Community Practice Connections™: 1st Annual Paris Breast Cancer Conference™

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

Activity Overview

Community Practice Connections™: 1st Annual Paris Breast Cancer Conference™ features a summary of clinical evidence guiding the treatment of patients with breast cancer. Topics include the utility of gene expression assays for making decisions about adjuvant chemotherapy for patients with hormone receptor‒positive, HER2-negative breast cancer; current therapeutic options for patients with early-stage and metastatic HER2-positive breast cancer, including the management of brain metastases; and emerging therapies for BRCA-mutated and/or triple-negative breast cancer, such as poly (ADP-ribose) polymerase (PARP) inhibitors and immune checkpoint inhibitors. This educational activity incorporates didactic reviews of key data accompanied by short video interviews with experts in the field, who share their perspectives on current treatment paradigms, practical patient management insights, and evolving prospects for the future.

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Genomic Health, Inc.

CME/CE Activity Table of Contents

• Module A: Utility of Genomic Assays for Hormone Receptor‒Positive Breast Cancer
• Module B: Current Perspectives on the Management of HER2‒Positive Breast Cancers
• Module C: Emerging Therapies for BRCA-Mutated or Triple-Negative Breast Cancer

Target Audience

This educational activity is directed toward healthcare professionals who practice primarily outside of the United States. It is specifically designed for medical oncologists and other healthcare professionals (eg, physicians, physicians-in-training, oncology nurses, pharmacists, physician assistants) involved in the treatment and management of patients with breast cancer.

Learning Objectives

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

• Integrate biomarkers, molecular assays, and other risk assessment tools appropriately in treatment decision making for breast cancer
• Review current standards and emerging data regarding systemic therapies for the treatment of early-stage, locally advanced, and metastatic breast cancer
• Consider therapeutic effectiveness, as well as patient and tumor characteristics, in individualizing treatment plans for patients receiving systemic therapies for breast cancer
• Identify appropriate clinical trials designed to benefit patients with breast cancer

Faculty, Staff, and Planners' Disclosures

Faculty

Thomas Bachelot, MD, PhD
Director, Breast Cancer Unit
Centre Lèon Bèrard
Lyon, FranceKingdom
 
 

Disclosure: Grant/Research Support: AstraZeneca, Pfizer; Consultant/Advisory Board: AstraZeneca, Roche, Pfizer, Novartis

Nicholas Turner, MD, PhD
Academic Consultant
Medical Oncologist
Biomedical Research Centre
The Royal Marsden NHS Foundation Trust
The Institute of Cancer Research
London, United Kingdom

Disclosure: Grant/Research Support: AstraZeneca, Pfizer, Roche; Consultant/Advisory Board: AstraZeneca, Pfizer, Roche, Novartis, Lilly, G1 Therapeutics, H3 Biomedicine, Synthon

Andrew Tutt, MD, PhD
Professor in Oncology and Director of the Breast Cancer Now Research Unit
King’s College London
Head of the Division of Breast Cancer Research and Professor of Breast Oncology
The Institute of Cancer Research
London, United Kingdom

Disclosure: Grant/Research Support: Myriad Genetics‒ Research costs for TNT trial; Consultant/Advisory Board: Vertex Pharmaceuticals, AstraZeneca; Shareholder: Rewards to inventors scheme Institute of Cancer Research

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)

Insight From Nicholas Turner, MD, PhD – PER Pulse™ Recap: Community Practice Connections™: 1st Annual Paris Breast Cancer Conference™

Community Practice Connections™: 1st Annual Paris Breast Cancer Conference™ is a continuing medical education (CME)-certified interactive online activity released in December 2017. In this activity, expert faculty Thomas Bachelot, MD, PhD; Nicholas Turner, MD, PhD; and Andrew Tutt, MD, PhD, discuss clinical evidence guiding the treatment of patients with breast cancer and share their perspectives on current therapeutic paradigms, practical patient management strategies, and prospects for the future.

This first of 3 PER Pulse™ Recaps summarizing the online activity focuses on the evolving role of gene expression assays for guiding decisions about adjuvant therapy for hormone receptor–positive (HR+) breast cancer. Below are some highlights from the activity featuring Dr. Turner:

• A review of the gene expression assays that have been validated for their prognostic ability in HR+/HER2-negative breast cancers.
• Results from a retrospective analysis based on long-term follow-up of patients who participated in the Stockholm tamoxifen trial, which showed that the 70-gene signature could identify a subset of patients with an ultra–low risk of recurrence at 20 years.
• Data from the prospective TAILORx trial showing that patients classified as low risk by the 21-gene recurrence score assay have an invasive disease-free survival rate of 94% at 5 years when treated with endocrine therapy alone.
• MINDACT results demonstrating that when patients classified as high clinical risk but low genomic risk by the 70-gene signature were randomized to not receive adjuvant chemotherapy, the 5-year rate of survival without distant metastasis was 95% compared with 96% for those who received adjuvant chemotherapy (P = .267).
• Ongoing evaluation of multigene assays for their prognostic ability between years 5 and 10 and their potential utility for the selection of patients for extended adjuvant endocrine therapy.

