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 1.5 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 1.5 Contact Hours.

Acknowledgment of Commercial Support

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

Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant Settings


Release Date: September 28, 2018
Expiration Date: September 28, 2019
Media: Internet - based

Activity Overview

This activity, Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant Settings, developed in Physicians’ Education Resource®, LLC, (PER®) established Advances in™ legacy format, will highlight best practices in the treatment and management of patients with BRAF-mutated melanoma in the adjuvant setting, including an extensive update on the biologic rationale behind BRAF/MEK inhibitor therapy, the current foundation of evidence in the adjuvant setting for BRAF/MEK inhibitors and checkpoint inhibitors, and the potential of BRAF/MEK targeted therapy in the neoadjuvant setting. Additional focus will be placed on sequencing strategies and adverse events related to BRAF/MEK inhibitor combinations.

You will hear expert perspectives and discussions of recent updates that have changed current treatment paradigms, and the factors that influence melanoma treatment decisions in the adjuvant setting.

Benefits of Completing Activity

By participating in this exciting program, you will learn about:

  • Recent clinical studies that inform clinical decision-making and evolving treatment strategies for the adjuvant treatment of resectable BRAF-mutated melanoma
  • Optimizing care for the patient receiving combination BRAF/MEK inhibitor therapy by mitigating adverse events
  • Potential therapies on the horizon for the treatment of BRAF-mutated melanoma in the neoadjuvant and adjuvant settings

Acknowledgement of Commercial Support

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

 

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 oncologists, surgical oncologists, and dermatologists who treat patients with melanoma. Nurse practitioners, nurses, physician assistants, pharmacists, and other healthcare professionals interested in the treatment of melanoma are also invited to participate.

Educational Objectives

Upon completion of this activity, you should be better prepared to:

  • Evaluate the rationale for the application of BRAF/MEK inhibition strategies to adjuvant and neoadjuvant settings in which patients with melanoma are managed
  • Utilize clinical trial results to inform sequencing decisions that optimize outcomes among patients with melanoma in the context of emerging BRAF/MEK combinations
  • Incorporate best practices to proactively identify and manage adverse events associated with combination strategies in the setting of melanoma
  • Identify key ongoing clinical trials examining emerging BRAF/MEK combination strategies in the management of melanoma

Faculty, Staff, and Planners' Disclosures

Faculty

Rodabe N. Amaria
Rodabe N. Amaria, MD
Assistant Professor
Department of Melanoma Medical Oncology
Division of Cancer Medicine
The University of Texas MD Anderson Cancer Center
Houston, TX

Disclosure: Dr. Amaria has no relevant financial relationships with commercial interests to disclose.

Jonathan S. Zager
Jonathan S. Zager, MD, FACS
Associate Chief Academic Officer
Chair of Graduate Medical Education
Director of Regional Therapies
Senior Member, Moffitt Cancer Center
Departments of Cutaneous Oncology and Sarcoma
Professor of Surgery, University of South Florida School of Medicine
Moffitt Cancer Center
Tampa, FL

Disclosure: Grant/Research Support: Delcath Systems, Philogen, Novartis, Castle Biosciences, Provectus; Consultant: Amgen, Delcath Systems; Speaker’s Bureau: Amgen, Array, Sun Pharma

The staff of Physicians’ Education Resource®, LLC 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 Recaps

1 of 3
Insights from Rodabe N. Amaria, MD, and Jonathan S. Zager, MD, FACS—PER Pulse™ Recap:
Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant Settings

The online continuing medical education activity Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant Settings features expert faculty Rodabe N. Amaria, MD, and Jonathan S. Zager, MD, FACS, discussing best practices in the treatment and management of patients with BRAF-mutated melanoma in the adjuvant setting. Faculty provides an extensive update on the biologic rationale behind BRAF/MEK inhibitor therapy and evidence in the adjuvant setting for BRAF/MEK inhibitors and checkpoint inhibitors, and the potential of BRAF-/MEK-targeted therapy in the neoadjuvant setting.

This first of 3 PER Pulse™ Recaps for the activity will focus on the pathophysiologic rationale for BRAF/MEK inhibition in adjuvant and neoadjuvant settings and the significance of the BRAF V600 mutation.

Below are some highlights from the activity featuring Dr. Amaria, assistant professor, department of melanoma medical oncology, Division of Cancer Medicine, MD Anderson Cancer Center, Houston, Texas, and Dr. Zager, director of regional therapies and senior member, Moffitt Cancer Center, and professor of surgery, University of South Florida School of Medicine, Tampa. The faculty discuss the following topics:

  • The role of the MAPK/ERK pathway in melanoma; in particular, the significance of the BRAF V600 mutation.1-3
  • Recent, novel, and practice-changing advances in BRAF/MEK inhibition in melanoma that practicing clinicians should take into consideration when making treatment decisions for their patients, especially novel options in the adjuvant and metastatic settings.
  • Major findings from the COMBI-AD4 and COLUMBUS trials.5
  • Significant differences in the safety and efficacy of the 3 BRAF/MEK inhibitor combinations based on real case scenarios from their clinical practice.

