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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 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.

Repurposing Statement

If you previously participated and received credit for the live CME/CE-certified webcast, School of Breast Oncology®: Mid-Year Video Update, which was held August 17, 2017, in Cranbury, New Jersey, please note that you will not receive credit for completing this activity. Participants who take part in an identical activity, even to validate learning or to clarify specific topics, cannot claim, nor will Physicians’ Education Resource®, LLC award, duplicate credit for the activity.

Acknowledgment of Commercial Support

This activity is supported by educational grants from Eisai Inc. and Lilly.

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

School of Breast Oncology®: Mid-Year Video Update Online

Release Date: September 30, 2017
Expiration Date: September 30, 2018
Media: Internet - based

 

Activity Overview

Since 2003, the School of Breast Oncology® (SOBO®) has revolutionized the advancement of patient care, and offers world-class continuing education programming for oncologists and healthcare professionals involved in the treatment of breast cancer. SOBO® emphasizes the latest in clinical data, from breast cancer diagnosis and screening to prevention and treatment.

Following 14 years of innovation and leadership, SOBO® continues to revolutionize the field of breast cancer education, and is proud to announce an educational extension to the conference: School of Breast Oncology®: Mid-Year Video Update. Mid-Year Video Update aired on August 17, 2017, as a live webcast, and enabled healthcare professionals from anywhere in the world to connect with leading experts to hear them discuss the latest clinical data and how to immediately incorporate advances into practice. This enduring CME activity is an archive of the live broadcast that has been edited into modules for ease of access.

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

Acknowledgment of Commercial Support

This activity is supported by educational grants from Eisai Inc. and Lilly.

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

CME/CE Activity Table of Contents

  • Introduction
  • New Advances in the Systemic Treatment of Early-Stage Breast Cancer
  • Panel Discussion
  • New Advances in the Systemic Treatment of Metastatic Breast Cancer
  • Panel Discussion
  • New Advances in Locoregional Control of Breast Cancer
  • Panel Discussion and Conclusion

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/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 medical oncologists, surgical oncologists, 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

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

  • Review the design and endpoints of noteworthy clinical trial studies that are focused on evaluating novel strategies in breast cancer treatment and management
  • Assess emerging data and novel strategies in the treatment of patients with breast cancer
  • Discuss how emerging evidence regarding novel agents and evolving strategies can be placed into clinical context for the treatment of breast cancer

Faculty, Staff, and Planners' Disclosures

Program Director

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: Arno Therapeutics, AstraZeneca, Celgene, Corcept Therapeutics, Eisai, Genentech, GlaxoSmithKline, Lilly, J&J, Merrimack, Novartis, Pfizer, Roche, Sanofi, Takeda, Medfusion

Faculty

William J. Gradishar, MD, FASCO, FACP
Betsy Bramsen Professor of Breast Oncology
Interim Chief, Division of Hematology/Oncology
Robert H. Lurie Comprehensive Cancer Center of Feinberg School of Medicine
Northwestern University
Chicago, IL

Disclosure: No relevant financial relationships with commercial interests to disclose.

Eleftherios Mamounas, MD, MPH, FACS
Medical Director, Comprehensive Breast Program
UF Health Cancer Center - Orlando Health
Orlando, FL
 
 

Disclosure: Consultant: Genomic Health Inc, Genentech, Pfizer, Novartis, Biotheranostics, Bayer, GRAIL, Cellucity; Speaker’s Bureau: Genomic Health Inc, Genentech/Roche

Joseph Sparano, MD
Professor of Medicine & Women’s Health
Albert Einstein College of Medicine
Montefiore Medical Center
Bronx, NY
 

Disclosure: Grant/Research Support: Deciphera, Prescient; Consultant: Genentech, Eli Lilly, Pfizer, Juno, AstraZeneca, Novartis; Stock/Shareholder: MetaStat

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/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 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®.

CME/CE Provider Contact Information

Physicians’ Education Resource®, LLC
2 Clarke Drive
Suite 110
Cranbury, NJ 08512
info@gotoper.com




PER Pulse™ Recap (1 of 3)

Since 2003, the School of Breast Oncology® (SOBO®) has provided world-class continuing education programming for oncologists and healthcare professionals involved in the treatment of breast cancer. SOBO® emphasizes the latest in clinical data, from breast cancer diagnosis and screening to prevention and treatment. Following 14 years of innovation and leadership, SOBO® continues to revolutionize the field of breast cancer education and is proud to announce an educational extension to the conference, School of Breast Oncology®: Mid-Year Video Update. The Mid-Year Video Update aired on August 17, 2017, as a live webcast and enabled healthcare professionals from anywhere in the world to connect with leading experts and hear them discuss the latest clinical data and how to immediately incorporate advances into practice.

