TARGET AUDIENCE
This program is intended for medical oncologists, hematology-oncology fellows and other allied healthcare professionals involved in the treatment of breast cancer (BC).

OVERVIEW OF ACTIVITY
BC remains the most frequently diagnosed cancer in women, with an estimated 268,670 new cases and 41,400 deaths in the United States in 2018. The current clinical management of BC is multidisciplinary and includes surgical resection of local disease with or without radiation therapy and the treatment of systemic disease with cytotoxic chemotherapy, endocrine therapy, biologic therapy or combinations of these agents. The indications for and utility of these options are based largely on prognostic and predictive risk factors in the patient or the tumor at the time of diagnosis. Despite various evidence- and/or consensus-based guidelines and algorithms that aim to assist oncologists in making treatment decisions, many areas of controversy persist within the academic and community settings.

This CME program was developed from the proceedings of a satellite symposium held during the 2018 ASCO Annual Meeting. It explores the most significant therapeutic advances in BC by using the perspectives of leading experts on challenging cases and questions to frame a discussion of how recent developments have aided in the refinement of current routine clinical practice. This activity will help medical oncologists find answers to the individualized questions and concerns that they frequently encounter and in turn provide high-quality cancer care.

LEARNING OBJECTIVES

• Consider published data and faculty preferences to guide the use of biomarkers and genomic classifiers in risk assessment and therapy customization for patients with hormone receptor-positive BC in the neoadjuvant, adjuvant and extended adjuvant settings.
• Appraise available research evidence and faculty recommendations to individualize the selection and duration of (neo)adjuvant and/or extended adjuvant therapy for patients with HER2-positive BC.
• Develop an understanding of the benefits and risks of PARP inhibitors for patients with HER2-negative and BRCA-mutated advanced BC.
• Implement a long-term clinical plan for the management of metastatic HER2-positive BC.
• Consider published research and patient preferences in the selection and sequencing of available therapeutic agents for metastatic ER/PR-positive, HER2-negative BC.

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
CME credit is no longer available for this issue

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
This CME activity consists of an audio component.
CME credit is no longer available for this issue

CONTENT VALIDATION AND DISCLOSURES
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.

FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

Harold J Burstein, MD, PhD
Associate Professor of Medicine
Harvard Medical School
Breast Oncology Center
Dana-Farber Cancer Institute
Boston, Massachusetts

No relevant conflicts of interest to disclose.

Angelo Di Leo, MD, PhD
Head of the Sandro Pitigliani Department of Medical Oncology
Hospital of Prato
Istituto Toscano Tumori
Prato, Italy

Advisory Committee: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Daiichi Sankyo Inc, Genomic Health Inc, Lilly, Novartis, Pfizer Inc, Roche Laboratories Inc; Consulting Agreements: Amgen Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Celgene Corporation, Eisai Inc, Genentech, Genomic Health Inc, Lilly, Novartis, Pfizer Inc, Roche Laboratories Inc; Contracted Research: AstraZeneca Pharmaceuticals LP, Novartis, Pfizer Inc.

Sara A Hurvitz, MD
Associate Professor of Medicine
Director, Breast Oncology Program, Division of Hematology/Oncology
University of California, Los Angeles
Medical Director, Jonsson Comprehensive Cancer Center Clinical Research Unit
Los Angeles, California
Co-Director, Santa Monica-UCLA Outpatient Oncology Practices
Santa Monica, California

Contracted Research: Amgen Inc, Bayer HealthCare Pharmaceuticals, BioMarin, Boehringer Ingelheim Pharmaceuticals Inc, Cascadian Therapeutics, Dignitana, Genentech, GlaxoSmithKline, Lilly, Medivation Inc, a Pfizer Company, Merrimack Pharmaceuticals Inc, Novartis, OBI Pharma Inc, Pfizer Inc, Puma Biotechnology Inc, Roche Laboratories Inc, Seattle Genetics; Paid Travel: Bayer HealthCare Pharmaceuticals, Lilly, Novartis, OBI Pharma Inc.

Mark Robson, MD
Clinic Director, Clinical Genetics Service
Associate Attending Physician, Clinical Genetics and Breast Cancer Medicine
Associate Member, Memorial Sloan Kettering Cancer Center
Associate Professor of Medicine, Weill Medical College of Cornell University
New York, New York

Advisory Committee, Consulting Agreement and Contracted Research: AstraZeneca Pharmaceuticals LP.

Hope S Rugo, MD
Professor of Medicine
Director, Breast Oncology and Clinical Trials Education
University of California, San Francisco
Helen Diller Family Comprehensive Cancer Center
San Francisco, California

Contracted Research: Eisai Inc, Genentech, Lilly, MacroGenics Inc, Merck, Novartis, OBI Pharma Inc, Pfizer Inc, Plexxikon Inc, Roche Laboratories Inc; Paid Travel: Lilly, Mylan NV, Puma Biotechnology Inc.

George W Sledge Jr, MD
Professor of Medicine
Chief, Division of Oncology
Department of Medicine
Stanford University School of Medicine
Stanford, California

Advisory Committee: Syndax Pharmaceuticals Inc, Taiho Oncology Inc; Contracted Research: Genentech.

MODERATOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, a Novartis Division, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals Inc.

RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent reviewers for Research To Practice have no relevant conflicts of interest to disclose.

This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

This activity is supported by educational grants from AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Foundation Medicine, Genentech, Merck and Takeda Oncology.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
Adobe Flash Player 27 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Release date: August 2018
Expiration date: August 2019