“COMBI-AD showing the advantage of BRAF/MEK inhibition in the adjuvant setting, and the COLUMBUS trial, being the third combination therapy, showing again great efficacy in terms of progression-free survival and overall survival for the patients with metastatic melanoma.”

— Jonathan S. Zager

References

  1. Davies H, Bignell GR, Cox C, et al. Mutations of the BRAF gene in human cancer. Nature. 2002;417(6892):949-954. doi: 10.1038/nature00766.
  2. Baik CS, Myall NJ, Wakelee HA. Targeting BRAF‐mutant non‐small cell lung cancer: from molecular profiling to rationally designed therapy. Oncologist. 2017;22(7):786-796. doi: 10.1634/theoncologist.2016-0458.
  3. Pratillas CA, Taylor BS, Ye Q, et al. (V600E) BRAF is associated with disabled feedback inhibition of RAF-MEK signaling and elevated transcriptional output of the pathway. Proc Natl Acad Sci U S A. 2009;106(11):4519-4524. doi: 10.1073/pnas.0900780106.
  4. Long GV, Menzies AM, Nagrial AM, et al. Prognostic and clinicopathologic associations of oncogenic BRAF in metastatic melanoma. J Clin Oncol. 2011;29(10):1239-1246. doi: 10.1200/JCO.2010.32.4327.
  5. Dummer R, Ascierto PA, Gogas HJ, et al. Encorafenib plus binimetinib versus vemurafenib or encorafenib in patients with BRAF-mutant melanoma (COLUMBUS): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2018;19(5):603-615. doi: 10.1016/S1470-2045(18)30142-6.

2 of 3
Insights from Rodabe N. Amaria, MD, and Jonathan S. Zager, MD, FACS—PER Pulse™ Recap:
Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant Settings

As a follow-up to the online continuing medical education activity Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant Settings, this second of 3 PER Pulse™ Recaps will focus on the role of BRAF/MEK inhibitors in the adjuvant setting and the identification and proactive management of adverse events associated with these therapies.

Below are some highlights from the meeting featuring Dr. Zager and Dr. Amaria:

  • The current rationale for the use of BRAF/MEK inhibitors as adjuvant therapy for melanoma.
  • The rationale for the use of combined therapies over monotherapies and how dual targeting seems to slow down the development of resistance to treatment as well as decrease the adverse effect (AE) profile.1-4
  • The most notable adverse events associated with BRAF and MEK inhibitors in the adjuvant and neoadjuvant settings and how educating patients is key to identifying, diagnosing, and managing the AEs.
  • How treatment-related AEs for BRAF/MEK inhibition compare to those for immunotherapy. The AE profiles are different and so are the strategies to mitigate the AEs.

References

  1. Daud A, Tsai K. Management of treatment-related adverse events with agents targeting the MAPK pathway in patients with metastatic melanoma. Oncologist. 2017;22(7):823-833. doi: 10.1634/theoncologist.2016-0456.
  2. Robert C, Karaszewska B, Schachter J, et al. Improved overall survival in melanoma with combined dabrafenib and trametinib. N Engl J Med. 2015;372(1):30-39. doi: 10.1056/NEJMoa1412690.
  3. Long GV, Stroyakovskiy D, Gogas H, et al. Combined BRAF and MEK inhibition versus BRAF inhibition alone in melanoma. N Engl J Med. 2014;371(20):1877-1888. doi: 10.1056/NEJMoa1406037.
  4. Long GV, Hauschild A, Santinami M, et al. Adjuvant dabrafenib plus trametinib in stage III BRAF-mutated melanoma. N Engl J Med. 2017;377(19):1813-1823. doi: 10.1056/NEJMoa1708539.

3 of 3
Insights from Rodabe N. Amaria, MD, and Jonathan S. Zager, MD, FACS—PER Pulse™ Recap:
Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant Settings

As a follow-up to the online continuing medical education activity Advances in™ Melanoma: Exploring BRAF/MEK in Adjuvant and Neoadjuvant Settings, this third of 3 PER Pulse™ Recaps will focus on the future of neoadjuvant and adjuvant treatment for BRAF-mutated melanoma.

Below are some highlights from the meeting featuring Dr. Zager and Dr. Amaria:

  • The potential neoadjuvant treatment in patients with resectable BRAF-mutated melanoma.
  • The horizon for the use of targeted agents in the treatment of BRAF-mutated melanoma from the surgeon’s perspective.

“Targeted therapy in the neoadjuvant setting has shown to increase overall survival and increase recurrence-free survival after being given to patients with bulky resectable disease.”

— Jonathan S. Zager MD, FACS, MD


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