This enduring CME activity is an archive of the live broadcast that has been edited into modules for ease of access. In this activity, distinguished breast cancer experts Joyce O’Shaughnessy, MD; William J. Gradishar MD, FASCO, FACP; Eleftherios Mamounas MD, MPH, FACS; and Joseph Sparano, MD, review the latest advances in breast cancer care and provide their perspectives on how to apply emerging data to clinical practice. This first of 3 PER Pulse™ Recaps focuses on recent advances in systemic therapies for early-stage breast cancers.

  • On July 17, 2017, the US Food and Drug Administration approved the HER2-directed tyrosine kinase inhibitor, neratinib, for the extended adjuvant treatment of patients with early stage HER2-positive breast cancer following trastuzumab-based adjuvant therapy. Treatment with neratinib significantly improved 2-year invasive disease-free survival (iDFS) compared with placebo in the phase III ExteNet trial. Not seen in other HER2 adjuvant trials, the subgroup of phase III ExteNet trial patients with hormone receptor (HR)-positive/centrally confirmed HER2-positive breast cancers derived the greatest benefit.
  • Results from the phase III APHINITY trial were recently published and show that adding pertuzumab to standard adjuvant chemotherapy with 1 year of trastuzumab significantly improved 3-year iDFS. Benefits appeared to be greater in node-positive disease compared with node-negative disease.
  • Results from 3 randomized trials investigating the value of anthracyclines in adjuvant chemotherapy demonstrate that for patients with high-risk HER2-negative breast cancers, inclusion of an anthracycline significantly improves iDFS compared with a regimen containing only a taxane and cyclophosphamide.
  • Numerous studies’ results demonstrate a benefit for extending adjuvant endocrine therapy beyond 5 years, but this decision needs to be individualized based on considerations such as recurrence risk, tolerance of endocrine therapy, age and comorbidities, bone health, and reproductive goals (in premenopausal women). Several gene expression assays are undergoing evaluation for their ability to assess risk of late recurrence in patients with HR-positive breast cancer.

For additional commentary about this topic and others, please visit www.gotoper.com.




PER Pulse™ Recap (2 of 3)

Since 2003, the School of Breast Oncology® (SOBO®) has provided world-class continuing education programming for oncologists and healthcare professionals involved in the treatment of breast cancer. SOBO® emphasizes the latest in clinical data, from breast cancer diagnosis and screening to prevention and treatment. Following 14 years of innovation and leadership, SOBO® continues to revolutionize the field of breast cancer education and is proud to announce an educational extension to the conference, School of Breast Oncology®: Mid-Year Video Update. The Mid-Year Video Update aired on August 17, 2017, as a live webcast and enabled healthcare professionals from anywhere in the world to connect with leading experts and hear them discuss the latest clinical data and how to immediately incorporate advances into practice.

This enduring CME activity is an archive of the live broadcast that has been edited into modules for ease of access. In this activity, distinguished breast cancer experts Joyce O’Shaughnessy, MD; William J. Gradishar MD, FASCO, FACP; Eleftherios Mamounas MD, MPH, FACS; and Joseph Sparano, MD, review the latest advances in breast cancer care and provide their perspectives on how to apply emerging data to clinical practice. This second of 3 PER Pulse™ Recaps focuses on recent advances in systemic therapies for metastatic breast cancers (MBCs).

