Release Date: February 28, 2018
Expiration Date: February 28, 2019
Media: Internet - based
Community Practice Connections™: 12th Annual New York Lung Cancer Symposium® features a case-based discussion of current and developing therapies for patients with non–small cell lung cancers (NSCLCs), including immunotherapy and inhibition of EGFR, ALK, and other oncogenic drivers. Interactive clinical vignettes are followed by short video interviews with leading lung cancer experts and short summaries of clinical data related to these issues. The video interviews address decision points in the clinical vignettes, as well as questions commonly faced in the community oncology practice setting by physicians engaged in the care of patients with NSCLCs.
Acknowledgement of Commercial Support
This activity is supported by educational grants from AbbVie, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb, Celgene Corporation, Ignyta, Lilly, Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Pfizer, and Takeda Oncology.
For further information concerning Lilly grant funding visit www.lillygrantoffice.com.
CME/CE Activity Table of Contents
Module 1: Immunotherapy in Lung Cancer
Module 2: EGFR Mutation-Positive NSCLC
Module 3. ALK and Other Oncogenic Drivers
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.
This activity is directed toward medical oncologists, radiation oncologists, thoracic surgeons, pulmonologists involved in the treatment and management of patients with lung cancer. Fellows, nurse practitioners, nurses, physician assistants, pharmacists, researchers, and other health care professionals interested in the treatment of lung cancer may also participate.
At the conclusion of this activity, you should be better prepared to:
Determine testing strategies to optimize tumor characterization and inform clinical decision making for the management of patients with lung cancers
Identify diagnostic and tumor testing results that inform individualized treatment planning and sequencing for patients with non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC)
Integrate recent clinical trial findings concerning single-agent and combination immunotherapeutic strategies to manage advanced forms of lung cancers
Apply personalized approaches to optimize sequencing of oncogenic-driven NSCLC via assessment of mutation subtypes in multiple lines of care
Determine frontline and subsequent options in patients without actionable mutations, including the role of chemotherapies and antiangiogenic strategies in these settings
Describe methods to proactively plan for and mitigate the impact of treatment-related toxicities in the care of patients with lung cancers
Faculty, Staff, and Planners' Disclosures
Justin F. Gainor, MD
Harvard Medical School
Massachusetts General Hospital
Disclosure: Consultant: Novartis, Bristol-Myers Squibb, Genentech, Theravance, Loxo; Other: Honorarium for speaking engagements from Merck and Incyte.
Mark G. Kris, MD
Attending, Thoracic Oncology Service
William and Joy Ruane Chair in Thoracic Oncology
Memorial Sloan Kettering Cancer Center
New York, NY
Disclosure: Consultant: AstraZeneca
Paul K. Paik, MD
Assistant Attending Physician
Clinical Director, Thoracic Oncology Service
Memorial Sloan Kettering Cancer Center
New York, NY
Disclosure: Grant/ Research Support: Celgene, EMD Serono
Roman Perez-Soler, MD
Chairman, Department of Oncology
Montefiore Medical Center
Professor of Medicine and Molecular Pharmacology
Deputy Cancer Center Director
Albert Einstein College of Medicine
Disclosure: Grant/Research Support: National Cancer Institute; Consultant: AstraZeneca, Clovis, Roche/Genentech, Boehringer Ingelheim, Lilly, Adgero; Stock/Shareholder: Adgero, Stelexis
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 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 Recap™
PER Pulse Recap (1 of 3)
This first of 3 PER Pulse™ Recaps from the New York Lung Cancer Symposium®
focuses on new developments in immunotherapy for patients with advanced lung cancers.
The results of several clinical trials launched just a few years ago now hold the potential to yield several new approvals shortly, in both non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC)
In patients with NSCLC of any histology and a tumor mutational burden (TMB) of ≥10 mutations per megabase, the CheckMate 227 trial demonstrated superior progression-free survival (PFS) with nivolumab/ipilimumab compared with standard first-line chemotherapy. This combination is currently in review with the US Food and Drug Administration (FDA), with a decision expected by February 20, 2019.
