TARGET AUDIENCE
This activity is intended for medical oncologists, breast surgeons, radiation oncologists and other healthcare professionals involved in the diagnosis and treatment of breast cancer.

OVERVIEW OF ACTIVITY
The long-term management of early and advanced ER-positive breast cancer has been in a constant state of evolution over the past several years. A number of relevant clinical and regulatory developments coupled with many lingering practical management concerns and the activation of a multitude of clinical trials evaluating novel agents have challenged physicians and their support staff as they attempt to deliver state-of-the-art care for this distinct patient population.

Toward this end, this CME activity features a one-on-one discussion with a leading breast cancer investigator. By providing information on the latest research developments and their potential application to routine practice, this activity is designed to assist medical oncologists and other healthcare professionals with the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

• Consider published research data, consensus-based guidelines and other peer-reviewed sources to inform the use of biomarkers and genomic classifiers to assess risk and customize therapy for patients with localized hormone receptor-positive breast cancer.
• Individualize the selection and sequence of systemic therapy for patients with newly diagnosed ER-positive metastatic breast cancer, considering clinical presentation (eg, age, menopausal status, comorbidities, extent and sites of disease), prior treatment course (eg, de novo metastatic disease, type and duration of adjuvant therapy) and psychosocial status.
• Appreciate the means by which the cyclin-dependent kinase (CDK) pathway contributes to breast cancer proliferation and growth, and recognize how the inhibition of CDK4/6 has improved outcomes for patients with ER-positive metastatic disease.
• Appraise available research data to formulate appropriate clinical recommendations for patients who experience disease progression on CDK4/6 inhibitors in combination with hormonal therapy.
• Recognize the frequency of PI3K (phosphoinositide-3 kinase) pathway mutations in patients with ER-positive metastatic breast cancer, and assess published research data with the use of novel agents targeting these abnormalities.
• Understand the side effects associated with existing and recently approved systemic therapies for ER-positive breast cancer, and develop strategies to prevent or ameliorate toxicities to support quality of life and continuation of treatment.
• Assess ongoing clinical research studies evaluating novel agents and treatment strategies under development for ER-positive breast cancer, and counsel patients regarding the potential benefits of trial participation.

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 THESE CME ACTIVITIES
Audio Program: This CME activity consists of an audio component.
CME credit is no longer available for this issue

Video Program: This CME activity consists of a video 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 his spouse/partner) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

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

No relevant conflicts of interest to disclose.

EDITOR — 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, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, EMD Serono Inc, Exelixis Inc, Foundation Medicine, Genentech, Genmab, Genomic Health Inc, Gilead Sciences Inc, GlaxoSmithKline, Guardant Health, 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, Loxo Oncology Inc, a wholly owned subsidiary of Eli Lilly & Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Oncopeptides, 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, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro, A GSK Company, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

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 AbbVie Inc, AstraZeneca Pharmaceuticals LP, Genomic Health Inc, Lilly and Novartis.

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: March 2020
Expiration date: March 2021