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 2.25 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 AstraZeneca Pharmaceuticals LP, Clovis Oncology, Inc., and Millennium Pharmaceuticals, Inc.

Cancer Summaries and Commentaries™: Update from Munich: Advances in the Treatment of Lung Cancer, Genitourinary Malignancies, and Gynecologic Malignancies


Release Date: December 30, 2018
Expiration Date: December 30, 2019
Media: Internet - based

Activity Overview

This online Physicians’ Education Resource, LLC® activity, Cancer Summaries and Commentaries™: Update from Munich: Advances in the Treatment of Lung Cancer, Genitourinary Malignancies, and Gynecologic Malignancies, is designed to update physicians on data presented at the European Society for Medical Oncology (ESMO) 2018 Congress, which took place October 19-23, 2018, in Munich, Germany. During this online activity, the program faculty, David Gandara, MD, Bernard Escudier, MD, and Richard Penson, MD, MRCP, will each review 3 abstracts within the fields of lung cancer, genitourinary malignancies, and gynecologic malignancies, respectively. These abstracts were chosen as the most clinically relevant to facilitate integration of cutting-edge data into practice. 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

  • Identify key ongoing clinical trial designs that evaluated novel strategies in patients with lung cancer, genitourinary malignancies, and gynecologic malignancies
  • Understand recent cutting-edge clinical trial results that impact treatment of patients with lung cancer, genitourinary malignancies, and gynecologic malignancies, and how to apply these results of recent clinical trials to your practice
  • Hear expert perspectives on the latest evidence from the ESMO 2018 Congress, and how these data affect evolving treatment paradigms for patients

Acknowledgement of Commercial Support

This activity is supported by educational grants from AstraZeneca Pharmaceuticals LP, Clovis Oncology, Inc., and Millennium Pharmaceuticals, 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 files/content until you finish the presentation.
  • At the end of the activity, educational content/audio files 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 ex-US medical oncologists, surgical oncologists, radiation oncologists, and pulmonologists involved in the treatment and management of patients with lung cancer, genitourinary cancers, and/or gynecologic malignancies. Fellows, nurse practitioners, nurses, physician assistants, pharmacists, researchers, and other healthcare professionals interested in the treatment of lung cancer, genitourinary cancers, and/or gynecologic malignancies are also invited to participate.

Learning Objectives

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

  • Describe clinical study designs from recently reported and ongoing trials evaluating novel strategies for the management of patients with lung cancer, genitourinary malignancies, and gynecologic malignancies
  • Detail results from recent practice-changing clinical trials that evaluated novel strategies for the treatment of lung cancer, genitourinary malignancies, and gynecologic malignancies
  • Place recent evidence into the context of evolving treatment paradigms for the care of patients with lung cancer, genitourinary malignancies, and gynecologic malignancies

Faculty, Staff, and Planners' Disclosures

Faculty

Bernard Escudier
Bernard Escudier, MD
Chair, Genitourinary Oncology Committee
Institut Gustave Roussy, Villejuif
Paris, France

Disclosures: Grant/Research Support: BMS, Novartis; Consultant: BMS, Pfizer, Novartis, Ipsen, EUSA, Aveo, Roche

David R. Gandara
David R. Gandara, MD
Professor of Medicine
Division of Hematology/Oncology
Director, Thoracic Oncology Program
Senior Advisor to the Director
UC Davis Comprehensive Cancer Center
Sacramento, CA

Disclosures: Grant/Research Support: AstraZeneca/Medi, Genentech; Consultant: AstraZeneca, Celgene, Genentech, Guardant Health, Lilly, Liquid Genomics

Richard T. Penson
Richard T. Penson, MD
Associate Professor of Medicine
Harvard Medical School
Clinical Director, Medical Gynecologic Oncology, Medicine
Massachusetts General Hospital
Boston, MA

Disclosures: Grant/Research Support: Array BioPharma, AstraZeneca, Cerulean, Vascular Biogenics, Eisai, Merck, Regeneron, Sanofi-Aventis; Scientific Advisory Board: AstraZeneca, Clovis, Eisai, Merck, Mersona, Sutro Biopharma, Vascular Biogenics; Other Support: DSMB: AbbVie