“Standard clinical predictors, such as tumor burden, and genomic predictors both provide complimentary information, and the very best way to use these tests is to integrate that altogether to get the very best picture of prognosis.”
— Nicholas Turner, MD, PhD

PER Pulse Recap (2 of 3)

Insight From Thomas Bachelot, MD, PhD – PER Pulse™ Recap: Community Practice Connections™: 1st Annual Paris Breast Cancer Conference™

Community Practice Connections™: 1st Annual Paris Breast Cancer Conference™ is a CME-certified interactive online activity released in December 2017. In this activity, expert faculty Thomas Bachelot, MD, PhD; Nicholas Turner, MD, PhD; and Andrew Tutt, MD, PhD, discuss clinical evidence guiding the treatment of patients with breast cancer and share their perspectives on current therapeutic paradigms, practical patient management strategies, and prospects for the future.

This second of 3 PER Pulse™ Recaps summarizing the online activity focuses on evolving paradigms for HER2-positive (HER2+) early-stage breast cancer and current standards for HER2+ metastatic breast cancer (MBC), including the management of brain metastases. Below are some highlights from the activity featuring Dr. Bachelot:

• Results from the phase III ExteNet trial, which evaluated extending adjuvant therapy for 1 year with neratinib versus placebo in patients who had completed standard adjuvant chemotherapy with 1 year of trastuzumab and showed a significant improvement in invasive disease-free survival (iDFS) with neratinib, particularly in patients with HR+/centrally confirmed HER2+ breast cancer.
• Data from the phase III APHINITY study, which compared standard adjuvant chemotherapy plus trastuzumab with or without pertuzumab. The addition of pertuzumab also significantly improved iDFS, and the greatest benefit was observed in patients with node-positive disease.
• A review of the current algorithm for HER2+ MBC, including a taxane/trastuzumab/pertuzumab triplet as first-line therapy and T-DM1 as second-line therapy, followed by a number of HER2-targeted options in the third-line setting and beyond.
• Multidisciplinary strategies for managing patients with HER2+ brain metastases, with a focus on preserving quality of life and maintaining cognitive function for as long as possible.

“Patients with [HER2+] brain metastases tend to live very long; not as long, but nearly as long as a patient without brain metastases.”
— Thomas Bachelot, MD, PhD

PER Pulse Recap (3 of 3)

Insight from Andrew Tutt, MD, PhD – PER Pulse™ Recap: Community Practice Connections™: 1st Annual Paris Breast Cancer Conference™

Community Practice Connections™: 1st Annual Paris Breast Cancer Conference™ is a CME-certified interactive online activity released in December 2017. In this activity, expert faculty, Thomas Bachelot, MD, PhD; Nicholas Turner, MD, PhD; and Andrew Tutt, MD, PhD, discuss clinical evidence guiding the treatment of patients with breast cancer and share their perspectives on current therapeutic paradigms, practical patient management strategies, and prospects for the future.

This third of 3 PER Pulse™ Recaps summarizing the online activity focuses on emerging therapies for BRCA-mutated and triple-negative breast cancers (TNBCs). Below are some highlights from the activity featuring Dr. Tutt:

• An overview of the emerging role of poly(ADP-ribose) polymerase (PARP) inhibitors in BRCA1/2-mutated MBC:
  • Results from the phase III OlympiAD trial, which showed a significant improvement in progression-free survival (PFS) with olaparib compared with chemotherapy in anthracycline- and taxane-pretreated MBC with a germline BRCA mutation (median PFS: 7.0 vs 4.2 months; P <.001).
  • Similar results were observed in the phase III EMBRACA trial with the PARP inhibitor talazoparib compared with chemotherapy (median PFS: 8.6 vs 5.6 months; P <.0001).
• Emerging data with immune checkpoint inhibitors, which have shown encouraging activity in TNBC as single agents and in combination with cytotoxic agents.
  • In the first-line metastatic setting, responses have been seen in approximately a quarter of patients, and many of these have been durable.
  • In the neoadjuvant I-SPY-2 trial, the addition of an immune checkpoint inhibitor to standard chemotherapy tripled the estimated pathologic complete response rate in the TNBC subset.
  • Phase III trials are further investigating the utility of these agents in TNBC.

“[For] patients who have genomically unstable, potentially homologous recombination–deficient forms of triple-negative breast cancer, I think it is very promising targeting those aberrations in the DNA damage response with PARP inhibition, potentially in combination with other DNA damage response–targeting therapies, perhaps in combination with immunotherapy.”
— Andrew Tutt, MD, PhD