Clinical Investigators Provide Perspectives on the Treatment of Metastatic Non-Small Cell Lung Cancer in Patients Without Targetable Tumor Mutations
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CONSENSUS OR CONTROVERSY: Clinical Investigators Provide Perspectives on the Treatment of Metastatic Non-Small Cell Lung Cancer in Patients without Targetable Tumor Mutations CME Information TARGET AUDIENCE • Devise an evidence-based approach to the selection of This activity is intended for hematologists, medical oncologists induction and maintenance systemic therapy for patients and other healthcare providers involved in the treatment of with NSCLC without a targetable mutation. non-small cell lung cancer (NSCLC). • Consider biologic and patient-related factors in the selection of second- and later-line therapy for patients with OVERVIEW OF ACTIVITY progressive NSCLC without a targetable mutation. Lung cancer is a devastating disease with broad-reaching • Describe available and emerging data on the efficacy and impact on public health, as it accounts for 13% of all new safety of tumor immunotherapy directed at the PD-1/PD-L1 cancer cases in the United States and the most cancer- pathway in lung cancer, and consider this information when related deaths among both men and women. A major focus counseling patients regarding protocol and nonresearch of recent lung cancer research has been the development — options. and subsequent approval — of a number of molecular-targeted agents and the identification of related biomarkers to help • Educate patients about the potential side effects associated guide treatment selection for those individuals who harbor with commonly employed chemotherapeutic, biologic specific oncogenic alterations. Despite these groundbreaking and immunotherapeutic agents, and provide preventive scientific advances, the truth is that only 15% to 20% of strategies to reduce or ameliorate these toxicities. patients harbor abnormalities that are truly “actionable” in • Describe ongoing trials evaluating novel applica- the clinic today based on FDA approvals. Fortunately for tions of immune checkpoint inhibitors alone (eg, these individuals and their caregivers, over the past several anti-PD-L1 antibodies) or in combination with other years major clinical trials in patients with advanced NSCLC systemic approaches (eg, anti-PD-1/ PD-L1 with without a targetable mutation have witnessed unprece- anti-CTLA-4 antibodies, anti-PD-1/PD-L1 antibodies with dented successes that will challenge the cancer commu- chemotherapy), and counsel appropriately selected patients nity’s collective understanding of the diagnosis and optimal about potential participation. management of this disease. These video proceedings from a CME symposium held during ACCREDITATION STATEMENT the 2017 Multidisciplinary Thoracic Cancers Symposium Research To Practice is accredited by the Accreditation feature discussions with leading researchers with an expertise Council for Continuing Medical Education to provide in the management of lung cancer about clinical research continuing medical education for physicians. findings relevant to treatment for patients without a targetable tumor mutation to address existing uncertainties and help CREDIT DESIGNATION STATEMENT keep clinicians up to date and informed. Research To Practice designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credits™. Physicians LEARNING OBJECTIVES should claim only the credit commensurate with the extent of • Recognize available and emerging research information their participation in the activity. validating the utility of diagnostic assays designed to measure PD-L1 status, assess which testing platforms AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — should be used and appropriately employ the results to MAINTENANCE OF CERTIFICATION (MOC) identify potential candidates for front-line treatment with an Successful completion of this CME activity enables the partic- anti-PD-1 antibody. ipant to earn up to 1.75 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification • Review published research data documenting the safety (MOC) program. Participants will earn MOC points equivalent and efficacy of available anti-PD-1 antibodies for patients to the amount of CME credits claimed for the activity. It is the with newly diagnosed metastatic NSCLC. ResearchToPractice.com/ThoracicCancers17/Nontargeted 1 CME activity provider’s responsibility to submit participant Vice Chair, Radiation Therapy Oncology Group completion information to ACCME for the purpose of granting Philadelphia, Pennsylvania ABIM MOC credit. Advisory Committee: Abbott Laboratories, AstraZeneca Please note, this program has been specifically designed for Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals the following