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

Physicians' Education Resource®, LLC designates this live activity for a maximum of 6.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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This activity is supported by educational grants from Astellas, AstraZeneca, Bristol-Myers Squibb, Celgene, Clovis Oncology, Foundation Medicine, Inc., Genentech, Inc., Lilly, Merck & Co., Inc., and Novartis Pharmaceuticals Corporation.

For further information concerning Lilly grant funding visit www.lillygrantoffice.com.
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3rd Annual Miami Lung Cancer Conference®

3rd Annual Miami Lung Cancer Conference®


PER Pulse™ Recap

Resources

Medical Crossfire®: 3rd Annual Miami Lung Cancer Conference®
Earn up to 1.5 AMA PRA Category 1 Credits™
This edition of Medical Crossfire®, filmed in conjunction with the 3rd Annual Miami Lung Cancer Conference®, is designed to provide a dynamic discussion of current and evolving paradigms in the treatment of lung cancer, including immunotherapies in development, molecular subsets, targeted agents in development, and the role of cytotoxic agents in the molecular age.

Our Program Chairs, Thomas J. Lynch, Jr., MD, and Heather A. Wakelee, MD, and our expert faculty, Charu Aggarwal, MD, MPH, Christina Baik, MD, MPH, Sarah B. Goldberg, MD, MPH, Rebecca S. Heist, MD, MPH, Edward S. Kim, MD, Sukhmani K. Padda MD, Rathi Pillai, MD, Karen L. Reckamp, MD, Gregory Riely, MD, PhD, and Thomas Stinchcombe, MD, will emphasize the cutting-edge clinical research that will shape the therapy of lung cancer in the near future. Our community oncology representatives, Debra S. Brandt, MD, and Carrie B. Wasserman, MD, will complement the academic perspective provided by our faculty.

Each brief, 10-minute presentation will be followed by an extensive question-and-answer segment led by either, Dr. Lynch or Dr. Wakelee. This extended discussion format will allow ample time for examining the nuances and challenges faced by clinicians in everyday practice, and include a discussion of strategies for applying emerging data to clinical practice to improve outcomes for patients.

PER Pulse™ Recap
PER Pulse™ Recaps for the 3rd Annual Miami Lung Cancer Conference® focus on clinical pearls from the expert Medical Crossfire® panel discussions regarding key therapeutic areas including immunotherapy, oncogene-targeted therapy, and patients with a poor performance status.



PER Pulse™ Recap

PER Pulse™ Recap
 


1 of 3
PER Pulse™ Recap
Optimizing the Use of Immunotherapy in Lung Cancer

The 3rd Annual Miami Lung Cancer Conference™, which was held on March 19, 2016, featured internationally recognized experts in thoracic malignancies. These experts, along with representatives from community practice, discussed best practices and key advances for the treatment of patients with lung cancer. This first of 3 PER Pulse™ Recaps from the Miami Lung Cancer Conference focuses on practical issues with immunotherapy in patients with non–small cell lung cancer, as discussed by Heather A. Wakelee, MD; Sarah B Goldberg, MD, MPH; Edward S. Kim, MD, FACP; and Rathi N. Pillai, MD.

Below are some clinical pearls from the Medical Crossfire® expert discussion panel:

  • Use of PD-L1 testing: Currently, nivolumab does not require PD-L1 testing, which makes it easier to administer. However, pembrolizumab is given every 3 weeks, compared with every 2 weeks with nivolumab, which can be a factor for patients in rural areas that have long travel times to reach the clinic.
  • Pseudoprogression: Patients may know about pseudoprogression, but this phenomenon does not occur too often. The experts thought that if a patient was clinically well and progression was not significant, it would be reasonable to continue immunotherapy. For true progression, it can be a challenge to convince patients to switch from immunotherapy.
  • Dealing with adverse events (AEs) and patient expectations for resuming immunotherapy: Patients can be anxious to restart immunotherapy after stopping to address immune-related AEs (irAEs). Restarting inappropriately can be fatal, however, so patient expectations must be managed.
  • Patient reporting of irAEs: It is important to educate patients so that they report when they experience rash, diarrhea, or other symptoms. The patient may be reluctant to mention toxicities out of concern that the physician will stop therapy. However, stopping immunotherapy and administering steroids does not necessarily reduce their efficacy.

2 of 3
PER Pulse™ Recap
Addressing Complexities With Oncogene-Driven Lung Cancers

The 3rd Annual Miami Lung Cancer Conference™, which was held on March 19, 2016, featured internationally recognized experts in thoracic malignancies. These experts, along with representatives from community practice, discussed best practices and key advances for the treatment of patients with lung cancer. This second of 3 PER Pulse™ Recaps from the Miami Lung Cancer Conference focuses on addressing complex situations with oncogene-driven lung cancers, as discussed by Heather A. Wakelee, MD; Karen L. Reckamp, MD; Christina Baik, MD, MPH; and Gregory Riely, MD, PhD.

Below are some clinical pearls from the Medical Crossfire® expert discussion panel:

  • Coping with the longer turnaround time with multigene panels: The multigene panels yield more information than single-gene tests, but require more time to obtain results. Experts described that they also have a quick panel of tests (eg, analysis of common mutations in exons 18, 19, 20, and 21 of the epidermal growth factor receptor [EGFR] gene), with which the results can be received in less than a week.
  • Treating patients with EGFR mutation–positive lung cancer and brain metastases at diagnosis: Experts would treat patients with symptomatic brain metastases with surgery, stereotactic radiosurgery, or whole-brain radiation therapy. For asymptomatic patients, an EGFR tyrosine kinase inhibitor (TKI) is preferred, since this is thought to delay treating the brain directly, which carries a risk of cognitive impairment.
  • Sequencing of anaplastic lymphoma kinase (ALK) TKIs: Crizotinib is still the first-line standard; ceritinib and alectinib are both appropriate choices for subsequent therapy following progression on, or intolerance to, crizotinib. Experts thought that, in the future, different agents may match to specific ALK-resistance mutations.

3 of 3
PER Pulse™ Recap
Management of Elderly or Poor Performance–Status Patients

The 3rd Annual Miami Lung Cancer Conference™, which was held on March 19, 2016, featured internationally recognized experts in thoracic malignancies. These experts, along with representatives from community practice, discussed best practices and key advances for the treatment of patients with lung cancer. This third of 3 PER Pulse™ Recaps from the Miami Lung Cancer Conference focuses on treating elderly patients and patients with a poor performance status (PS), as discussed by Thomas J. Lynch, MD; Thomas Stinchcombe, MD; and Charu Aggarwal, MD, MPH.

Below are some clinical pearls from the Medical Crossfire® expert discussion panel:

  • Use of PS to choose therapy: Experts generally considered PS to be superior to age in deciding on the intensity of therapy. For example, they would not withhold bevacizumab from a 76-year-old patient if the patient was otherwise a good candidate. Nevertheless, it is often difficult to predict which patients will experience toxicity.
  • Dosing of carboplatin in an 80-year-old patient: Experts would not start carboplatin at the standard area under the curve (AUC) of 6 and would have a low threshold to reduce the dose to an AUC of 4. They would be more aggressive in the use of prophylactic granulocyte-colony stimulating factor and would have the patient visit the clinic weekly during the first cycle to monitor them.


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 Astellas, AstraZeneca, Bristol-Myers Squibb, Celgene, Clovis Oncology, Foundation Medicine, Inc., Genentech, Inc., Lilly, Merck & Co., Inc., and Novartis Pharmaceuticals Corporation.






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