View all Medical Crossfire CME

Share a PER® activity with your colleagues or friends. Connect with the PER® social network.



Accreditation/ Credit Designation

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

This activity is not approved for AMA PRA Category 1 Credit™.


Acknowledgment of Commercial Support

This activity is supported by an educational grant from Pfizer.


Medical Crossfire®: Integrating CDK4/6 Inhibitors into the Management of Breast Cancers - PER Pulse™ Recap
PER Pulse™ Recap

Resources

Medical Crossfires®: Integrating CDK4/6 Inhibitors into the Management of Breast Cancers
Earn up to 1.5 AMA PRA Category 1 Credits™
This edition of Medical Crossfire®, filmed in conjunction with the 33rd Annual Miami Breast Cancer Conference™, is designed to provide a dynamic discussion of current and evolving paradigms in the use of CDK inhibition to treat breast cancer, accompanied by discussion of strategies for applying emerging data to clinical practice to improve outcomes for patients. Program faculty engage in case-based discussions of clinical strategies regarding the use of CDK inhibition, and offer expert perspectives on the latest clinical evidence and practice recommendations, including dose adjustments for adverse-event management. The activity features a brief didactic overview on current management of estrogen receptor–positive, metastatic breast cancer, followed by case presentations and panel discussions that touch on treatment selection in the first-line and for progressive disease, molecular testing, monitoring for treatment response and progression of disease, and adverse-event management. Throughout the activity, interactive online questions are posed to participants to assess knowledge and facilitate self-assessment.

PER Pulse™ Recap
PER Pulse™ Recaps for Medical Crossfire®: Integrating CDK4/6 Inhibitors Into the Management of Breast Cancers focus on key topics presented during the program. A brief overview of expert perspectives on areas of clinical challenge faced by practicing oncologists and case management decisions is provided in these summaries.



PER Pulse™ Recap

PER Pulse™ Recap
 


1 of 3
PER Pulse™ Recap
Medical Crossfire®: Integrating CDK4/6 Inhibitors Into the Management of Breast Cancers
featured nationally recognized breast cancer experts. Program Chairs, Dr. Debu Tripathy, MD, and Dr. Joyce O'Shaughnessy, MD, along with faculty, Dr. Kimberly Blackwell, MD, and Dr. Andrew Seidman, MD, discuss the evolving science around cyclin-dependent kinase (CDK) signaling as a therapeutic target in hormone receptor-positive (HR+), metastatic breast cancer, and provided guidance on the use of a CDK4/6 inhibitor in real-world clinical scenarios.

See more at: http://www.gotoper.com/online-cme-activities/medical-crossfire/medical-crossfire-integrating-cdk46-inhibitors-into-the-management-of-breast-cancers

This first of 3 PER Pulse™ Recaps from this Medical Crossfire® focuses on Dr. Tripathy's presentation, "How Do We Treat With Hormonal Therapy in the Metastatic Setting?" that provided an overview of treatment algorithms, mechanisms of action of common therapies, relevant key trial data, and clinical dilemmas, as well as new drugs and emerging indications.

Dr Tripathy introduces this as an important topic because HR+ breast cancer represents the most common subtype in both early-stage and metastatic disease. He describes the treatment of HR+, metastatic breast cancer as complicated because it is based on a variety of patient- and disease-related factors. However, he notes, most patients do receive hormonal therapy. Premenopausal women are likely to receive tamoxifen/toremefine or ovarian suppression plus tamoxifen/toremifene, whereas postmenopausal women are likely to receive an aromatase inhibitor. Today, the CDK4/6 inhibitor palbociclib is available for postmenopausal women, as well. Upon progression, fulvestrant plus palbociclib or exemestane plus everolimus are standard options.

Many biologic pathways involved in breast cancer feed into the cell cycle. Preclinical studies have suggested CDK inhibition as a potentially valuable therapeutic target in estrogen receptor-positive/luminal breast cancer cells. To date, the most effective pharmacologic CDK inhibitory agents that have been developed--palbociclib, ribociclib, and abemaciclib--are targeted at CDK4/6. Dr. Tripathy reviews efficacy and safety data from trials that led to the approval of palbociclib (ie, the open-label, phase II PALOMA-1 [frontline palbociclib + letrozole for postmenopausal women] and the placebo-controlled, phase III PALOMA-3 [second-line palbociclib plus fulvestrant for pre-/peri- or postmenopausal women]). Finally, he walks participants through the recommendations for palbociclib dose modifications in the event that a patient experiences toxicity.



