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 Celgene Corporation.

Oncology Briefings™: Treating Advanced NSCLC Without Actionable Mutations


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

Activity Overview

This activity, Oncology Briefings™: Treating Advanced NSCLC Without Actionable Mutations, developed in Physicians’ Education Resource, LLC, (PER®) established Oncology Briefings™ legacy format, is an online interactive monograph that provides treatment strategies for patients with advanced non-small cell lung cancer (NSCLC) without actionable mutations. This presentation features a national thought leader, Thomas E. Stinchcombe, MD, who provides key insights.

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Celgene Corporation.

 

Instructions for This Activity and Receiving Credit

  • 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 files” will be available for your reference.
  • In order to receive a CME 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 certificate upon completion of these steps.


Target Audience

This activity is directed toward oncology healthcare professionals who treat patients with lung cancer, including medical oncologists, radiology oncologists, and surgical oncologists. Fellows, nurses, nurse practitioners, pulmonologists, physician assistants, and other healthcare professionals involved in the management of patients with lung cancers are also invited to participate.

Educational Objectives

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

  • Discuss current and emerging strategies for the treatment of patients with advanced NSCLC without actionable oncogenic drivers in the frontline setting and beyond
  • Integrate emerging clinical data on systemic and immunotherapeutic combination treatment strategies into the paradigm for advanced lung cancer
  • Determine initial and subsequent therapeutic options for patients with lung cancer without actionable mutations
  • Identify and mitigate treatment-related adverse events in the overall management of patients with lung cancers

Faculty, Staff, and Planners' Disclosures

Faculty

Thomas E. Stinchcombe, MD
Professor of Medicine
Duke Cancer Institute
Durham, NC
 
 

Disclosure: Grant/Research Support: AstraZeneca, Genentech/Roche, Takeda (institution); Consultant: Takeda, Novartis, Genentech/Roche, AstraZeneca

The staff of PER® have no relevant financial relationships with commercial interests to disclose.

Disclosure Policy and Resolution of Conflicts of Interest

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 conflict of interest (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 only, and is not meant to substitute for the independent clinical 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 member, and do not reflect those of PER® or the company that provided commercial support for this activity.

PER Pulse™ Recaps

1 of 3


In this continuing medical education (CME)-certified activity, Oncology Briefings™: Treating Advanced NSCLC Without Actionable Mutations, expert faculty Thomas Stinchcombe, MD, discusses recent treatment decisions and therapeutic options for advanced non-small cell lung cancer (NSCLC) for patients who do not have targetable genetic mutations or rearrangements.
 
This first of 3 PER Pulse™ Recaps summarizing the online program focuses on evidence-based, practical guidance regarding the evaluation of genetic alterations in NSCLC, and how these markers can guide therapeutic decision-making using available targeted agents, as outlined in the National Comprehensive Cancer Network (NCCN) Guidelines.1 Below are some highlights from the activity featuring Dr. Stinchcombe:

  • Discussion of NCCN recommendations for a broad sequencing panel that includes EGFR mutations, ALK rearrangements, ROS1 rearrangements, and BRAF mutations, and PD-L1 testing as a part of the routine workup for all patients with NSCLC, and prior to first-line therapy initiation1
  • Overview of several targeted agents, both as first-line and subsequent therapy, directed at these genetic alterations that are available and provide a vehicle for improving outcomes for patients with NSCLC1
  • Review of the importance of tumor histology, including PD-L1 expression levels, and other factors to help guide therapeutic decisions for patients with NSCLC who do not have actionable mutations1

“I think that histology still remains important, particularly when selecting the chemotherapy platform. I think for patients with high PD-L1, you have the pembrolizumab monotherapy as an option. But maybe for patients with lower PD-L1, currently the carboplatin-pemetrexed-pembrolizumab combinations are a therapeutic option for patients.”

— Thomas E. Stinchcombe, MD

Reference

  1. National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Non-Small Cell Lung Cancer. Version 6. 2018. Published August 17, 2018. https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed September 26, 2018.

