Friday, June 2, 2017, Chicago, IL — 7:00 PM – 9:00 PM

Point-Counterpoint: Investigators Discuss and Debate Clinical Questions and Controversies in Non-Small Cell Lung Cancer

Location:
Hilton Chicago
720 South Michigan Avenue
Chicago, IL 60605
Hotel Phone: (312) 922-4400

Time:
6:30 PM – 7:00 PM (Central Time) — Registration and Dinner Buffet
7:00 PM – 9:00 PM (Central Time) — Educational Meeting

Meeting Room:
Grand Ballroom (Level 2)

There is no registration fee for this event. However, preregistration is advised as seating is limited.  
 
Faculty:
Ramaswamy Govindan, MD
Professor of Medicine
Co-Director, Section of Medical Oncology
Division of Oncology
Washington University School of Medicine
St Louis, Missouri

Leora Horn, MD, MSc
Associate Professor of Medicine
Clinical Director
Thoracic Oncology Research Program
Assistant Vice Chairman for Faculty Development
Vanderbilt University Medical Center
Nashville, Tennessee

Corey J Langer, MD
Director of Thoracic Oncology
Abramson Cancer Center
Professor of Medicine
Perelman School of Medicine
University of Pennsylvania
Vice Chair, Radiation Therapy Oncology Group
Philadelphia, Pennsylvania

Gregory J Riely, MD, PhD
Associate Attending
Memorial Sloan Kettering Cancer Center
New York, New York

Jean-Charles Soria, MD, PhD
Full Professor, Paris University XI
Division of Cancer Medicine
Institut Gustave Roussy
Villejuif, France

Moderator:
Neil Love, MD
Research To Practice
Miami, Florida

Not an official event of the 2017 ASCO Annual Meeting. Not sponsored, endorsed, or accredited by ASCO or the Conquer Cancer Foundation.

MODULE 1: Optimizing the Application of Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer (NSCLC) — Dr Langer

Sample Point-Counterpoint Questions

  • Given the recent approval of pembrolizumab in combination with carboplatin/pemetrexed as front-line treatment of metastatic nonsquamous NSCLC regardless of PD-L1 tumor proportion score (TPS), is PD-L1 testing still indicated for all patients with newly diagnosed nonsquamous NSCLC?
  • Is pembrolizumab in combination with carboplatin/pemetrexed the new standard front-line treatment for metastatic nonsquamous NSCLC in patients who can tolerate that therapy?
  • For patients with nonsquamous disease and a high PD-L1 TPS, is pembrolizumab in combination with chemotherapy preferable to pembrolizumab alone?
  • What would you generally recommend for a 60-year-old patient with newly diagnosed PD-L1-positive (TPS ≥50%) metastatic squamous cell NSCLC who is experiencing significant respiratory distress related to the disease?
  • Which preexisting autoimmune diseases, if any, represent an absolute contraindication to the use of an anti-PD-1/PD-L1 antibody for patients with metastatic NSCLC?
  • What is your usual treatment approach for a patient with PD-L1-negative metastatic adenocarcinoma who receives carboplatin/pemetrexed/bevacizumab followed by pemetrexed/bevacizumab maintenance, during which the disease progresses?

MODULE 2: Optimal Use of Chemotherapy with or without Biologic Therapy for Metastatic Nonsquamous and Squamous Lung Cancer — Dr Govindan

Sample Point-Counterpoint Questions

  • Are there patients for whom you would recommend chemotherapy in the front-line setting? If so, what would be your usual initial induction and maintenance therapy (if any) for a 65-year-old otherwise healthy patient with metastatic adenocarcinoma of the lung and no contraindications to bevacizumab?
  • In general, what first-line agent or regimen would you most likely recommend for an otherwise healthy 60-year-old patient with PD-L1-negative metastatic squamous cell carcinoma (mSCC)?
  • For which patients with newly diagnosed, PD-L1-negative mSCC would you recommend the addition of necitumumab to standard cytotoxic therapy?
  • What treatment strategy would you generally recommend for a patient who received carboplatin/pemetrexed and pembrolizumab and responded but then experienced disease progression? How, if at all, does the duration of response to this combination affect your choice of second-line treatment?
  • In general, what is your treatment approach for a patient with metastatic adenocarcinoma who has received carboplatin/pemetrexed followed by pemetrexed maintenance and then an immune checkpoint inhibitor as second-line therapy but is now experiencing progressive disease?
  • Given the survival benefit observed in the Phase III REVEL trial, do you believe that ramucirumab should always be added to docetaxel — regardless of histology or line of therapy — for a patient healthy enough to receive the regimen?

MODULE 3: Treatment of NSCLC with Actionable Tumor Mutations — Dr Riely

Sample Point-Counterpoint Questions

  • How does your approach to mutational testing (EGFR, ALK, ROS1) change, if at all, for patients with newly diagnosed metastatic NSCLC based on histology, age/performance status or tumor-related complications?
  • Should specific mutations be screened for selectively, or do you believe it is more effective/efficient to request next-generation sequencing up front for patients with newly diagnosed metastatic disease?
  • What is the optimal first-line treatment for patients with EGFR exon 19 deletion and exon 21 L858R mutations?
  • What systemic therapy would you generally recommend for a patient with EGFR mutation-positive NSCLC who is found to have a T790M mutation after disease progression on a front-line EGFR TKI? What if the patient’s disease were T790M-negative?
  • What is the optimal first-line treatment for patients with ALK rearrangements, and does this differ based on the presence of CNS metastases?
  • In general, where in the treatment algorithm, if at all, do you integrate immune checkpoint inhibitors for patients with metastatic NSCLC and targetable tumor mutations?

