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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 live activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credits 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.

Acknowledgment of Commercial Support

This activity is supported by educational grants from AstraZeneca, Genomic Health, Inc, and Lilly.

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

Enduring CME activity from the School of Breast Oncology®: 2018 Mid-Year Video Update


Release Date: September 28 2018
Expiration Date: September 28 2019
Media: Internet - based

Activity Overview

Since 2003, the School of Breast Oncology® (SOBO®) has revolutionized the advancement of patient care by offering world-class comprehensive continuing education programming for oncologists and healthcare professionals involved in the treatment of breast cancer. To extend this educational initiative further, the SOBO®: 2018 Mid-Year Video Update aired on August 27, 2018, as a live-stream, interactive broadcast featuring leading experts in the field of breast cancer who provided a comprehensive overview of noteworthy data presented at recent international society meetings. The expert panel also discussed and debated the clinical application of these data and the future direction of the treatment landscape in breast cancer.

This enduring CME activity is an archive of the live broadcast that has been edited into modules for ease of access. This activity will help you to keep pace with rapidly emerging data and advancing treatment paradigms in breast cancer by augmenting your knowledge and clinical competence in several areas, including:

  • Integrating prognostic genomic assays to individualize treatment selection for early-stage, hormone receptor‒positive (HR+)/HER2-negative breast cancers
  • Evolving paradigms in (neo)adjuvant therapy for HR+, HER2+, and triple-negative breast cancers
  • Clinical insights regarding endocrine, cytotoxic, targeted, and immunotherapeutic agents for the treatment of metastatic breast cancer, including current treatment options and emerging agents
  • Trends, challenges, and controversies in the locoregional management of early-stage and locally advanced breast cancers

SOBO®: 2018 Mid-Year Video Update brings conference-caliber education to the convenience of your screen!

Benefits of Attending

  • Insights into using predictive and prognostic biomarkers for treatment selection
  • Tactics for individualizing therapy for early-stage and locally advanced breast cancers
  • Strategies for integrating new agents for metastatic disease
  • Innovations in locoregional management approaches

Acknowledgement of Commercial Support

This activity is supported by educational grants from AstraZeneca, Genomic Health, Inc, and Lilly.

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

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 educational activity is directed toward medical, surgical, and radiation oncologists involved in the treatment and management of patients with breast cancer. Fellows, nurse practitioners, nurses, physician assistants, pharmacists, researchers, and other healthcare professionals interested in the treatment of breast cancer may also participate.

Learning Objectives

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

  • Assess recently presented efficacy and safety data from clinical trials conducted in the setting of breast cancer
  • Explain key recent findings concerning tumor testing to help optimize care for patients with breast cancer
  • Appraise recent evidence regarding treatment sequencing and combination strategies for patients who may be candidates for new therapies for breast cancer
  • Develop evidence-based treatment plans for patients with breast cancer, incorporating new treatment options when appropriate

Faculty, Staff, and Planners' Disclosures

Faculty

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

Disclosure: Consultant: AstraZeneca, Novartis, Lilly, Pfizer

Claudine Isaacs, MD
Professor
Medical Director, Fisher Center for Familial Cancer Research
Co-Director, Breast Cancer Program
Georgetown University
Washington, DC

Disclosure: Consultant: AstraZeneca, Pfizer, Genentech; Speaker's Bureau: AstraZeneca, Pfizer, Genentech

Ruth O'Regan, MD
Chief, Division of Hematology/Oncology
University of Wisconsin
Carbone Cancer Center
Madison, WI
 

Disclosure: Grant/Research Support: Novartis, Pfizer, Eisai; Consultant: Novartis, Biotheranostics, Pfizer, Lilly, Genomic Health, Genentech

Lawrence J. Solin, MD, FACR, FASTRO
Chairman, Department of Radiation Oncology
Albert Einstein Healthcare Network
Philadelphia, PA
 
 

Disclosure: No financial relationships with commercial interests to disclose.

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 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 Recap™

PER Pulse Recap (1 of 3)

Insight from Ruth O’Regan, MD – PER Pulse™ Recap: SOBO®: 2018 Mid-Year Video Update

SOBO®: 2018 Mid-Year Video Update is a continuing medical education (CME)-certified archive of a live-stream, interactive broadcast that aired on August 27, 2018. For this program, chairperson Joyce O’Shaughnessy, MD, was joined by expert faculty Ruth O’Regan, MD, Claudine Isaacs, MD, and Lawrence J. Solin, MD, to discuss the implications and clinical applications of noteworthy data regarding the treatment of breast cancer presented at recent international society meetings.

This first of 3 PER Pulse™ Recaps summarizing the online activity focuses on strategies for individualizing decision-making with regard to adjuvant therapy strategies for patients with early-stage breast cancer. Below are some highlights from the activity featuring Dr. O’Regan:

  • Results from the prospective TAILORx trial in the subgroup of 6711 patients with hormone receptor–positive (HR+)/HER2+, node-negative breast cancer with an intermediate recurrence score (RS; 11-25) using the Oncotype DX assay, which showed that endocrine therapy was statistically noninferior to chemotherapy plus endocrine therapy in the intent-to-treat population. However, exploratory analysis suggests that there may be some benefit for chemotherapy in patients age ≤50 years with an RS between 16-25.
  • Updated results from the SOFT and TEXT trials, which compared ovarian suppression in combination with either tamoxifen or exemestane versus tamoxifen alone in premenopausal patients with HR+ early-stage breast cancer. STEPP analysis suggested that women with higher composite risk factors derived the greatest benefit from the combination of ovarian suppression plus an aromatase inhibitor. However, there was no improvement in overall survival with this combination compared with tamoxifen alone, despite a significant decrease in distant recurrences.
  • An overview of prognostic gene expression assays, and their ability to predict recurrence risk between years 5 and 10 post-diagnosis in patients with HR+ breast cancer.
  • A review of updated HER2 testing guidelines from the American Society of Clinical Oncology and the College of American Pathologists, focusing on algorithms for the evaluation of HER2 gene amplification.