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 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 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 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 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™ Recaps

1 of 3
Insights from David R. Gandara, MD, PER Pulse™ Recap:
Cancer Summaries and Commentaries™: Update from Munich: Advances in the Treatment of Lung Cancer, Genitourinary Malignancies, and Gynecologic Malignancies

In this continuing medical education (CME)-certified activity, Cancer Summaries and Commentaries™: Update from Munich: Advances in the Treatment of Lung Cancer, Genitourinary Malignancies, and Gynecologic Malignancies, expert faculty, including David R. Gandara, MD; Bernard Escudier, MD; and Richard T. Penson, MD; discuss recent clinical trials and treatment decisions based on data presented at the European Society for Medical Oncology (ESMO) 2018 Congress in Munich, Germany.

This first of 3 PER Pulse™ Recaps summarizing the online program focuses on clinical trial design and results and how these data from recent trials influence practical guidance regarding clinical decision making for patients with non–small-cell lung cancer (NSCLC). Below are some highlights from the activity featuring Dr. Gandara:

  • Discussion of the phase III ALTA-1L trial1 that evaluated the intracranial efficacy of brigatinib versus crizotinib in tyrosine kinase inhibitor (TKI)-naïve patients with ALK-positive tumors, which demonstrated that brigatinib significantly improved intracranial progression-free survival (PFS) and objective response rate (ORR) compared with crizotinib.
  • Overview of the phase III Impower130 trial2 of carboplatin plus nab-paclitaxel (CnP) with or without atezolizumab as first-line therapy in advanced nonsquamous NSCLC, which showed that atezolizumab plus CnP resulted in clinical benefit in overall survival (OS) and PFS across PD-L1–high, PD-L1–low, and PD-L1–negative subgroups.
  • Recently reported results from the phase III FLAURA trial3 that evaluated resistance mechanisms in treatment-naïve patients with EGFR mutation-positive advanced NSCLC who received osimertinib versus standard EGFR TKIs, showing heterogeneous resistance mechanisms in those who received osimertinib and those who received standard-of-care EGFR TKIs, with novel acquired mutations, namely MET amplification and the EGFR C797S mutation, in those treated with osimertinib.

“Overall, this [ALTA-1L] was a very positive trial for brigatinib, and it really solidifies its use as a frontline therapy.”
— David R. Gandara, MD

References

  1. Popat S, Kim HR, Ahn MJ, et al. Intracranial efficacy of brigatinib (BRG) vs crizotinib (CRZ) in the phase III ALTA-1L trial. Presented at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. Abstract LBA58.
    https://oncologypro.esmo.org/Meeting-Resources/ESMO-2018-Congress/Intracranial-efficacy-of-brigatinib-BRG-vs-crizotinib-CRZ-in-the-phase-3-ALTA-1L-trial. Accessed May 1, 2019.
  2. Cappuzzo F, McCleod M, Hussein M, et al. IMpower130: Progression-free survival (PFS) and safety analysis from a randomized phase 3 study of carboplatin + nab-paclitaxel (CnP) with or without atezolizumab (atezo) as first-line (1L) therapy in advanced non-squamous NSCLC. Presented at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. Abstract LBA53.
    https://oncologypro.esmo.org/Meeting-Resources/ESMO-2018-Congress/IMpower130-Progression-free-survival-PFS-and-safety-analysis-from-a-randomised-phase-3-study-of-carboplatin-nab-paclitaxel-CnP-with-or-without-atezolizumab-atezo-as-first-line-1L-therapy-in-advanced-non-squamous-NSCLC. Accessed May 1, 2019.
  3. Ramalingam SS, Cheng Y, Zhou C, et al. Mechanisms of acquired resistance to first-line osimertinib: preliminary data from the phase III FLAURA study. Presented at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. Abstract LBA50.
    https://oncologypro.esmo.org/Meeting-Resources/ESMO-2018-Congress/Mechanisms-of-acquired-resistance-to-first-line-osimertinib-preliminary-data-from-the-phase-III-FLAURA-study. Accessed May 1, 2019.

