Module 1: Approved and Emerging Treatment Approaches for Metastatic Hepatocellular Carcinoma (HCC)

DISCUSSION TOPICS

• Local treatment approaches for HCC: liver resection, transarterial chemoembolization, radiofrequency ablation
• Efficacy and safety outcomes with lenvatinib as first-line therapy for unresectable HCC; recent FDA approval of lenvatinib and patient selection for its use in routine practice
• Data informing the FDA approval and clinical use of regorafenib for patients with disease progression on sorafenib; optimal starting dose as second-line therapy
• Major efficacy and tolerability findings leading to the recent FDA approval of cabozantinib for patients who have experienced disease progression on sorafenib
• Available efficacy and safety results from pivotal clinical trials of nivolumab and pembrolizumab for patients with disease progression on sorafenib; factors guiding the use of immunotherapy versus targeted therapy for these patients
• Key findings with second-line ramucirumab for patients with progressive HCC and elevated alpha-fetoprotein levels

Module 2: Optimal Sequence and Selection of Systemic Therapy for Locally Advanced and Metastatic Gastric, Gastroesophageal Junction (GEJ) and Esophageal Cancer

DISCUSSION TOPICS

• Integration of ramucirumab into current clinical algorithms for metastatic gastric/GEJ cancer; impact, if any, of age, performance status, prior therapeutic exposure and comorbidities on its use as second-line therapy
• Management of hypertension and other side effects of ramucirumab
• Research supporting the FDA approval of pembrolizumab for recurrent or advanced gastric/GEJ adenocarcinoma with a PD-L1 combined positive score (CPS) ≥1 after 2 or more lines of chemotherapy and, if appropriate, HER2-targeted therapy; clinical and research implications of the negative Phase III trial results
• Results with pembrolizumab versus single-agent chemotherapy as second-line treatment for locally advanced or metastatic esophageal or esophagogastric junction carcinoma
• Supportive care approaches to ameliorate side effects associated with anti-PD-1/PD-L1 antibodies
• Data supporting the recent FDA approval of TAS-102 for patients with heavily pretreated metastatic gastric cancer; practical implementation in clinical practice

Module 3: Long-Term Management of Metastatic Colorectal Cancer (mCRC)

DISCUSSION TOPICS

• Indications for biomarker testing in mCRC (eg, MSI, RAS, BRAF, HER2); correlation of tumor location with long-term outcomes and emerging data linking tumor sidedness to response to specific therapies
• Clinical implications of trials evaluating the earlier use of regorafenib and alternative dosing strategies with that agent
• Optimal sequencing of regorafenib and TAS-102 for patients with mCRC; use of clinical characteristics to inform this decision
• Research supporting the FDA approvals of pembrolizumab, nivolumab and nivolumab/ipilimumab for MSI-high mCRC; patient selection for anti-PD-1 monotherapy or combination therapy
• Available and emerging research evaluating the use of combination BRAF/MEK/EGFR inhibition for patients with mCRC and BRAF V600E tumor mutations

Module 4: Therapeutic Decision-Making for Patients with Localized, Locally Advanced and Metastatic Pancreatic Adenocarcinoma (PAD)

DISCUSSION TOPICS

• Current role of chemotherapy, including FOLFIRINOX and gemcitabine/nab paclitaxel, in the neoadjuvant, adjuvant and metastatic settings
• Importance of age, performance status and symptomatology in the selection of first-line therapy for patients with metastatic PAD
• Management of side effects associated with currently available agents; palliative care considerations in advanced PAD
• Mechanism of action of and available research data with nanoliposomal irinotecan (nal-IRI)
• Integration of nal-IRI/5-FU/LV into the management of metastatic disease; patient education issues with the use of nal-IRI