  • Results from 3 phase III trials (PALOMA-2/palbociclib; MONALEESA-2/ribociclib; MONARCH-3/abemaciclib) have established that adding a CDK4/6 inhibitor to an aromatase inhibitor in the first-line setting for hormone receptor (HR)-positive MBC significantly improves progression-free survival (PFS). The addition of the CDK4/6 inhibitor also increased objective response rates (ORR) and clinical benefit rates in these studies. Palbociclib and ribociclib have received regulatory approval from US the Food and Drug Administration (FDA) for use in this setting, and abemaciclib is currently undergoing regulatory review.
  • For patients with HR-positive MBC who have previously received endocrine therapy, results of the PALOMA-3 and MONARCH-2 trials showed that adding a CDK4/6 inhibitor (palbociclib or abemaciclib, respectively) to fulvestrant significantly improves PFS in this setting also. Both palbociclib and abemaciclib have received FDA approval for this indication. Ribociclib is being evaluated in combination with fulvestrant in this setting in the ongoing MONALEESA-3 trial.
  • The phase III OlympiAD trial compared treatment with the poly (ADP-ribose) polymerase (PARP) inhibitor, olaparib, versus physician’s choice of chemotherapy in patients with BRCA-mutated, anthracycline- and taxane-pretreated MBC. Results showed a significant improvement in PFS, as well as response rates, with olaparib compared with standard cytotoxic chemotherapy. Grade ≥3 anemia was more frequent with olaparib, while grade ≥3 neutropenia occurred more often with chemotherapy. Another PARP inhibitor, talazoparib, demonstrated activity in both platinum pretreated and platinum naïve BRCA-mutated MBC in a phase II study; talazoparib is currently being evaluated in the phase III EMBRACA trial.
  • Immune checkpoint inhibitors are also being investigated for triple-negative breast cancer (TNBC). In the metastatic setting, the anti–PD-1/PD-L1 antibodies, pembrolizumab and atezolizumab, have produced response rates in the range of 20% to 25% as single agents in the first-line setting, but ORRs were <10% when these agents were used as later-line therapies. These agents have also exhibited promising activity when used in combination with cytotoxic agents, such as nab-paclitaxel and eribulin. Phase III trials are underway to further evaluate these agents as single agents or in combination with cytotoxic agents for the treatment of TNBC.

For additional commentary about this topic and others, please visit www.gotoper.com.




PER Pulse™ Recap (3 of 3)

Since 2003, the School of Breast Oncology® (SOBO®) has provided world-class continuing education programming for oncologists and healthcare professionals involved in the treatment of breast cancer. SOBO® emphasizes the latest in clinical data, from breast cancer diagnosis and screening to prevention and treatment. Following 14 years of innovation and leadership, SOBO® continues to revolutionize the field of breast cancer education and is proud to announce an educational extension to the conference, School of Breast Oncology®: Mid-Year Video Update. The Mid-Year Video Update aired on August 17, 2017, as a live webcast and enabled healthcare professionals from anywhere in the world to connect with leading experts and hear them discuss the latest clinical data and how to immediately incorporate advances into practice.

This enduring CME activity is an archive of the live broadcast that has been edited into modules for ease of access. In this activity, distinguished breast cancer experts Joyce O’Shaughnessy, MD; William J. Gradishar MD, FASCO, FACP; Eleftherios Mamounas MD, MPH, FACS; and Joseph Sparano, MD, review the latest advances in breast cancer care and provide their perspectives on how to apply emerging data to clinical practice. This third of 3 PER Pulse™ Recaps focuses on recent advances in the surgical management of breast cancer.

  • New consensus guidelines regarding surgical margins for ductal carcinoma in situ (DCIS) following breast conserving surgery were issued in 2016 by the Society of Surgical Oncology, the American Society for Radiation Oncology, and the American Society of Clinical Oncology, based on a meta-analysis of 20 studies that included 8651 patients. Margins of at least 2 mm minimize the risk of ipsilateral breast tumor recurrence relative to narrower negative margin widths in patients receiving whole breast radiation therapy. The determination of whether patients with smaller negative margin widths (<2 mm) require re-excision requires clinical judgment incorporating multiple clinical factors.
  • Neoadjuvant chemotherapy has been used to convert inoperable breast cancers to operable and mastectomy candidates to candidates for breast conserving surgery. However, neoadjuvant therapy may also downstage axillary nodal involvement, thereby reducing the extent of axillary surgery needed. The feasibility and accuracy of sentinel lymph node biopsy after neoadjuvant chemotherapy has been demonstrated in single-institution studies, multi-center studies, and meta-analyses. New techniques, such as dual-agent lymphatic mapping and clipping of a clinically positive node prior to chemotherapy, may further reduce false negative rates.
  • Lymphatic mapping is most commonly performed using radiocolloids and blue dyes, but each of these agents has drawbacks, such as the potential for skin necrosis or anaphylactic reactions, as well as a high cost and the requirement for involvement of the nuclear medicine department. A newer method, using magnetic nanoparticles, has demonstrated sentinel node detection rates comparable to Tc99 ± blue dye.
  • New methods are being evaluated for localizing nonpalpable breast lesions to avoid the need for wire localization.

For additional commentary about this topic and others, please visit www.gotoper.com.








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