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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 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Resources

PER Pulse™ Recaps highlight key elements of the Oncology Briefings™: Updates in Novel Therapeutic Options for Lung Neuroendocrine Tumors online CME activity.

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.

Oncology Briefings™: Updates in Novel Therapeutic Options for Lung Neuroendocrine Tumors

Release Date: May 31, 2017
Expiration Date: May 31, 2018
Media: Internet - based

 

Activity Overview

Oncology Briefings™ is an online interactive monograph that will provide an overview of the biology of lung neuroendocrine tumors (NETs) in addition to a review of recent data regarding emerging and novel treatment strategies in patients with lung NETs. This format includes a brief presentation of clinical science, and features discussion by a national thought leader to provide key take-home points and pearls for practice that will place the content into perspective. Audio sidebars and tables provide supporting evidence.

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.

CME Activity Table of Contents

  • Background and Disease Biology
  • Diagnosis and Risk Stratification
  • Current Treatment and Management Strategies
  • Emerging Treatment and Management Strategies

Instructions for This Activity and Receiving Credit

  • You will need to login to participate in the activity.
  • This activity contains an interactive question(s). You may move forward through the activity; however, you may not go back to change answers or review content until you finish the activity.
  • At the end of the activity, "educational content/audio files" will be available for your reference.
  • If you close the Web browser after you complete the activity, the “Educational Content” link will disappear, and you will need to review the activity in its entirety to once again access the link to the educational content.
  • In order to receive a CME 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 certificate upon completion of these steps.

Target Audience

This activity is directed toward oncology healthcare professionals who treat patients with lung NETs, including medical oncologists, radiology oncologists, and surgical oncologists. Fellows, nurses, nurse practitioners, physician assistants, and other healthcare professionals (HCPs) involved in the management of patients with lung NETs are also invited to participate.

Learning Objectives

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

  1. Review the biology of neuroendocrine tumors (NETs) of the lung
  2. Discuss the current and emerging techniques used in the differential diagnosis and monitoring of patients with lung NETs
  3. Assess current and emerging therapeutic options as well as sequential strategies for the treatment of patients with lung NETs
  4. Describe the importance of a multidisciplinary approach in accurately diagnosing and treating patients with lung NETs

Faculty, Staff, and Planners' Disclosures

Faculty

Jonathan R. Strosberg, MD
Associate Professor
Head, Gastrointestinal Department Research Program
H. Lee Moffitt Cancer Center
Tampa, FL
 

Disclosure: Grant/Research Support- Advanced Accelerator Applications, Pharmacyclics; Consultant-Novartis; Speakers Bureau- Ipsen, Lexicon Pharmaceuticals

The staff of Physicians' Education Resource® 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 activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME 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 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 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 or treatment 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


Criteria in Risk Stratification of Lung NETs

The online Oncology Briefings™ CME activity, Updates in Novel Therapeutic Options for Lung Neuroendocrine Tumors, provides oncologists and other healthcare professionals with an engaging presentation on the current and evolving treatment standards in lung neuroendocrine tumors (NETs). Leading expert Jonathan R. Strosberg, MD, associate professor and head of the Gastrointestinal Department Research Program at H. Lee Moffitt Cancer Center, Tampa, FL, answers key questions supported by the presentation of clinical science about lung NETs. This first of 3 PER Pulse™ Recaps from this program focuses on important criteria in the stratification of lung NETs.

Dr. Strosberg presented diagnostic criteria using standards delineated in the World Health Organization (WHO) 2015 criteria, and provided his insights on this topic, comparing the current stratification to that which exists in gastrointestinal (GI) NETs:

  • Typical carcinoids (TCs) are well-differentiated neoplasms characterized by less than 2 mitoses per 2 mm2 observed field and an absence of necrosis. Typical carcinoids are similar in grading to low-grade NETs in the GI tract.
  • Atypical carcinoids (ACs) are well-differentiated neoplasms characterized by 2 to 10 mitoses per observed field and display focal necrosis. Atypical carcinoids are similar in grading to intermediate-grade ones.
  • Large-cell neuroendocrine carcinomas (LCNECs) are poorly differentiated tumors characterized by a high mitotic rate (median of 70 per observed field) and extensive necrosis. Large-cell neuroendocrine carcinomas correspond to high-grade GI NETs.
  • Small cell lung cancers (SCLCs) also are poorly differentiated tumors characterized by a high mitotic rate (median of 80 per observed field) and extensive necrosis, but are morphologically distinct from LCNECs. Small cell lung cancer corresponds to high-grade GI NETs.
  • Gastrointestinal NETs have 2 separate classification criteria for grade and differentiation. Additionally, GI NETs rely on the immunohistochemical proliferation marker ki-67 in determining pathology.