In 2017, pembrolizumab with carboplatin/pemetrexed was approved as first-line therapy, regardless of PD-L1 expression, for patients with metastatic, nonsquamous NSCLC, based on the phase II KEYNOTE-021 trial. Subsequently, the phase III KEYNOTE-189 trial demonstrated improved PFS and overall survival (OS) with the addition of pembrolizumab to platinum-based chemotherapy (cisplatin or carboplatin) and pemetrexed; these data have resulted in priority review, with a decision deadline of September 23, 2018.
The phase III IMpower150 trial has demonstrated improved OS and PFS with the addition of atezolizumab to carboplatin/paclitaxel/bevacizumab in patients with metastatic, nonsquamous NSCLC; priority review has been granted by the FDA, with a decision anticipated by September 5, 2018.
The squamous-specific, phase III KEYNOTE-407 trial investigated the addition of pembrolizumab to carboplatin/nab-paclitaxel. Compared with placebo, the pembrolizumab arm demonstrated superior OS and PFS. This combination is also in priority review with the FDA, with a target decision date of October 30, 2018.
Finally, in patients with SCLC, data from the phase I/II CheckMate 032 trial have led to priority review of single-agent nivolumab for patients with SCLC and disease progression after ≥2 prior lines of therapy. A decision is expected from the FDA by August 16, 2018.
PER Pulse Recap (2 of 3)
This second of 3 PER Pulse™ Recaps from the New York Lung Cancer Symposium®
focuses on the development of immunotherapy in stage I-III NSCLC.
With the establishment of immunotherapy in metastatic NSCLC, investigation has also begun in earlier stages of disease. This has resulted in approval of immunotherapy as consolidation therapy in patients with stage III NSCLC.
The phase III PACIFIC trial compared durvalumab with placebo as consolidation therapy after concurrent chemoradiation therapy in patients with unresectable stage III NSCLC who achieved at least stable disease after combined modality therapy. The PFS was significantly improved with durvalumab, leading to approval by the FDA in February 2018. In May 2018, it was announced that the co-primary endpoint of OS was also met in the durvalumab arm.
In patients with resectable, stage I-IIIA NSCLC, single-agent nivolumab as neoadjuvant therapy was evaluated in a pilot study. In a cohort of 20 patients with completely resected tumors, a major pathological response (defined as ≤10% viable tumor cells) was observed in 9 patients (45%) after 2 doses of nivolumab.
PER Pulse Recap (3 of 3)
This third of 3 PER Pulse™ Recaps from the New York Lung Cancer Symposium®
focuses on advances in targeted therapy.
For patients with NSCLC and sensitizing mutations in the epidermal growth factor receptor (EGFR) gene, the third-generation EGFR tyrosine kinase inhibitor (TKI) osimertinib was approved as first-line therapy in April 2018, based on superior PFS with osimertinib compared with erlotinib or gefitinib in the phase III FLAURA trial. Follow-up of this trial continues for OS.
In patients with less common EGFR mutations (ie, other than exon 19 deletions or L858R), afatinib received approval in January 2018.
A second-generation EGFR TKI, dacomitinib, demonstrated improved PFS compared with gefitinib as first-line therapy in the phase III ARCHER 1050 trial, resulting in priority review; a decision from the FDA is anticipated by September 2018. Subsequently, it was reported that OS was also improved in the dacomitinib arm.
The phase III ALEX trial established alectinib as a new standard of care for patients with rearrangements in the anaplastic lymphoma kinase (ALK) gene, with approval in November 2017. A follow-up report in June 2018 showed that the median PFS for alectinib was 34.8 months, compared with 10.9 months for the comparator arm of crizotinib.
Targeted agents are being developed for other oncogenes, including NTRK. Larotrectinib is currently in priority review with the FDA for tumors with an NTRK gene fusion, with a decision expected by November 26, 2018.
For additional commentary about these topics and others, visit www.gotoper.com
to access more resources from the 12th Annual New York Lung Cancer Symposium®
, including downloadable slides from the meeting.