; Sara Hurvitz, MD; Richard S. Finn, MD; and Adam M. Brufsky, MD, PhD, provide perspective on the clinical implications and patient management applications of emerging evidence and state-of-the-art approaches to the management of patients with breast cancer. This second of 3 PER Pulse™ Recaps focuses on expanding therapeutic options strategies for treatment individualization for patients with HER2-positive breast cancers.

  • The HER2-directed tyrosine kinase inhibitor neratinib was approved by the Food and Drug Administration on July 17, 2017, for the extended adjuvant treatment of patients with early-stage HER2+ breast cancer following trastuzumab-based adjuvant therapy. This approval was based on the statistically significant improvement in 2-year invasive disease-free survival (iDFS) compared with placebo observed in the phase III ExteNet trial. Benefit was greatest in the subgroup of patients with HR (hormone receptor)-positive/centrally confirmed HER2+ cancers.
  • Results from the phase III APHINITY demonstrated that the addition of pertuzumab to standard adjuvant chemotherapy with 1 year of trastuzumab significantly improved 3-year iDFS compared with placebo, and benefit was greater in node-positive disease compared with node-negative disease.
  • For HER2+ metastatic breast cancer (MBC), the standard algorithm for most patients involves first-line treatment with a taxane plus trastuzumab plus pertuzumab, followed in the second-line by ado-trastuzumab emtansine (T-DM1), based on the demonstrated progression-free and overall survival benefits observed with these regimens in the CLEOPATRA and EMILIA trials in these settings, respectively.
  • More recently, results from the phase II PERTAIN trial and phase III ALTERNATIVE trial demonstrated that dual-HER2-targeted therapy (trastuzumab plus pertuzumab or lapatinib) in combination with an endocrine agent is more effective than a single HER2-targeted agent, and may be an option for some patients with HER2+/HR+ MBC for whom chemotherapy is contraindicated.

For additional commentary about this topic and others, please visit www.gotoper.com.




PER Pulse™ Recap (3 of 3)
Managing Hormone Receptor-Positive Breast Cancer and the Utility of Molecular Signatures

Community Practice Connections™: 16th Annual International Congress on the Future of Breast Cancer®, features a review of key data and evolving treatment paradigms highlighted at the live conference. Interviews with distinguished breast cancer experts, including Joyce O’Shaughnessy, MD; Sara Hurvitz, MD; Richard S. Finn, MD; and Adam M. Brufsky, MD, PhD, provide perspective on the clinical implications and patient management applications of emerging evidence and state-of-the-art approaches to the management of patients with breast cancer. This third of 3 PER Pulse™ Recaps focuses on integrating targeted therapies into the treatment of hormone receptor-positive (HR+) metastatic breast cancer (MBC), and integrating molecular assays into treatment decision making for early-stage HR+ breast cancers.

  • In the first-line setting for HR+ MBC, three phase III trials have now established the significant clinical benefit of adding a CDK4/6 inhibitor to an aromatase inhibitor (PALOMA-2/palbociclib; MONALEESA-2/ribociclib; MONARCH-3/abemaciclib). In all three studies, there was a statistically significant improvement in progression-free survival (PFS) with the CDK4/6 inhibitor compared with placebo; objective response rates and clinical benefit rates were also increased. Palbociclib and ribociclib are currently approved by the Food and Drug Administration (FDA) for use in this setting, and abemaciclib is currently undergoing regulatory review.
  • For patients with HR+ MBC who have previously received endocrine therapy, the PALOMA-3 and MONARCH-2 trials have shown that the addition of a CDK4/6 inhibitor (palbociclib or abemaciclib respectively) to fulvestrant significantly improves PFS in this setting also. Palbociclib is currently approved by the FDA for this use, and abemaciclib is undergoing regulatory review. Ribociclib is being evaluated in this setting in the ongoing MONALEESA-3 trial.
  • Exemestane plus the mTOR inhibitor everolimus remains an option for postmenopausal patients with HR+ MBC that has progressed on treatment with an aromatase inhibitor. The SWISH study demonstrated that prophylactic use of a steroid-containing mouth rinse could substantially reduce the incidence and severity of stomatitis.
  • Several commercially available molecular assays have demonstrated prognostic ability in early-stage HR+ breast cancer. At the present time, these assays have demonstrated the greatest utility in identifying patients at low risk for recurrence for whom adjuvant endocrine therapy is sufficient. In addition, these molecular signatures are being evaluated for their ability to identify patients with HR+ breast cancer at greatest risk for late recurrence, for potential treatment with extended adjuvant endocrine therapy.

For additional commentary about this topic and others, please visit www.gotoper.com.








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