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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

Acknowledgment of Commercial Support

This activity is supported by educational grants from Bayer HealthCare Pharmaceuticals Inc., Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC, and Lilly.

For further information concerning Lilly grant funding, visit

Clinical Interchange™: Moving Forward From the Status Quo for the Treatment of Soft Tissue Sarcoma: Key Questions and New Answers to Optimize Outcomes

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


Activity Overview

Are you prepared to provide state-of-the-art care to the next patient who presents to your clinic with a soft tissue sarcoma (STS)? Don’t miss this opportunity to hear renowned experts discuss the current standard of care, and provide insights into the evolving approaches and breakthroughs occurring in the field of STS.

Historically poor outcomes in patients with metastatic STS have led to therapeutic nihilism among some physicians. However, a greater appreciation of the heterogeneous, complex biologies across the many STS subtypes, as well as the development of new and emerging therapeutic approaches, are transforming the ways in which these malignancies are managed. Optimal treatment requires a highly skilled, multidisciplinary team that encompasses medicine, pathology, radiology, and surgery.

Join us to learn about what’s on the horizon for STS, and to gain up-to-date guidance on the delivery of cross-discipline care for patients with STS that leverages the resources of both community- and academic-based healthcare providers.

Acknowledgment of Commercial Support

This activity is supported by educational grants from Bayer HealthCare Pharmaceuticals Inc., Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC, and Lilly.

For further information concerning Lilly grant funding, visit

CME Activity Table of Contents

  • Module I: Optimization of Molecular Diagnostic Techniques in Light of New Targets and New Options
  • Module I Panel Discussion
  • Module II: Choosing First-Line Therapy: Key Questions Driving Treatment Decisions
  • Module II Panel Discussion
  • Module III: Therapy for Recurrent Disease and Sequencing Multiple Lines of Care
  • Module III Panel Discussion
  • Module IV: Evolving Data and Approaches to Immuno-Oncology for Sarcomas
  • Module IV Panel Discussion
  • Module V: Key Takeaway Panel Discussion

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 CMEcertificate, 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 educational activity is directed toward medical, surgical, and radiation oncologists, as well as fellows, who manage patients with soft tissue sarcoma (STS). Nurse practitioners, physician assistants, nurses, and other healthcare professionals interested in the treatment and management of patients with STS may also participate.

Educational Objectives

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

  • Detail methods to engage community-based oncologists to communicate with sarcoma specialists in the care of patients with soft tissue sarcoma in multiple lines of treatment
  • Evaluate clinical circumstances that impact sequencing decision making along the disease continuum in the management of soft tissue sarcoma
  • Explain disease heterogeneity in advanced soft tissue sarcomas, and its impact on treatment strategies and methods to overcome challenges to optimized diagnoses in the field
  • Describe novel mechanistic approaches that have been applied to the treatment of patients with metastatic or unresectable soft tissue sarcoma

Faculty, Staff, and Planners' Disclosures


George D. Demetri, MD
Professor of Medicine, Harvard Medical School
Co-Director, Ludwig Center at Harvard
Director, Center for Sarcoma and Bone Oncology
Dana-Farber Cancer Institute
Boston, MA

Disclosure: Grant/Research Support: Bayer, Novartis, Pfizer; Janssen Oncology; Consultant: Novartis, Pfizer, EMD Serono, Sanofi Oncology, Janssen Oncology, PharmaMar, Daiichi-Sankyo, WIRB Copernicus Group, ZioPharm, Polaris Pharmaceuticals, Kymab, Genocea, Nektar Tharapeutics, Adaptimmune, Eisai, Kolltan Pharmaceuticals, G1 Therapeutics, Caris Life Sciences, Champions Oncology, Bessor Pharma; Stock/Shareholder: Blueprint Medicines, G1 Therapeutics, Caris Life Sciences, Champions Oncology, Bessor Pharma; Other: Patent licensed to Novartis and paid to Dana-Farber Cancer Institute, Member of the Scientific Advisory Boards for: Blueprint Medicines, G1 Therapeutics, Caris Life Sciences, Champions Oncology, Bessor Pharma


Sandra P. D’Angelo, MD
Assistant Attending Physician
Sarcoma Medical Oncology/Immunotherapeutics Core
Memorial Sloan Kettering Cancer Center
New York, NY

Disclosure: Grant/Research Support: Nektar Therapeutics, EMD Serono

Brian A. Van Tine, MD, PhD
Associate Professor of Medicine
Sarcoma Program Director of the Barnes and Jewish Hospital
Washington University
St. Louis, MO

Disclosure: Grant/Research Support: Merck, Pfizer; Consultant: Novartis, Janssen, Lilly, Caris Life Sciences; Speaker’s Bureau: Caris Life Sciences, Janssen, Lilly