2 of 3
PER Pulse™ Recap
Medical Crossfire®: Integrating CDK4/6 Inhibitors Into the Management of Breast Cancers featured nationally recognized breast cancer experts. Program Chairs Debu Tripathy, MD, and Joyce O’Shaughnessy, MD, along with faculty Kimberly Blackwell, MD, and Andrew Seidman, MD, discuss the evolving science around cyclin-dependent kinase (CDK) signaling as a therapeutic target in hormone receptor (HR)‒positive, metastatic breast cancer and provided guidance on the using a CDK4/6 inhibitor in real-world clinical scenarios.

See more at: http://www.gotoper.com/online-cme-activities/medical-crossfire/medical-crossfire-integrating-cdk46-inhibitors-into-the-management-of-breast-cancers

This second of 3 PER Pulse™ Recaps from this Medical Crossfire® focuses on a faculty panel discussion, led by Dr. O’Shaughnessy, regarding their approach toward treatment of first-line metastatic estrogen receptor (ER)‒positive, HER2-negative breast cancer. Information included the following:

  • Dr. Seidman listed some key factors that he considers during decision making for first-line ER-positive, HER2-negative, metastatic breast cancer, including menopausal status, prior adjuvant endocrine therapy (Yes or no? If yes, what therapy, for how long, how long ago, and how well was it tolerated?). He also considers trial data from the PALOMA trials, BOLERO-2, the Southwest Oncology Group (SWOG) S0226 study, and the FIRST study.
  • Dr. Blackwell agreed with Dr. Seidman’s comments and noted that she also considers tumor markers, the extent of tumor ER expression, and patient compliance with therapy. In general, she offers palbociclib in the first line for all patients, but agrees that the SWOG S0226 data are compelling.
  • Dr. Tripathy remarked that pending data will be important to clinical decision making; however, in his practice, he recommends palbociclib for all patients who are candidates to receive it.
  • Dr. O’Shaughnessy concurred that the PALOMA-1 data are important, but that PALOMA-2 data will provide clearer guidance.

Note: This activity took place prior to the presentation of results from the phase III PALOMA-2 trial at the 2016 American Society of Clinical Oncology Annual Meeting. In PALOMA-2 (N = 666), the risk of progression among patients with ER-positive, HER2-negative, advanced or metastatic breast cancer was reduced by 42% with palbociclib plus letrozole versus letrozole alone (median follow-up, 23 months). Palbociclib also improved median progression-free survival (PFS) by >10 months (median PFS: 24.8 months (palbociclib + letrozole) vs 14.5 months (letrozole); HR, 0.58; 95% CI, 0.46-0.72; P <.000001). Benefits with palbociclib were evident across all subgroups examined. The combination therapy was associated with more grade 3 and 4 hematologic adverse events



3 of 3
PER Pulse™ Recap
Medical Crossfire®: Integrating CDK4/6 Inhibitors Into the Management of Breast Cancers featured nationally recognized breast cancer experts. Program Chairs Debu Tripathy, MD, and Joyce O’Shaughnessy, MD, along with faculty Kimberly Blackwell, MD, and Andrew Seidman, MD, discuss the evolving science around cyclin-dependent kinase (CDK) signaling as a therapeutic target in hormone receptor‒positive, metastatic breast cancer, and provided guidance on the use of CDK4/6 inhibitors in real-world clinical scenarios.

See more at: http://www.gotoper.com/online-cme-activities/medical-crossfire/medical-crossfire-integrating-cdk46-inhibitors-into-the-management-of-breast-cancers

This third of 3 PER Pulse™ Recaps from this Medical Crossfire® focuses on adverse-event management for a patient receiving palbociclib. During the program:
  • Dr. O’Shaughnessy notes that she has not found fatigue to be problematic with palbociclib.
  • Dr. Tripathy provides an overview of dose adjustment recommendations for palbociclib.
  • Dr. Tripathy estimates that about one-third of patients have problems with neutropenia, requiring adjustments.
  • Regarding neutropenia, Dr. Tripathy finds that most neutropenia arises on day 2 of cycle 2 or 3. In these cases, holding for 1 week and resuming as indicated in the package insert is appropriate. Dr. Blackwell agrees, noting that in the PALOMA-1 study, the majority of problems with neutropenia occurred within the first 2 cycles.
  • Dr. Tripathy also finds that a subgroup of patients experiences persistent neutropenia, and that fatigue is often problematic for these patients.
  • The faculty review some case scenarios related to dose adjustment for patients with neutropenia.
  • The faculty also share some practical tips regarding workflow, blood count monitoring, appointment scheduling, as well as patient and staff education based on their experiences with palbociclib.


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

This activity is not approved for AMA PRA Category 1 Credit™.

Supported by an educational grant from Pfizer.




Calendar of Events
SUNMONTUESWEDTHURSFRISAT
 123456
78910111213
14151617181920
21222324252627
28293031
Filter By