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 1.0 AMA PRA Category 1 Credit™. 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 Merck & Co, Inc.

Cancer Summaries and Commentaries™: Update from Barcelona: Advances in the Treatment of Breast Cancer

Release Date: December 23, 2019
Expiration Date: December 23, 2020
Media: Internet - based

Activity Overview

This online activity is designed to update physicians on data presented at the European Society for Medical Oncology (ESMO) Annual Meeting, held in September 2019 in Barcelona, Spain. Cancer Summaries and Commentaries™: Update From Barcelona: Advances in the Treatment of Breast Cancer online continuing medical education (CME) activity facilitates critical assessment and clinical integration of new evidence, when appropriate. This activity reviews 4 late-breaking abstracts with some of the most compelling and clinically relevant breast cancer presentations from the meeting. For each abstract, a short summary of key clinical data is accompanied by expert perspectives that provide insight into how clinicians can apply these findings to their clinical practice to improve patient care.

Benefits of Participating

  • Hear from the experts about recent clinical trials in HR-positive (+)/HER2-negative (–) advanced breast cancer; early-stage, triple-negative breast cancer; and germline BRCA1/2-mutated metastatic/advanced breast cancer and their impact on clinical practice decisions
  • Identify opportunities to implement emerging treatments for the management of HR+/HER2– advanced breast cancer; early-stage, triple-negative breast cancer; and germline BRCA1/2-mutated metastatic/advanced breast cancer
  • Explore the role of PARP inhibitors and immunotherapy in the treatment and management of breast cancer

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Merck & Co, Inc.

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 audio/content until you finish the presentation.
  • At the end of the activity, “Educational Content/Audio” 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

This educational activity is directed toward medical oncologists and fellows who treat patients with breast cancer. Surgical oncologists, radiation oncologists, nurse practitioners, nurses, physician assistants, pharmacists, investigators, and other healthcare professionals interested in the treatment of breast cancer will be invited to participate.

Learning Objectives

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

  • Outline testing methods that allow for optimized characterization of tumor biology among patients with breast cancer
  • Explain the study design, rationale, and results of recent clinical trials evaluating novel strategies for breast cancer treatment
  • Consider recent evidence in the context of evolving treatment paradigms in the field of breast cancer management

Faculty, Staff, and Planners’ Disclosures

Faculty

Joyce O’Shaughnessy
Joyce O’Shaughnessy, MD
Celebrating Woman Chair in Breast Cancer Research
Baylor University Medical Center
Texas Oncology
Chair, Breast Cancer Research Program
The US Oncology Network
Dallas, TX

Disclosures: Grant Research Support: AbbVie Inc, Agendia, Amgen, Biotechnology, AstraZeneca, Bristol-Myers Squibb, Celgene Corporation, Eisai, Genentech, Genomic Health, GRAIL, Immunomedics, Heron Therapeutics, Ipsen Biopharmaceuticals, Jounce Therapeutics, Lilly, Merck, Myriad, Novartis, Ondonate Therapeutics, Pfizer, Puma Biotechnology, Roche, Seattle Genetics, Syndax Pharmaceuticals, Takeda.

Nicholas Turner
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

Disclosures: Advisory Board Honoraria: Astra Zeneca, Bristol-Myers Squibb, Lilly, Merck Sharpe and Dohme, Novartis, Pfizer, Roche/Genentech, Tesaro, Bicycle Therapeutics, Taiho and research funding from Astra Zeneca, BioRad, Pfizer, Roche/Genentech, Clovis, Merck Sharpe and Dohme, Guardant Health.

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

Cancer Summaries and Commentaries™: Update From Barcelona: Advances in the Treatment of Breast Cancer is a continuing medical education (CME)-certified program. For this program, Joyce O’Shaughnessy, MD and Nicholas Turner, MD, PhD provide expert commentary on recent abstracts presented on September 2019 at the European Society for Medical Oncology (ESMO) Annual Meeting held in Barcelona, Spain.

This first of 3 PER Pulse™ Recaps summarizing the online activity focuses on the overall survival (OS) results reported from the phase III MONALEESA-3 trial (LBA7_PR) and the phase III MONARCH 2 trial (LBA6_PR). Below are some highlights from the activity featuring Dr Joyce O’Shaughnessy.

  • In the phase III MONALEESA-3 trial, patients who had received ribociclib + fulvestrant experienced statistically significant OS improvement and a 28% relative risk reduction of death compared with those who had fulvestrant alone.1,2
  • Median progression-free survival reported in the first-line cohort with ribociclib + fulvestrant is the longest reported in a phase III trial involving patients with postmenopausal HR+/HER– advanced breast cancer (33.6 months versus 19.2 months in the placebo + fulvestrant arm).1,2
  • In the phase III MONARCH 2 trial, results showed that the addition of abemaciclib to fulvestrant significantly improved median OS by 9.4 months in patients with HR+/HER2– advanced breast cancer who previously progressed on endocrine therapy.3,4
  • For patients who received chemotherapy after progression, time to chemotherapy treatment was more than twice as long for patients in the abemaciclib arm compared with the placebo arm (50.2 vs 22.1 months).3,4

“I was pleased to see with regard to MONALEESA-3 in the overall survival analysis that both patients with primary refractory disease and those with secondary resistance benefitted—that is new information.”
—Joyce O’Shaughnessy, MD