2 of 3
Insights from Bernard Escudier, MD, PER Pulse™ Recap:
Cancer Summaries and Commentaries™: Update from Munich: Advances in the Treatment of Lung Cancer, Genitourinary Malignancies, and Gynecologic Malignancies

As a follow-up to this continuing medical education (CME)-certified activity, Cancer Summaries and Commentaries™: Update from Munich: Advances in the Treatment of Lung Cancer, Genitourinary Malignancies, and Gynecologic Malignancies, this second of 3 PER Pulse™ Recaps summarizing the online program focuses on clinical trial design and results from the ESMO 2018 Congress and how these data from recent trials influence practical guidance regarding clinical decision making for patients with genitourinary malignancies. Below are some highlights from the activity featuring Dr. Escudier:

  • Discussion of the phase II TRITON2 trial1 of rucaparib in patients with metastatic castration-resistant prostate cancer with homologous repair gene alterations, which showed that nearly 50% of those with a BRCA alteration had a confirmed prostate-specific antigen response or investigator-assessed RECIST response.
  • Overview of the phase III JAVELIN Renal 101 trial2 of avelumab plus axitinib versus sunitinib as first-line therapy in advanced renal cell carcinoma, demonstrating progression-free survival (PFS) was 13.7 months for avelumab plus axitinib compared with 8.4 months for sunitinib in patients regardless of their PD-L1 expression status.
  • Recently reported results from the phase II CheckMate 032 trial that evaluated nivolumab alone or in combination with ipilimumab in patients with platinum-pretreated metastatic urothelial carcinoma, showing that the higher dosage of ipilimumab (3 mg/kg) in combination with nivolumab resulted in greater (objective response rate (ORR) and longer PFS than previously reported outcomes of immune checkpoint inhibitors when used as monotherapies in this patient population.

“Overall, the study of rucaparib in patients with metastatic prostate cancer with resistance to previous therapy is both encouraging in terms of activity, because almost 50% of the patients do benefit from this drug in this specific patient population.”
— Bernard Escudier, MD

References

  1. Abida W, Bryce AH, Vogelzang NJ, et al. Preliminary results from TRITON2: A phase II study of rucaparib in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) associated with homologous recombination repair (HRR) gene alterations. Presented at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. Abstract 793PD.
    https://oncologypro.esmo.org/Meeting-Resources/ESMO-2018-Congress/Preliminary-results-from-TRITON2-a-phase-2-study-of-rucaparib-in-patients-pts-with-metastatic-castration-resistant-prostate-cancer-mCRPC-associated-with-homologous-recombination-repair-HRR-gene-alterations. Accessed May 1, 2019.
  2. Motzer RJ, Penkov K, Haanen JB, et al. JAVELIN Renal 101: A randomized, phase III study of avelumab + axitinib vs sunitinib as first-line treatment of advanced renal cell carcinoma (aRCC). Presented at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. Abstract LBA6_PR.
    https://www.esmo.org/Press-Office/Press-Releases/Javelin101-renal-cancer-immunotherapy-Motzer. Accessed May 1, 2019.
  3. Rosenberg JE, Sharma P, de Braud FG, et al. Nivolumab (N) alone or in combination with ipilimumab (I) in patients (pts) with platinum-pretreated metastatic urothelial carcinoma (mUC), including the nivolumab 1 mg/kg + ipilimumab 3 mg/kg expansion from CheckMate 032. Presented at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. Abstract LBA32.
    https://oncologypro.esmo.org/Meeting-Resources/ESMO-2018-Congress/Nivolumab-N-Alone-or-in-Combination-With-Ipilimumab-I-in-Patients-pts-With-Platinum-Pretreated-Metastatic-Urothelial-Carcinoma-mUC-Including-the-Nivolumab-1-mg-kg-Ipilimumab-3-mg-kg-Expansion-From-CheckMate-032. Accessed May 1, 2019.