MODULE 4: Protocol and Nonresearch Decision-Making for Patients with Localized and Locally Advanced NSCLC — Dr Horn

Sample Point-Counterpoint Questions

  • In general, do you believe it is reasonable to substitute carboplatin for cisplatin for most patients to whom you are recommending adjuvant chemotherapy?
  • Given the equivalent efficacy and better tolerability observed with the cisplatin/pemetrexed backbone in the Phase III ECOG-E1505 trial, do you believe that regimen should be offered as a preferred option to patients considering adjuvant therapy?
  • In what situations, if any, do you use targeted therapy (eg, an EGFR TKI or ALK inhibitor) in the adjuvant and/or locally advanced settings?
  • Given the equivalent efficacy and better tolerability observed with the use of cisplatin/pemetrexed (versus cisplatin/etoposide) in the Phase III PROCLAIM trial, do you believe that regimen should be discussed and/or offered to patients considering chemoradiation therapy for locally advanced NSCLC?
  • Given that the Phase III PACIFIC trial recently achieved its primary endpoint, are there patients with Stage III disease for whom you will attempt to access an anti-PD-1/PD-L1 antibody as maintenance therapy after the completion of chemoradiation therapy?
  • Do you agree that recommending participation in the ongoing ALCHEMIST study represents the highest quality of care that a clinician can provide to patients?

MODULE 5: Ongoing Investigation and Future Directions in the Treatment of NSCLC — Prof Soria

Sample Point-Counterpoint Questions

  • What has been observed with the combination of an anti-PD-1/PD-L1 antibody and an anti-CTLA-4 antibody? Are there situations in which you would use this approach outside of a trial setting? How does this combination approach affect the frequency and severity of side effects?
  • Are other agents or regimens being evaluated in combination with anti-PD-1/PD-L1 antibodies that look particularly promising? From a biologic perspective, are there specific approaches that may confer significant potential benefits?
  • Do you believe there are other novel agents or strategies currently undergoing Phase III testing (eg, CDK4/6 inhibition, IDO inhibition) that appear to be particularly promising?
  • What other identifiable genomic alterations (eg, BRAF, RET, MET), if any, do you believe are currently actionable with commercially available therapies?
  • Why has targeting KRAS mutations been so difficult? Is there something about their biology that makes them different from EGFR, ALK and other mutations/alterations? Do you believe that any strategies currently under investigation will be effective for patients with these abnormalities?

Target Audience:
This activity is intended for hematologists, medical oncologists and other healthcare providers involved in the treatment of non-small cell lung cancer (NSCLC).

Learning Objectives and Goals:
At the conclusion of this activity, participants should be able to:

  • Design evidence-based strategies for the diagnosis and management of Stage I to III NSCLC, considering the potential contributions of systemic and local therapeutic modalities.
  • Compare and contrast expert perspectives on the indications for mutation and/or PD-L1 analysis for patients with localized and metastatic NSCLC, and, when appropriate, use validated testing platforms to obtain this information.
  • Review published research data documenting the safety and efficacy of available anti-PD-1 antibodies for patients with newly diagnosed PD-L1-positive NSCLC, and use this information to appropriately integrate the use of pembrolizumab into this setting.
  • Consider age, performance status and other patient- or disease-related factors to guide the selection of induction and maintenance systemic therapy for patients with newly diagnosed PD-L1-negative metastatic NSCLC without an identifiable driver mutation.
  • Appreciate available clinical trial data documenting the efficacy of necitumumab and ramucirumab in metastatic NSCLC, and discern how these agents can be optimally integrated into clinical practice for patients with PD-L1-positive and PD-L1-negative squamous and nonsquamous disease.
  • Educate patients about the side effects associated with recently approved novel agents and immunotherapeutic approaches, and provide preventive strategies to reduce or ameliorate these toxicities.
  • Consider published safety and efficacy data with available and emerging therapeutic strategies, and appropriately incorporate targeted therapies into the care of patients with identified tumor driver mutations or alterations.
  • Recall the scientific rationale for ongoing investigation of novel agents or therapeutic approaches in NSCLC, and counsel appropriately selected patients about study participation.

CME Credit Form:
A CME credit form will be given to each participant at the conclusion of the activity.

Accreditation Statement:
Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement:
Research To Practice designates this live activity for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure Policy:
Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations. Financial disclosures will be provided in meeting course materials.

Supporter:
This activity is supported by an educational grant from Lilly.

Hilton Chicago
720 South Michigan Avenue
Chicago, IL 60605
Hotel Phone: (312) 922-4400

Meeting Room:
Grand Ballroom (Level 2)

Directions:
The Hilton Chicago hotel is located just 5 minutes (2.5 miles) north of the McCormick Place convention center, where the ASCO Annual Meeting is taking place.

 

Thank you for your interest in our educational program. At this time online preregistration is closed. However, seats are still available for the conference. Onsite registration will be open starting at 6:30 PM (Central Time) on Friday, June 2nd. If you are interested in attending, please visit our registration desk in the Grand Ballroom foyer located on the second level of the Hilton Chicago hotel (720 Michigan Avenue, Chicago, IL).

Please note, onsite registrant seating will be prioritized for healthcare professionals directly involved in the care of patients. If you have any questions, please feel free to contact us via email at Meetings@ResearchToPractice.com or call (800) 233-6153.