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.

Acknowledgment of Commercial Support

This activity is supported by an educational grant from AstraZeneca.

Community Practice Connections™: Medical Crossfire®: Leveraging the Lung Cancer Team in Stage III NSCLC With Immuno-Oncology Strategies

Release Date: November 27, 2019
Expiration Date: November 27, 2020
Media: Internet - based

Activity Overview

Community Practice Connections™: Medical Crossfire®: Leveraging the Lung Cancer Team in Stage III NSCLC With Immuno-Oncology Strategies consists of a series of interactive clinical vignettes, short video interviews with leading experts in lung cancer, 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.

Benefits of Participating

  • Learn about the rationale for using immunotherapy with multimodality approaches
  • Discuss the role of biomarker testing in patients with unresectable stage III non–small cell lung cancer (NSCLC)
  • Incorporate standard-of-care management for patients with unresectable stage III NSCLC
  • See how experts manage immunotherapy-related adverse events

Acknowledgement of Commercial Support

This activity is supported by an educational grant from AstraZeneca.

Instructions for This Activity and Receiving Credit

  • You will need to log in 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 video/content until you finish the presentation.
  • At the end of the activity, “Educational Content/Videos” will be available for your reference.
  • In order to receive a CME Certificate, you 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.” You may immediately download a CME Certificate upon completion of these steps.

Target Audience

These activities are intended for an international audience of medical oncologists interested in the latest advances in the treatment of patients with NSCLC. Fellows, investigators, nurses, nurse practitioners, physician assistants, and other healthcare professionals interested in the treatment of patients with NSCLC are also invited to participate.

Learning Objectives

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

  • Describe the scientific underpinnings of tumor immunology and the scientific rationale for immune checkpoint inhibition in the management of early-stage and locally advanced NSCLC
  • Apply clinical trial evidence to optimize the use of immune checkpoint inhibitors for the treatment of stage III NSCLC
  • Evaluate evolving uses of biomarkers and how they have been investigated as methods to inform clinical decision making in the care of patients with NSCLC
  • Discuss methods to proactively identify and mitigate the impact of immune-related adverse events in stage III NSCLC

Faculty, Staff, and Planners’ Disclosures

Faculty

Naiyer A. Rizvi
Naiyer A. Rizvi, MD
Price Family Professor of Medicine
Director, Thoracic Oncology
Codirector, Cancer Immunotherapy
Price Chair, Clinical Translational Research
Columbia University Medical Center
New York, NY

Disclosures: Grant Research Support: AstraZeneca, Bristol-Myers Squibb, Genentech, GlaxoSmithKline, Merck, Regeneron; Consultant: AbbVie, AstraZeneca, Bristol-Myers Squibb, EMD Serono, Genentech, GlaxoSmithKline, Janssen, Lilly, Merck, Novartis, Pfizer, Regeneron; Speaker Advisory Board: Bellicum Pharmaceuticals, Brooklyn ImmunoTherapeutics, NeoGenomics, Gritstone Oncology; Shareholder: ARMO BioSciences, Bellicum, Brooklyn ImmunoTherapeutics, Gritstone Oncology; Other: Royalties – Personal Genome Diagnostics Memorial Sloan Kettering Cancer Center Patent – Determinants of cancer response to immunotherapy.

Keith M. Kerr
Keith M. Kerr, FRCPath
Consultant Pathologist, Department of Pathology
Aberdeen Royal Infirmary
Professor of Pulmonary Pathology
Aberdeen University Medical School
Scotland, United Kingdom

Disclosures: Consultant: AbbVie, Archer Diagnostics, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Lilly, EMD Serono, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Ventana; Speaker Advisory Board: AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, EMD Serono, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Ventana, Medscape, Prime Oncology.

Suresh Senan
Suresh Senan, MRCP, PhD, FRCR
Professor of Clinical Experimental Radiotherapy
Department of Radiation Oncology
Amsterdam University Medical Center
Amsterdam, Netherlands

Disclosures: Grant Research Support: AstraZeneca; ViewRay, Inc; Varian Medical Systems; Consultant: AstraZeneca, Varian Medical Systems, Celgene; Speakers Bureau: AstraZeneca.

Rolf Stahel
Rolf Stahel, MD
Chair, Comprehensive Cancer Center Zurich
University Hospital Zurich
Zurich, Switzerland

Disclosures: Grant Research Support: AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Genentech, Merck Sharp & Dohme, Roche, Pfizer; Consultant: AbbVie, AstraZeneca, Merck Sharp & Dohme, Pfizer, Regeneron, Roche, Seattle Genetics, Takeda; Speakers Bureau: AstraZeneca, Boehringer Ingelheim, Lilly, Merck Sharp & Dohme, Roche; Other: DMC – Genentech, Roche, Takeda.

