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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 1.5 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 1.5 Contact Hours.

Acknowledgment of Commercial Support

This activity is supported by independent educational grants from AstraZeneca and Boehringer Ingelheim Pharmaceuticals, Inc.

Year in Review: Reflecting on Recent Evidence With an Eye to the Future of Lung Cancer Management


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

 

Activity Overview

This online activity will feature a comprehensive overview of noteworthy lung cancer data presented at major society meetings, and will include expert discussions on the clinical application of these data and the future direction of the lung cancer treatment landscape.

The format for today’s Year in Review will include 3 modules of didactic presentations and interactive discussion among our panel of experts and provide insight into recent advances in immunotherapy, targeted therapy, and molecular testing/personalized medicine.

Acknowledgement of Commercial Support

This activity is supported by independent educational grants from AstraZeneca and Boehringer Ingelheim Pharmaceuticals, Inc.

CME Activity Table of Contents

  • Module 1: Immunotherapy
  • Module 2: Targeted Therapy
  • Module 3: Molecular Testing/Personalized Medicine

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 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, 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/CE certificate upon completion of these steps.


Target Audience

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

Learning Objectives

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

  • Discuss testing methods used to facilitate the application of personalized treatment strategies among patients with advanced forms of lung cancer in multiple lines of care
  • Explain recent evidence from clinical trials conducted in the setting of advanced non-small cell lung cancer (NSCLC)
  • Determine the applicability of recent trial results in the context of real-world clinical scenarios commonly encountered in care for patients with lung cancer
  • Identify planned/ongoing clinical trials intended to address remaining unanswered clinical questions in the field of advanced NSCLC management

Faculty, Staff, and Planners' Disclosures

Moderator

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: Research Grants: AstraZeneca/MedImmune, Bristol-Myers Squibb, Clovis, Genentech, Johnson & Johnson, Lilly, Merck, Novartis; Consultant: Ariad, AstraZeneca, Bayer, Boehringer Ingelheim, Celgene, Clovis, Genentech, Guardant Health, Lilly, Liquid Genomics, Merck, Mirati, Novartis, Peregrine, Pfizer, Roche Diagnostics, Synta, Trovagene

Faculty

Mark Kris, MD
Attending Physician, Thoracic Oncology Service
Memorial Sloan Kettering Cancer Center
New York, NY
 
 

Disclosure: Research Grants: AstraZeneca/MedImmune, Bristol-Myers Squibb, Clovis, Genentech, Johnson & Johnson, Lilly, Merck, Novartis; Consultant: Ariad, AstraZeneca, Bayer, Boehringer Ingelheim, Celgene, Clovis, Genentech, Guardant Health, Lilly, Liquid Genomics, Merck, Mirati, Novartis, Peregrine, Pfizer, Roche Diagnostics, Synta, Trovagene

Naiyer A. Rizvi, MD
Professor of Medicine
Director, Thoracic Oncology
Co-Director, Cancer Immunotherapy Program
Price Chair in Clinical Translational Research
Columbia University Medical Center
New York, NY

Disclosure: Consultant: Roche, AstraZeneca, Novartis, Merck, Lilly, Bristol-Myers Squibb, Pfizer, Gritstone Oncology, ARMO Biosciences.

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™ Recap

PER Pulse Recap (1 of 3)

Crossing Into New Immunology Frontiers in Lung Cancer
 
This first of 3 PER Pulse™ Recaps from this Year in Review focuses on recent developments in immunotherapy, including data in stage III non–small cell lung cancer (NSCLC).
 