ABIM specialty: medical oncology. Inc, Bristol-Myers Squibb Company, Celgene Corporation, Personal information and data sharing: Research To Practice EMD Serono Inc, Genentech BioOncology, GlaxoSmithKline, aggregates deidentified user data for program-use analysis, ImClone Systems, a wholly owned subsidiary of Eli Lilly and program development, activity planning and site improvement. Company, Lilly, Merck, Novartis Pharmaceuticals Corpo- We may provide aggregate and deidentified data to third ration, Pfizer Inc;Consulting Agreements: AstraZeneca parties, including commercial supporters. We do not share Pharmaceuticals LP, Boehringer Ingelheim Pharmaceu- or sell personally identifiable information to any unaffiliated ticals Inc, Bristol-Myers Squibb Company, Celgene Corpo- third parties or commercial supporters. Please see our privacy ration, Genentech BioOncology, GlaxoSmithKline, ImClone policy at ResearchToPractice.com/Privacy-Policy for more Systems, a wholly owned subsidiary of Eli Lilly and Company, information. Lilly, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc; Contracted Research: Advantagene Inc, Celgene Corpo- HOW TO USE THIS CME ACTIVITY ration, GlaxoSmithKline, Merck, Inovio Pharmaceuticals; Data This CME activity consists of a video component. To receive and Safety Monitoring Board: Abbott Laboratories, Amgen Inc, credit, the participant should watch the video, complete Lilly, Peregrine Pharmaceuticals Inc, Synta Pharmaceuticals the Post-test with a score of 80% or better and fill out Corp. the Educational Assessment and Credit Form located at Naiyer Rizvi, MD ResearchToPractice.com/ThoracicCancers17/Nontargeted/ Professor of Medicine CME. Director of Thoracic Oncology and Phase I Immunotherapeutics CONTENT VALIDATION AND DISCLOSURES Price Chair in Clinical Translational Research Research To Practice (RTP) is committed to providing its Columbia University Medical Center participants with high-quality, unbiased and state-of-the- New York, New York art education. We assess conflicts of interest with faculty, Advisory Committee and Consulting Agreements: AstraZeneca planners and managers of CME activities. Conflicts of interest Pharmaceuticals LP, Merck, Novartis Pharmaceuticals Corpo- are identified and resolved through a conflict of interest ration, Roche Laboratories Inc; Ownership Interest: Gritstone resolution process. In addition, all activity content is reviewed Oncology. by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific Heather Wakelee, MD objectivity of studies referenced and patient care recommen- Associate Professor of Medicine dations. Division of Oncology Stanford University School of Medicine FACULTY — The following faculty (and their spouses/partners) Stanford Cancer Institute reported relevant conflicts of interest, which have been Stanford, California resolved through a conflict of interest resolution process: Consulting Agreements: ACEA Biosciences Inc, Genentech Julie R Brahmer, MD BioOncology, Helsinn Group, Peregrine Pharmaceuticals Inc, Director, Thoracic Oncology Program Pfizer Inc;Contracted Research: AstraZeneca Pharmaceu- Interim Director ticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Johns Hopkins Kimmel Cancer Center at Bayview Clovis Oncology, Exelixis Inc, Genentech BioOncology, Gilead Associate Professor of Oncology Sciences Inc, Lilly, Novartis Pharmaceuticals Corporation, Sidney Kimmel Comprehensive Cancer Center Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Roche Johns Hopkins School of Medicine Laboratories Inc, Xcovery; Grants: Clovis Oncology, Exelixis Baltimore, Maryland Inc, Gilead Sciences Inc, Pharmacyclics LLC, an AbbVie Advisory Committee: Bristol-Myers Squibb Company, Merck; Company, Xcovery. Consulting Agreements: Bristol-Myers Squibb Company, MODERATOR — Dr Love is president and CEO of Research Celgene Corporation, Lilly, Merck; Contracted Research: To Practice, which receives funds in the form of educa- AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb tional grants to develop CME activities from the following Company, Merck. commercial interests: AbbVie Inc, Acerta Pharma, Agendia Corey J Langer, MD Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Director of Thoracic Oncology Inc, Astellas Pharma Global Development Inc, AstraZeneca Abramson Cancer Center Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharma- Professor of Medicine ceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Perelman School of Medicine Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma University of Pennsylvania Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Daiichi Sankyo Inc, ResearchToPractice.com/ThoracicCancers17/Nontargeted 2 Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Food and Drug Administration. Research To Practice does not