The staff of Physicians' Education Resource®, LLC (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 activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME 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 create 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 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 activity is for continuing medical education purposes only and is not meant to substitute for the independent clinical judgment of a physician relative to diagnostic or treatment 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® or the company that provided commercial support.

PER Pulse™ Recaps

1 of 3

A New Standard of Care for Patients With Unresectable Stage III NSCLC

Medical Crossfire®: Leveraging the Lung Cancer Team in Stage III NSCLC With Immuno-Oncology Strategies, which was held September 8, 2019, in Barcelona, Spain, updated physicians and other practitioners on current standards of care in patients with unresectable stage III non–small cell lung cancer (NSCLC), the role of biomarkers in this setting, and management of immune-related adverse events. This first of 3 PER Pulse™ Recaps from this program focuses on data supporting the use of consolidation immunotherapy after chemoradiation therapy (CRT) in stage III NSCLC.

  • For several decades, the main definitive standard of care for patients with unresectable, stage III NSCLC has been concurrent CRT; neither induction chemotherapy nor consolidation chemotherapy have been able to improve overall survival (OS) compared with concurrent CRT alone.
  • In the metastatic setting, immunotherapy has demonstrated improved OS and progression-free survival (PFS) compared with standard chemotherapy, prompting investigation in earlier stages of disease.
  • The PACIFIC trial randomized patients with unresectable stage III NSCLC, who did not experience disease progression following concurrent CRT, to receive either durvalumab or placebo.
  • The median PFS with durvalumab was significantly increased compared with placebo (17.2 vs 5.6 months; HR, 0.51). With a median follow-up time of 25.2 months, the median OS was not yet reached in the durvalumab arm and was 29.1 months with placebo (HR, 0.69).
  • In Europe, the data from the PACIFIC study led to approval, in September 2018, of durvalumab as consolidation therapy in patients with PD-L1–positive (≥1%) unresectable, locally advanced NSCLC whose disease has not progressed after CRT.

2 of 3

The Role of PD-L1 Testing in Patients With Unresectable Stage III NSCLC

Medical Crossfire®: Leveraging the Lung Cancer Team in Stage III NSCLC With Immuno-Oncology Strategies, which was held September 8, 2019, in Barcelona, Spain, updated physicians and other practitioners on current standards of care in patients with unresectable stage III non–small cell lung cancer (NSCLC), the role of biomarkers in this setting, and management of immune-related adverse events. This second of 3 PER Pulse™ Recaps from this program focuses on the role of PD-L1 testing in patients with stage III NSCLC.

  • The overall patient cohort in the PACIFIC trial obtained an overall survival (OS) benefit with consolidation durvalumab compared with placebo.
  • Prior to approval in Europe, an unplanned, post hoc analysis was performed that included a PD-L1 expression cutoff of 1%.
  • In the subgroup of 148 patients with a PD-L1 expression of <1%, no OS benefit with durvalumab was observed (HR, 1.36) with a median follow-up time of 25.2 months. With additional follow-up (33.3 months total), the HR was 1.14.
  • While a group of European oncology experts have described the lack of statistical power in this post hoc analysis, the European approval of durvalumab in stage III NSCLC includes a requirement for a PD-L1 expression level of ≥1%. Physicians therefore should consult local guidelines and ensure that PD-L1 testing is carried out as needed in patients with unresectable stage III NSCLC.

3 of 3

Management of Immune-related Adverse Events

Medical Crossfire®: Leveraging the Lung Cancer Team in Stage III NSCLC With Immuno-Oncology Strategies, which was held September 8, 2019, in Barcelona, Spain, updated physicians and other practitioners on current standards of care in patients with unresectable stage III non–small cell lung cancer (NSCLC), the role of biomarkers in this setting, and management of immune-related adverse events (irAEs). This third of 3 PER Pulse™ Recaps from this program focuses on considerations for irAE management in the context of combined modality therapy.

  • Several comprehensive reviews are available regarding the management of irAEs in general; however, some additional considerations are appropriate in the context of patients with unresectable stage III NSCLC, given the use of radiation therapy.
  • Prior to treatment, the radiation oncologist should be consulted to determine whether or not the patient is a candidate for concurrent chemoradiation therapy.
  • Following treatment, in the event of toxicity, it is important to consult the radiation oncologist for interpretation, particularly if the medical oncologist is not aware of the radiation fields.
    • It may be necessary to irradiate healthy lung tissue in order to spare vital organs, such as the heart. Therefore, it should be determined if the irAE, such as pneumonitis, may be occurring in the radiation field, to help differentiate radiation-induced pneumonitis from immunotherapy-related pneumonitis.

Login or Register to Start Activity

Please use the form below to Register or Log In to begin Activity.

*Required Fields
Calendar of Events
SUNMONTUESWEDTHURSFRISAT
      1
2345678
9101112131415
16171819202122
23242526272829
3031
Filter By