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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 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physicians' Education Resource®, LLC is approved by the California Board of Registered Nursing, Provider #16669 for 2.0 Contact Hours.

Resources

PER Pulse™ Recaps for Medical Crossfire®: Translating Recent Data into Informed Sequencing Decisions in Advanced Non–Small Cell Lung Cancer

Acknowledgment of Commercial Support

This activity is supported by an educational grant from Lilly.

For further information concerning Lilly grant funding visit www.lillygrantoffice.com.

Medical Crossfire®: Translating Recent Data Into Informed Sequencing Decisions in Advanced Non–Small Cell Lung Cancer

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

 

Activity Overview

Medical Crossfire®: Translating Recent Data Into Informed Sequencing Decisions in Advanced Non–Small-Cell Lung Cancer will highlight best practices in the care of patients with lung cancers.

This interactive and dynamic session will aid physicians, nurse practitioners, and nurses in assessing the wealth of new data, choosing treatment based upon patient and tumor characteristics and applying those findings to their practices. This case-based activity will serve to update practitioners on advances in the field, with a particular focus on optimized advanced strategies for patients with non–small-cell lung cancer (NSCLC), practical information concerning how to assess response and when to switch therapies, and multidisciplinary methods to facilitate proactive management of treatment-related adverse effects. The activity will use a variety of formats, including presentation of new data, clinical scenarios exploring the evidence behind treatment decisions and adverse-event management, and faculty Q&A to encourage peer-to-expert interactions, as well as, the sharing of best practices.

  

Acknowledgment of Commercial Support

This activity is supported by an educational grant from Lilly.

For further information concerning Lilly grant funding visit www.lillygrantoffice.com.

Requirements for Successful Completion

  • 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” 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.


Target Audience

This educational activity is directed toward oncologists, nurse practitioners, nurses, and physician assistants involved in the treatment and management of patients with lung cancers. Pharmacists, researchers, fellows, and other healthcare professionals interested in the treatment of lung cancers may also participate.

Learning Objectives

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

  • Review key concepts that inform front-line clinical decision making in advanced NSCLC in the context of recent clinical trial evidence
  • Assess current and emerging testing methods to identify tumor characteristics that allow for personalized treatment strategies for patients with lung cancer
  • Discuss methods to monitor response in patients receiving treatment for advanced NSCLC
  • Review clinical trial evidence in NSCLC that informs decisions on the timing of treatment switching beyond disease progression
  • Summarize strategies to proactively plan for and manage treatment-related adverse events in patients with advanced NSCLC


Faculty, Staff, and Planners' Disclosures

Faculty

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

Disclosure: Grant/Research Support: AstraZeneca/Medi, Bristol- Myers Squib, Clovis, Genentech, Johnson & Johnson, Lilly, Merck, Novartis; Consultant: Ariad, AstraZeneca, Boehringer-Ingelheim, Celgene, Clovis, Genentech, Guardant Health, Lilly, Merck, Mirati, Novartis, Pfizer

Edward B. Garon, MD, MS
Associate Professor
Department of Medicine; Hematology-Oncology
David Geffen School of Medicine at UCLA
Los Angeles, CA
 

Disclosure: Grant/Research Support: AstraZeneca, Bristol-Myers Squibb, Lilly, Genentech, Merck, Novartis, Pfizer

Suresh Ramalingam, MD
Professor
Chief of Thoracic Oncology
Director of Medical Oncology
Winship Cancer Institute of Emory University
Atlanta, GA

Disclosure: Consultant: AstraZeneca, Bristol-Myers Squibb, Boehringer-Ingelheim, Celgene, Lilly, Genentech, Novartis

Karen Reckamp, MD
Associate Professor
City of Hope Comprehensive Cancer Center
Duarte, CA

 

Disclosure: Grant/Research Support: To institution: Ariad, Bristol- Myers Squibb, Boehringer Ingelheim, Clovis, Eisai, Novartis, Pfizer, Xcovery, Adaptimmune, Medimmune, Stemcentrx; Consultant: Amgen, Astellas, Ariad, Boehringer Ingelheim, Euclises, Nektar.

The staff of Physicians' Education Resource®, LLC 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 education purposes only, and is not meant to substitute for the independent medical judgment of a physician or nurse 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® or any of the companies that provided commercial support for this activity.