  • Immunotherapy became an established therapeutic modality in locally advanced disease, with the approval of durvalumab in February 2018 for patients with unresectable stage III NSCLC whose disease does not progress after concurrent chemoradiation therapy. This approval was based on the phase III PACIFIC trial, which demonstrated a significant improvement in progression-free survival (PFS) with durvalumab compared with placebo (16.8 months vs 5.6 months, respectively; hazard ratio [HR], 0.52; P <.001); analysis of overall survival (OS) is ongoing. 
  • The combination of pembrolizumab and pemetrexed/carboplatin received accelerated approval in May 2017 for the initial treatment of patients with advanced, nonsquamous NSCLC, marking the establishment of immunotherapy-based combinations in lung cancer. Data from the phase II KEYNOTE-021 trial provided the rationale for this initial approval; data from the subsequent phase III KEYNOTE-189 trial were presented and published in April 2018. In this trial, pembrolizumab plus platinum/pemetrexed yielded a PFS of 8.8 months compared with 4.9 months with placebo plus chemotherapy (HR, 0.52; P <.001). The 12-month OS was 69% with pembrolizumab/chemotherapy and 49% in the placebo/chemotherapy group (HR, 0.49; P <.001). The OS benefit with pembrolizumab was observed even in patients with a PD-L1 expression level of <49%.
  • Additional data from the phase III IMpower150 trial were also presented in April 2018. This analysis focused on the addition of atezolizumab to paclitaxel/carboplatin/bevacizumab. In this trial, patients with molecular aberrations in the epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) genes were eligible if they had previously received ≥1 prior tyrosine kinase inhibitors. In 108 patients with EGFR or ALK aberrations, the addition of atezolizumab to bevacizumab/chemotherapy improved PFS (9.7 months vs 6.1 months; HR, 0.59), indicating that in certain contexts, patients with oncogene-driven NSCLC may receive benefit from immunotherapy.
 
To view the videos and expert commentary for this edition of Year in Review, please visit www.gotoper.com.


PER Pulse Recap (2 of 3)

EGFR and Beyond: New Options for Oncogene-Addicted Lung Cancer
 
This second of 3 PER Pulse™ Recaps from this Year in Review focuses on recent developments in targeted agents for patients with oncogene-driven non–small cell lung cancer (NSCLC).
 
  • For patients with mutations in the epidermal growth factor receptor (EGFR) gene, the phase III FLAURA demonstrated superior progression-free survival (PFS) with osimertinib compared with standard therapy (erlotinib or gefitinib; 18.9 months vs 10.2 months, respectively; HR, 0.46; P <.001), leading to FDA priority review in December 2017. Post-progression outcomes presented in April 2018 showed that patients initially receiving osimertinib had a superior time from randomization to second progression, referred to as PFS2, even when factoring in crossover in the standard-therapy arm (median not reached vs 20.0 months; HR, 0.58; P <.001). A second-generation EGFR inhibitor, dacomitinib, showed superior PFS compared with gefitinib in the phase III ARCHER 1050 trial (14.7 months vs 9.2 months, respectively; HR, 0.59; P <.0001), although this trial did not allow patients with central nervous system metastases. Dacomitinib was granted priority review by the FDA in April 2018. Finally, in January 2018, the approval of afatinib expanded to include patients with less-common EGFR mutations, including S768I, L861Q, and G719X. 
  • Other milestones included the November 2017 approval of alectinib for first-line therapy of patients with rearrangements of the anaplastic lymphoma kinase (ALK) gene, based on results of the phase III ALEX trial. Targeted agents have demonstrated activity in other oncogenes, including the approval of dabrafenib/trametinib in June 2017 for patients with BRAF V600E mutation‒positive NSCLC, and the application for larotrectinib in patients with advanced tumors and an NTRK gene fusion.
 
 
To view the videos and expert commentary for this edition of Year in Review, please visit www.gotoper.com.


PER Pulse Recap (3 of 3)

Updated Molecular Testing Guidelines in Lung Cancer
 
This third of 3 PER Pulse™ Recaps from this Year in Review focuses on highlights from new recommendations in the molecular testing guidelines issued by the College of American Pathologists, the International Association for the Study of Lung Cancer, and Association for Molecular Pathology.
 
  • Testing for ROS1 aberrations is now recommended for all patients with adenocarcinoma.
  • Testing for additional genes (eg, ERBB2, MET, BRAF, KRAS, and RET) is recommended in laboratories that use next-generation sequencing panels.
  • The American Society of Clinical Oncology recommends stand-alone testing for BRAF mutations in all patients with advanced lung adenocarcinoma.
  • Immunohistochemistry is an acceptable alternative to fluorescence in situ hybridization in testing for molecular aberrations in ROS1 and/or anaplastic lymphoma kinase (ALK) genes.
 
To view the videos and expert commentary for this edition of Year in Review, please visit www.gotoper.com.







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