“One of the questions that TAILORx brings up in these younger women is, do they all need chemotherapy, or would perhaps some of them do fine if they had ovarian suppression?”
— Ruth O’Regan, MD


PER Pulse Recap (2 of 3)

Insight from Claudine Isaacs, MD – PER Pulse™ Recap: SOBO®: 2018 Mid-Year Video Update

SOBO®: 2018 Mid-Year Video Update is a continuing medical education (CME)-certified archive of a live-stream, interactive broadcast that aired on August 27, 2018. For this program, chairperson Joyce O’Shaughnessy, MD, was joined by expert faculty Ruth O’Regan, MD, Claudine Isaacs, MD, and Lawrence J. Solin, MD, to discuss the implications and clinical applications of noteworthy data regarding the treatment of breast cancer presented at recent international society meetings.

This second of 3 PER Pulse™ Recaps summarizing the online activity focuses on evolving standards and emerging therapies for patients with metastatic breast cancer (MBC). Below are some highlights from the activity featuring Dr. Isaacs:

  • A review of results from the numerous phase III trials of CDK4/6 inhibitors in combination with endocrine therapies for hormone receptor–positive (HR+)/HER2-negative MBC. Notably, these agents have now been shown to significantly improve progression-free survival (PFS) with either a nonsteroidal aromatase inhibitor (AI) or fulvestrant as first-line therapy, and in AI-pretreated patients in combination with fulvestrant in the second or third line.
    • A recent pooled analysis performed by the US Food and Drug Administration (FDA) showed that the magnitude of benefit is similar across all patient subsets, including those with progesterone receptor–negative disease, de novo metastatic disease, or lobular histology.
  • Results from the phase III OlympiAD and EMBRACA trials, which compared the PARP inhibitors olaparib and talazoparib, respectively, versus chemotherapy in anthracycline- and taxane-pretreated, BRCA1/2-mutated MBC. Both trials showed a significant improvement in PFS with the PARP inhibitor. Based on these results, olpaparib has received FDA approval for this indication, and talazoparib is undergoing regulatory review.
  • A summary of early-phase trials evaluating immune checkpoint inhibitors in metastatic triple-negative breast cancer (mTNBC), showing activity with these agents both for monotherapy and in combination with chemotherapy. In addition, a recent press release reported that the IMPASSION130 trial comparing nab-paclitaxel with atezolizumab or placebo in mTNBC was positive, showing a significant improvement in PFS with atezolizumab in the intent-to-treat and PD-L1–positive populations; full results are expected to be presented at an upcoming scientific meeting.
  • An overview of novel antibody-drug conjugates under evaluation for MBC, including sacituzumab govitecan, ladiratuzumab vedotin, trastuzumab deruxtecan, and trastuzumab duocarmazine.

“The results were extraordinarily consistent across the trials. CDK4/6 inhibitors are associated with somewhere between a 9 – 10 month prolongation in progression-free survival [first-line], and the hazard ratios are virtually superimposable.”
— Claudine Isaacs, MD


PER Pulse Recap (3 of 3)

Insight from Lawrence J. Solin, MD – PER Pulse™ Recap: SOBO®: 2018 Mid-Year Video Update

SOBO®: 2018 Mid-Year Video Update is a continuing medical education (CME)-certified archive of a live-stream, interactive broadcast that aired on August 27, 2018. For this program, chairperson Joyce O’Shaughnessy, MD, was joined by expert faculty Ruth O’Regan, MD, Claudine Isaacs, MD, and Lawrence J. Solin, MD, to discuss the implications and clinical applications of noteworthy data regarding the treatment of breast cancer presented at recent international society meetings.

This third of 3 PER Pulse™ Recaps summarizing the online activity focuses on trends, challenges, and controversies in the locoregional management of early-stage and locally advanced breast cancers. Below are some highlights from the activity featuring Dr. Solin:

  • Controversies in the management of the axilla and nodal regions, including:
    • 10-year results from the IBCSG 23-01 trial comparing axillary dissection versus no axillary dissection in patients with micrometastases only in a sentinel node, showing no difference in overall survival (OS) or disease-free survival.
    • Results from the EORTC 22922/10925 trial evaluating the benefit of radiation to the internal mammary and medial supraclavicular (IM/MS) nodes in patients with stage I-III breast cancer with involved axillary nodes or a central/medial tumor. IM/MS radiation significantly reduced breast cancer mortality at 15 years, but there was no significant difference in OS.
  • An overview of molecular tools for assisting in locoregional treatment decision-making in patients with ductal carcinoma in situ (DCIS), including the DCIS Score with refinements integrating clinical/pathologic factors, and the DCIS Biologic Risk Signature.
  • A summary of appropriate surgical margins for patients with early-stage breast cancer undergoing breast-conserving surgery. Current guidelines from the Society of Surgical Oncology and the American Society for Radiation Oncology indicate that no tumor on ink is sufficient; however, a recent meta-analysis suggests that recurrence risk is further reduced with margins of 2 mm or 5 mm.

“We live in a very interesting time because we have trials that pull us in two different directions. We have a number of randomized trials that favor less aggressive surgical and radiotherapy treatment, so-called ‘de-escalation of therapy.’ But conversely, we also have randomized trials in favor of more aggressive radiation treatment.”
— Lawrence J. Solin, MD







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