For additional information and commentary on this topic, as well as audio and supporting text, visit http://www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefings-updates-in-novel-therapeutic-options-for-lung-neuroendocrine-tumors.

For information on other topics, visit www.gotoper.com.


2 of 3
PER Pulse™ Recap

Current Management Strategies in Lung NETs

The online Oncology Briefings™ CME activity, Updates in Novel Therapeutic Options for Lung Neuroendocrine Tumors, provides oncologists and other healthcare professionals with an engaging presentation on the current and evolving treatment standards in lung neuroendocrine tumors (NETs). Leading expert Jonathan R. Strosberg, MD, associate professor and head of the Gastrointestinal Department Research Program at H. Lee Moffitt Cancer Center, Tampa, FL, answers key questions supported by the presentation of clinical science about lung NETs. This second of 3 PER Pulse™ Recaps from this program focuses on the treatment and management strategies considered standard in the field of lung NETs.

Dr. Strosberg presented the essential takeaways from 2011’s practice-changing, phase 3 RADIANT-4 trial evaluating everolimus, an oral inhibitor of mammalian target of rapamycin, resulting in the drug’s approval in 2016, specifically:

  • 302 patients with lung or gastrointestinal (GI) NETs were enrolled in the trial: 205 to everolimus, 97 to placebo. Patients were treated with everolimus 10 mg per day orally or with placebo; both trial arms were treated with supportive care at physician discretion.
  • In patients receiving everolimus, progression-free survival (PFS) was 11.0 months (95% CI, 9.2-13.3). In patients receiving placebo, PFS was 3.9 months (95% CI, 3.6-7.4).
  • Overall, everolimus was associated with a 52% reduction in estimated risk of progression/death (HR, 0.48; 95% CI, 0.35-0.67; P <.00001).
  • Specifically, among the 90 patients with lung NETs enrolled, PFS was 9.2 months (95% CI, 6.8-10.9) for those receiving everolimus compared with 3.6 months (95% CI, 1.9-5.1) for those receiving placebo.

Dr. Strosberg also expanded upon the somatostatin analogues octreotide and lanreotide that are used in hormone-producing NETs, the latter of which is being investigated in the phase 3 SPINET trial (NCT02683941), which is currently active and recruiting participants.

For additional information and commentary on this topic, as well as audio and supporting text, visit http://www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefings-updates-in-novel-therapeutic-options-for-lung-neuroendocrine-tumors.

For information on other topics, visit www.gotoper.com.


3 of 3
PER Pulse™ Recap

Emerging Management Strategies in Lung NETs

The online Oncology Briefings™ CME activity, Updates in Novel Therapeutic Options for Lung Neuroendocrine Tumors, provides oncologists and other healthcare professionals with an engaging presentation on the current and evolving treatment standards in lung neuroendocrine tumors (NETs). Leading expert Jonathan R. Strosberg, MD, associate professor and head of the Gastrointestinal Department Research Program at H. Lee Moffitt Cancer Center, Tampa, FL, answers key questions supported by the presentation of clinical science about lung NETs. This third and final PER Pulse™ Recap from this program focuses on the emerging treatment and management strategies in the field of lung NETs.

Beyond the current phase 3 SPINET trial (NCT02683941) investigating lanreotide in patients with lung NETs, Dr. Strosberg discussed the potential for peptide receptor radionucleotide therapy (PRRT) in the treatment of lung NETs:

  • Peptide receptor radionucleotide therapy utilizes a somatostatin analog (SSA) bound to a radiation-emitting isotope, typically yttrium-90 or lutetium-177. The radiolabeled SSA is able to deliver highly targeted radiation to SSTR-expressing tumor cells.
  • While primarily studied in gastrointestinal (GI) NETs, similar responses have been observed in patients with lung NETs receiving PRRT. However, the need remains for a larger investigation into this therapy.
  • A single-institution series investigating the use of PRRT in 114 patients with advanced lung NETs showed a progression-free survival of 28.0 months and an overall survival of 58.8 months.
  • The National Comprehensive Cancer Network and European Neuroendocrine Tumor Society both suggest that PRRT treatment be pursued only after failure of currently approved therapies. Peptide receptor radionucleotide therapy very much remains an investigational drug.

Dr. Strosberg also discussed the debate and investigation into maintenance therapy versus second-line treatment upon progression, and expressed skepticism about the ability of current trials investigating maintenance therapy to prove a survival benefit.

For additional information and commentary on this topic, as well as audio and supporting text, visit http://www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefings-updates-in-novel-therapeutic-options-for-lung-neuroendocrine-tumors.

For information on other topics, visit www.gotoper.com.







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