 
2 of 3

As a follow-up to this continuing medical education (CME)-certified activity, Oncology Briefings™: Treating Advanced NSCLC Without Actionable Mutations, this second of 3 PER Pulse™ Recaps summarizing the online program focuses on evidence-based, practical guidance regarding clinical decision-making for patients with advanced non-small cell lung cancer (NSCLC) without actionable mutations, including discussion of recent clinical trial results. Treatment for these patients may include chemotherapies, immunotherapies, and radiation/surgical therapies.1 Below are some highlights from the activity featuring Dr. Stinchcombe:

  • Discussion of notable changes in the National Comprehensive Cancer Network (NCCN) Guidelines for patients with PD-L1 levels greater than or less than 50% and the indicated therapeutic options1
  • Clinical impact of the KEYNOTE-042 study,2 comparing pembrolizumab monotherapy with chemotherapy in the first-line setting for patients with advanced NSCLC, and the KEYNOTE-407 study,3 comparing pembrolizumab plus carboplatin and paclitaxel/nab-paclitaxel with chemotherapy alone in patients with metastatic squamous NSCLC, with both data sets showing a survival benefit with the addition of pembrolizumab
  • Overview of the key immune-related adverse events associated with immunotherapy for patients with NSCLC, and the strategies used to manage those challenges1

“I think that this is an emerging field, especially one that has been rapidly adopted with immunotherapies as a first-line treatment option. I think going forward, we are going to really focus on refining that patient population that is most likely to benefit.”

— Thomas E. Stinchcombe, MD

References

  1. National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Non-Small Cell Lung Cancer. Version 6. 2018. Published August 17, 2018. https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed September 26, 2018.
  2. Lopes G, Wu Y-L, Kudaba I, et al. Pembrolizumab versus platinum-based chemotherapy as first-line therapy for advanced/metastatic NSCLC with a PD-L1 tumor proportion score (TPS) ≥1%: open-label, phase 3 KEYNOTE-042 study. Presented at the 2018 American Society of Clinical Oncology Annual Meeting; June 1-5, 2018; Chicago, IL. Abstract LBA4.
  3. Paz-Ares LG, Luft A, Tafreshi A, et al. Phase 3 study of carboplatin-paclitaxel/nab-paclitaxel with or without pembrolizumab for patients with metastatic squamous non-small cell lung cancer. Presented at the 2018 American Society of Clinical Oncology Annual Meeting; June 1-5, 2018; Chicago, IL. Abstract 105.

 
3 of 3

As a follow-up to this continuing medical education (CME)-certified activityOncology Briefings™: Treating Advanced NSCLC Without Actionable Mutations, this third of 3 PER Pulse™ Recaps summarizing the online program focuses on evidence-based, practical guidance regarding clinical decision-making for patients with advanced non-small cell lung cancer (NSCLC) without actionable mutations in the second-line setting and in those with reduced performance status (PS), with a special focus on safety and tolerability. Below are some highlights from the activity featuring Dr. Stinchcombe: 

  • Overview of the efficacy and tolerability of nab-paclitaxel/carboplatin regimens in the ABOUND.70+ study,1 which evaluated elderly patients with advanced NSCLC who received either staggered or continuous therapy, and in the ABOUND PS2 study,2 which evaluated response in chemotherapy-naïve patients with advanced NSCLC and ECOG PS 2
  • Based on recent clinical trial data, the integration of the checkpoint inhibitors, atezolizumab, nivolumab, and pembrolizumab, into current National Comprehensive Cancer Network (NCCN) Guidelines as preferred treatment options for patients with PS 0-2 without genetic alterations and who have progressed on initial therapy, regardless of histologic subtype3
  • Discussion of treatment-emergent adverse events for both chemotherapy and immunotherapy regimens, with dosing considerations outlined in clinical trials and other interventions for toxicity management with immunotherapy

“I think more and more, our second-line treatment options are greatly influenced by our first-line selection. For patients who’ve gotten pembrolizumab monotherapy, a platinum doublet has been my preferred option. For patients who’ve gotten carboplatin-pemetrexed-pembrolizumab, I think single-agent chemotherapy, such as docetaxel or docetaxel and ramucirumab, are options.”

— Thomas E. Stinchcombe, MD

References

  1. Langer CJ, Kim ES, Anderson EC, et al. nab-paclitaxel-based therapy in underserved patient populations: the ABOUND.70+ study in elderly patients with advanced NSCLC [published online July 24, 2018]. Front Oncol. 2018;8:262. DOI: 10.3389/fonc.2018.00262.
  2. Gajra A, Karim NA, Mulford DA, et al. nab-paclitaxel-based therapy in underserved patient populations: the ABOUND.PS2 study in patients with NSCLC and a performance status of 2 [published online July 24, 2018]. Front Oncol. 2018;8:253. doi: 10.3389/fonc.2018.00253.
  3. National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Non-Small Cell Lung Cancer. Version 6. 2018. Published August 17, 2018. https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed September 25, 2018.

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