3 of 3
Insights from Richard T. Penson, MD, PER Pulse™ Recap:
Cancer Summaries and Commentaries™: Update from Munich: Advances in the Treatment of Lung Cancer, Genitourinary Malignancies, and Gynecologic Malignancies

As a follow-up to this continuing medical education (CME)-certified activity, Cancer Summaries and Commentaries™: Update from Munich: Advances in the Treatment of Lung Cancer, Genitourinary Malignancies, and Gynecologic Malignancies, this third of 3 PER Pulse™ Recaps summarizing the online program focuses on clinical trial design and results from the ESMO 2018 Congress and how these data from recent trials influence practical guidance regarding clinical decision making for patients with gynecologic malignancies. Below are some highlights from the activity featuring Dr. Penson:

  • Discussion of the phase III SOLO1 trial1 of maintenance olaparib following platinum-based chemotherapy in patients newly diagnosed with advanced ovarian cancer with a BRCA1/2 mutation, which showed that patients who received olaparib had a 70% reduction in the risk of progression or death and an estimated progression-free survival (PFS) 3 years longer as compared with placebo.
  • Overview of a phase III trial2 of carboplatin/pegylated liposomal doxorubicin/bevacizumab (CD-BEV) versus carboplatin/gemcitabine/bevacizumab (CG-BEV) in patients with recurrent ovarian cancer, demonstrating significantly longer PFS in patients treated with CD-BEV compared with CG-BEV.
  • Recently reported results from the phase II trial3 of combination nivolumab and bevacizumab in patients with recurrent ovarian cancer, showing that this combination therapy resulted in a confirmed objective response rate (ORR) of 21% and a median PFS of 9.4 months.

“This [SOLO1] is a practice-changing study… The unequivocal thing is that every patient with ovarian cancer who carries a BRCA1 or 2 mutation should be doing this switch maintenance therapy with olaparib…to try and keep them in remission longer.”
— Richard T. Penson, MD

References

  1. Moore KN, Colombo N, Scambia G, et al. Maintenance olaparib following platinum-based chemotherapy in newly diagnosed patients (pts) with advanced ovarian cancer (OC) and a BRCA1/2 mutation (BRCAm): phase III SOLO1 trial. Presented at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. Abstract LBA7_PR.
    https://oncologypro.esmo.org/Meeting-Resources/ESMO-2018-Congress/Maintenance-olaparib-following-platinum-based-chemotherapy-in-newly-diagnosed-patients-pts-with-advanced-ovarian-cancer-OC-and-a-BRCA1-2-mutation-BRCAm-Phase-III-SOLO1-trial. Accessed May 1, 2019.
  2. Pfisterer J, Dean AP, Baumann K, et al. Carboplatin/pegylated liposomal doxorubicin/bevacizumab (CD-BEV) vs. carboplatin/gemcitabine/bevacizumab (CG-BEV) in patients with recurrent ovarian cancer: a prospective randomized phase III ENGOT/GCIG-Intergroup study (AGO Study Group, AGO-Austria, ANZGOG, GINECO, SGCTG). Presented at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. Abstract 9330.
    https://oncologypro.esmo.org/Meeting-Resources/ESMO-2018-Congress/Carboplatin-pegylated-liposomal-Doxorubicin-Bevacizumab-CD-BEV-vs.-Carboplatin-Gemcitabine-Bevacizumab-CG-BEV-in-patients-with-recurrent-ovarian-cancer.-A-prospective-randomized-phase-III-ENGOT-GCIG-Intergroup-study-AGO-Study-Group-AGO-Austria-ANZG. Accessed May 1, 2019.
  3. Liu JF, Herold C, Luo W, et al. A phase II trial of combination nivolumab and bevacizumab in recurrent ovarian cancer. Presented at: ESMO 2018 Congress; October 19-23, 2018; Munich, Germany. Abstract 937PD.
    https://oncologypro.esmo.org/Meeting-Resources/ESMO-2018-Congress/A-phase-2-trial-of-combination-nivolumab-and-bevacizumab-in-recurrent-ovarian-cancer. Accessed May 1, 2019.

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