PER Pulse™ Recap



1 of 3

First-Line Therapy of Metastatic Squamous Lung Cancer

Medical Crossfire®: Translating Recent Data into Informed Sequencing Decisions in Advanced Non–Small Cell Lung Cancer featured nationally recognized lung cancer experts. The program chair, David R. Gandara, MD, along with faculty, Edward Garon, MD; Suresh Ramalingam, MD; and Karen L. Reckamp, MD, discussed updated treatment options over multiple lines of therapy for patients with advanced non–small cell lung cancer (NSCLC).

This first of 3 PER Pulse™ Recaps from this Medical Crossfire® focuses on first-line therapeutic options for patients with advanced, squamous NSCLC:

  • A major change in lung cancer therapeutic algorithms occurred in 2016 with the introduction of pembrolizumab, the immune checkpoint inhibitor, as the first-line standard of care in patients whose tumors have a PD-L1 expression ≥50%. This applies to squamous and nonsquamous histologies, although it is not indicated for patients with oncogene-driven lung cancer.
  • For patients whose tumors do not meet the ≥50% PD-L1 expression requirement, platinum-based chemotherapy remains the standard of care. Several regimens are available, including gemcitabine/platinum with or without necitumumab, paclitaxel/carboplatin, and nab-paclitaxel/carboplatin.


2 of 3
PER Pulse™ Recap

Subsequent Lines of Therapy in Metastatic Squamous Lung Cancer

Medical Crossfire®: Translating Recent Data into Informed Sequencing Decisions in Advanced Non–Small Cell Lung Cancer featured nationally recognized lung cancer experts. The program chair, David R. Gandara, MD, along with faculty, Edward Garon, MD; Suresh Ramalingam, MD; and Karen L. Reckamp, MD, discussed updated treatment options over multiple lines of therapy for patients with advanced non–small cell lung cancer (NSCLC).

This second of 3 PER Pulse™ Recaps from this Medical Crossfire® focuses on the management of patients with squamous NSCLC whose disease progresses after first-line therapy:

  • For patients who received chemotherapy in the first-line setting, immunotherapy has become the standard of care based on phase III trials demonstrating superior overall survival with antibodies to PD-1 or PD-L1 compared with the previous standard of docetaxel. Several immunotherapeutic options are available, including nivolumab, pembrolizumab, and atezolizumab.
  • In patients who received immunotherapy in the first-line setting, platinum-based chemotherapy may be considered. The options would be similar to the frontline setting and include gemcitabine/platinum with or without necitumumab, paclitaxel/carboplatin, and nab-paclitaxel/carboplatin.
  • Following chemotherapy-based and immunotherapy-based lines of therapy, docetaxel with or without ramucirumab may be considered based on patient and disease characteristics. In patients with squamous NSCLC, single-agent afatinib is indicated after platinum-based chemotherapy.

3 of 3
PER Pulse™ Recap

Subsequent Lines of Therapy in Metastatic Nonsquamous Lung Cancer

Medical Crossfire®: Translating Recent Data into Informed Sequencing Decisions in Advanced Non–Small Cell Lung Cancer featured nationally recognized lung cancer experts. The program chair, David R. Gandara, MD, along with faculty, Edward Garon, MD; Suresh Ramalingam, MD; and Karen L. Reckamp, MD, discussed updated treatment options for patients with advanced non–small cell lung cancer (NSCLC) over multiple lines of therapy.

This third of 3 PER Pulse™ Recaps from this Medical Crossfire® focuses on the management of patients with nonsquamous NSCLC whose disease progresses after first-line therapy:

  • For patients with oncogene-driven disease, the use of all available targeted therapies is preferred prior to switching to chemotherapy or immunotherapy:
    • For NSCLC driven by mutations in the epidermal growth factor receptor (EGFR) gene, osimertinib is indicated in patients with progressive disease and the T790M resistance mutation.
    • For patients whose disease is driven by rearrangements in the anaplastic lymphoma kinase gene, ceritinib and alectinib are currently available upon disease progression with first-line crizotinib.
  • After available targeted therapies have been exhausted, platinum-based chemotherapy may be considered. Following disease progression on a platinum-based regimen, limited data are available, but subset analyses of phase III trials showed a lack of overall survival benefit with immunotherapy compared with docetaxel in patients with EGFR mutations. Therefore, docetaxel with or without ramucirumab may be considered following progression on platinum-based chemotherapy, with immunotherapy reserved as subsequent treatment.
  • In patients with no identified actionable oncogenic driver, treatment after progression on first-line therapy would be similar to that of patients with squamous NSCLC, although afatinib is not approved in this setting for patients with nonsquamous histology.






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