Richard F. Riedel, MD
Associate Professor of Medicine with Tenure
Division of Medical Oncology
Associate Director of Clinical Research at the Duke Sarcoma Program
Duke University
Durham, NC

Disclosure: Grant/Research Support: Aadi Bioscience, Daiichi-Sankyo, Immune Design, Karyopharm, Plexxikon, Tracon; Consultant: Ignyta, Immune Design, Janssen, Lilly. Other: Spouse is owner of LimbGuard, LLC

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 CMEactivities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CMEactivity 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 CMEactivity 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, 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

PER Pulse Recap (1 of 3)

Choosing First-Line Therapy: Key Questions Driving Treatment Decisions
This first of 3 PER Pulse Recaps from this Clinical Interchange focuses on optimized treatment care during diagnosis and first-line treatment planning.
  • The low incidence and heterogeneity of STS poses a clinical challenge.
  • The faculty agree that diagnosis of STS is complex and that they often seek input from multiple colleagues. It is important that community oncologists seek consultation with academic experts as early as possible to ensure accurate diagnosis and optimized treatment planning.
  • Optimal patient care depends on accurate diagnostic STS subtyping.
  • Dr Demetri estimates a diagnostic change is made for ≥ 25% cases referred to his center for pathology review; more than 15% of those changes are associated with important alterations to the patient care plan.
  • All patients should be managed, but not necessarily treated, by a multidisciplinary team with expertise in sarcoma.
  • Histology, burden of disease, chemosensitivity of tumor type, patient performance status, and need for response are key factors to consider during selection of first-line therapy.
  • Standards of care in frontline therapy include anthracycline-based regimens (ie, doxorubicin + ifosfamide, doxorubicin + olaratumab, doxorubicin), gemcitabine + docetaxel, or clinical trial.
  • The addition of the newest frontline option for STS, olaratumab, to docetaxel prolonged 2-year overall survival by 11.8 months in a phase II randomized study.
PER Pulse Recap (2 of 3)

Therapy for Recurrent Disease and Sequencing Multiple Lines of Care
This second of 3 PER Pulse™ Recaps from this Clinical Interchange focuses on the importance of STS subtype in therapy selection, clinical trial data that are informing current decision making, and strategies for sequencing existing therapies for recurrent disease:
  • The number of chemotherapeutic options and their efficacy are limited for STS.
  • Newer treatment options available beyond the first-line setting include olaratumab in combination with an anthracycline, pazopanib (for non-gastrointestinal stromal tumor [GIST], nonadipocytic sarcomas), trabectedin (for liposarcoma or leiomyosarcoma), and eribulin (for liposarcoma).
  • In a phase III clinical trial that randomized 518 patients with liposarcoma or leiomyosarcomas to receive trabectedin or dacarbazine, progression-free survival (PFS) was improved with trabectedin across all subgroups (overall median PFS, 4.2 months with trabectedin vs 1.5 months with dacarbazine; hazard ratio [HR], 0.55; 95% CI, 0.44-0.70; P<.001). The primary endpoint of overall survival (OS) did not differ across study arms.
  • In a phase III clinical trial that randomized 452 patients with advanced liposarcoma or leiomyosarcoma to receive eribulin or dacarbazine, median OS was improved with eribulin compared with dacarbazine (respectively, 13.5 months vs 11.5 months; HR, 0.77; 95% CI, 0.62-0.95; P = .0169). Upon subgroup analysis, the OS benefit was limited to patients with liposarcoma (HR, 0.51, 95% CI, 0.35-0.75).
  • Clinical trials should always be considered for patients with STS.
  • Optimal sequence of therapies for non-GIST STS is not well defined; the faculty discussed their approaches based on best-available evidence and their own clinical experiences.
PER Pulse Recap (3 of 3)

Evolving Data and Approaches to  Immuno-Oncology for Sarcomas
This third of 3 PER Pulse™ Recaps from this Clinical Interchange focuses on the biologic rationale to explore immunotherapeutic agents in sarcoma and ongoing investigations in this field.
  • Tumor-infiltrating lymphocyte expression in sarcoma is variable and subtype dependent.
  • Best available evidence suggests that PD-L1 expression as a predictive biomarker in STS is of limited utility.
  • The median tumor mutational burden in sarcoma is 2.5 mutations per megabase; approximately 5% of patients with STS have “high” tumor mutation burden.
  • Highly expressed genes in undifferentiated pleomorphic sarcoma and leiomyosarcoma include those associated with antigen presentation, T-cell infiltration, and clonality.
  • Ongoing investigations to drive an immune response in sarcoma include studies of adoptive T-cell therapy, vaccines, checkpoint inhibition, radiation therapy, oncolytic viral therapy, pegylated interleukin-2, and indoleamine 2,3-dioxygenase inhibition.

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