References

  1. Slamon DJ, Neven P, Chia S, et al. Overall survival (OS) results of the phase III MONALEESA-3 trial of postmenopausal patients (pts) with hormone receptor-positive (HR+), human epidermal growth factor 2-negative (HER2−) advanced breast cancer (ABC) treated with fulvestrant (FUL) ± ribociclib (RIB). Ann Oncol. 2019;30(suppl 5; abstr LBA7_PR). doi: 10.1093/annonc/mdz394.007.
  2. Slamon DJ, Neven P, Chia S, et al. Overall survival with ribociclib plus fulvestrant in advanced breast cancer [published online December 11, 2019]. N Engl J Med. doi: 10.1056/NEJMoa1911149.
  3. Sledge GW Jr, Toi M, Neven P, et al. MONARCH 2: Overall survival of abemaciclib plus fulvestrant in patients with HR+, HER2- advanced breast cancer. Ann Oncol. 2019;30(suppl 5; abstr LBA6_PR). doi: 10.1093/annonc/mdz394.
  4. Sledge GW Jr, Toi M, Neven P, et al. The effect of abemaciclib plus fulvestrant on overall survival in hormone receptor-positive, ERBB2-negative breast cancer that progressed on endocrine therapy - MONARCH2: a randomized clinical trial [published online September 29, 2019]. JAMA Oncol. doi: 10.1001/jamaoncol.2019.4782.

2 of 3

Cancer Summaries and Commentaries™: Update From Barcelona: Advances in the Treatment of Breast Cancer is a continuing medical education (CME)-certified program. For this program, Joyce O’Shaughnessy, MD and Nicholas Turner, MD, PhD provide expert commentary on recent abstracts presented on September 2019 at the European Society for Medical Oncology (ESMO) Annual Meeting held in Barcelona, Spain.

This second of 3 PER Pulse™ Recaps summarizing the online activity focuses on the results from the phase III KEYNOTE-522 trial evaluating pembrolizumab plus chemotherapy in the neoadjuvant setting followed by adjuvant use of pembrolizumab for patients with early triple-negative breast cancer (LBA8_PR). Below are some highlights from the activity featuring Dr Nicholas Turner:

  • Data from the phase III KEYNOTE-522 trial showed that the addition of pembrolizumab to neoadjuvant chemotherapy significantly improved the pathological complete response (pCR) rate in patients with early triple-negative breast cancer (TNBC) regardless of PD-L1 status.1
  • This analysis also showed a modest favorable trend regarding event-free survival (91.3% vs 85.3%), although those results were not yet statistically significant.1
  • Benefits of pembrolizumab were seen independent of PD-L1 expression status: 68.9% vs 54.9%, respectively, achieved pCR (ypT0/Tis vpN0) for the PD-L1–positive cohort and 45.3% vs 30.3%, respectively, for the PD-L1–negative cohort.1

“The ability of new drugs to increase pathological complete response [in the early TNBC setting] is potentially a surrogate end point that can be used by studies to bring forward accelerated approval for new treatment.”
—Nicholas Turner, MD, PhD

Reference

  1. Schmid P, Cortés J, Dent R, et al. LBA8_PR: KEYNOTE-522: phase III study of pembrolizumab (pembro) + chemotherapy (chemo) vs placebo (pbo) + chemo as neoadjuvant treatment, followed by pembro vs pbo as adjuvant treatment for early triple-negative breast cancer (TNBC). Ann Oncol. 2019;30(suppl 5; abstr LBA8_PR). doi: 10.1093/annonc/mdz394.003.

3 of 3

Cancer Summaries and Commentaries™: Update From Barcelona: Advances in the Treatment of Breast Cancer is a continuing medical education (CME)-certified program. For this program, Joyce O’Shaughnessy, MD and Nicholas Turner, MD, PhD provide expert commentary on recent abstracts presented on September 2019 at the European Society for Medical Oncology (ESMO) Annual Meeting held in Barcelona, Spain.

This third of 3 PER Pulse™ Recaps summarizing the online activity focuses on the results from the phase III BROCADE3 trial evaluating veliparib plus chemotherapy in HER2-negative, advanced/metastatic gBRCA-associated breast cancer (LBA9). Below are some highlights from the activity featuring Dr Nicholas Turner:

  • Veliparib, in combination with carboplatin and paclitaxel, showed a statistical improvement in progression-free survival and a clinically meaningful benefit for patients with HER2-negative, advanced breast cancer and a germline BRCA mutation.1
  • A total of 26% of patients in the veliparib arm were alive and progression free at 3 years compared with 11% of patients in the placebo arm.1
  • BROCADE3 is the first phase III trial to examine the efficacy of a poly (ADP-ribose) polymerase (PARP) inhibitor in combination with platinum-containing chemotherapy in patients with metastatic/advanced germline BRCA mutation–associated breast cancer.1

“Guidelines increasingly suggest that patients with advanced breast cancer should be offered genetic testing to identify which patients have germline BRCA1 or BRCA2 mutations to help identify patients who could benefit from the addition of PARP inhibitors to their care.”
—Nicholas Turner, MD, PhD

Reference

  1. Diéras VC, Han HS, Kaufman B, et al. Phase III study of veliparib with carboplatin and paclitaxel in HER2-negative advanced/metastatic gBRCA-associated breast cancer. Ann Oncol. 2019;30(suppl 5; abstr LBA9). doi: 10.1093/annonc/mdz394.008.

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