TARGET AUDIENCE
This activity is intended for medical oncologists, radiation oncologists and other healthcare providers involved in the treatment of lung cancer.

OVERVIEW OF ACTIVITY
Lung cancer is a devastating disease with broad-reaching impact on public health, as it accounts for 14% of all new cancer cases in the United States and the most cancer-related deaths among both men and women. For NSCLC, chemotherapy has been the mainstay systemic therapeutic intervention, often combined with adjunctive radiation therapy among patients with inoperable Stage III disease. Data have also demonstrated the role of cytotoxic and biologic maintenance therapy among patients with Stage IIIB/IV NSCLC experiencing initial response to standard front-line regimens. Development of new therapeutic strategies beyond cytotoxic chemotherapy that target specific mutations associated with the pathogenesis of NSCLC has been the focus of extensive recent research and has led to an explosion in lung cancer genetic and biologic knowledge. In addition to the significant strides made in understanding and targeting specific mutations, recent insights into how to harness the body’s own immune system are now being applied to the management of this lethal disease. The advent of these next-generation targeted treatments presents new promise of both efficacy and enhanced safety for patients with lung cancer but also challenges practicing oncologists to appropriately select individuals who may benefit from these agents and to determine how to integrate such therapies, as they become available, into standard lung cancer treatment algorithms.

Over the past 2 years, major clinical trials in advanced NSCLC have witnessed unexpected failures and promising successes. These setbacks and achievements challenge the collective understanding of the biology and optimal management of this disease. Although several consensus- and evidence-based treatment guidelines are currently available and aim to assist clinicians with making lung cancer treatment decisions in the face of this dynamic clinical environment, many areas of controversy persist within academic and community settings. This CME activity will use the perspectives of clinical investigators on key challenges and controversies in the treatment of NSCLC to address the existing management uncertainties of clinician learners and help keep them up to date in a continuously evolving therapeutic environment.

LEARNING OBJECTIVES

• Compare and contrast expert perspectives on the indications for mutation analysis in patients with metastatic NSCLC, and use the appropriate validated testing platforms to obtain this information.
• Employ an understanding of personalized medicine to individualize the use of available EGFR inhibitors in the first- and later-line management of metastatic NSCLC.
• Assess the role of novel liquid biopsy testing platforms for the detection of EGFR T790M mutations associated with acquired resistance in patients whose disease progresses on EGFR tyrosine kinase inhibitors.

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

CME credit is no longer available for this issue

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 a text 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:

D Ross Camidge, MD, PhD
Director, Thoracic Oncology Clinical Program
Associate Director for Clinical Research
University of Colorado Cancer Center
Aurora, Colorado

Consulting Agreements: AbbVie Inc, ARIAD Pharmaceuticals Inc, Array BioPharma Inc, Celgene Corporation, Clovis Oncology, G1 Therapeutics, Lilly, Novartis Pharmaceuticals Corporation, Orion Corporation.

Alexander E Drilon, MD
Assistant Attending Physician
Thoracic Oncology Service and Developmental Therapeutics
Memorial Sloan Kettering Cancer Center
New York, New York

Contracted Research: GlaxoSmithKline, Ignyta Inc; Speakers Bureau: Genentech BioOncology, Ignyta Inc.

Edward B Garon, MD, MS
Associate Professor
Director, Thoracic Oncology Program
Jonsson Comprehensive Cancer Center
David Geffen School of Medicine at UCLA
Los Angeles, California

Contracted Research: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Genentech BioOncology, Lilly, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc.

Sarah B Goldberg, MD, MPH
Assistant Professor of Medicine
Medical Oncology
Yale Cancer Center
New Haven, Connecticut

Advisory Committee: Clovis Oncology; Contracted Research: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc.

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

Advisory Committee: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, EMD Serono Inc, Genentech BioOncology, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc; Contracted Research: Advantagene Inc, Celgene Corporation, GlaxoSmithKline, Inovio Pharmaceuticals Inc, Merck; Data and Safety Monitoring Board: Abbott Laboratories, Amgen Inc, Lilly, Peregrine Pharmaceuticals Inc, Synta Pharmaceuticals Corp.

Tony SK Mok, MD
Chairman, Department of Clinical Oncology
The Chinese University of Hong Kong
Hong Kong, China

Advisory Committee: ACE Pharmaceuticals BV, Amgen Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, GeneCode Ltd, Lilly, Merck, Novartis Pharmaceuticals Corporation, OncoGenex Pharmaceuticals Inc, Pfizer Inc, Roche Laboratories Inc, Vertex Pharmaceuticals Incorporated; Consulting Agreements: ACE Pharmaceuticals BV, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, GeneCode Ltd, GlaxoSmithKline, Lilly, Merck, Novartis Pharmaceuticals Corporation, OncoGenex Pharmaceuticals Inc, Pfizer Inc, Roche Laboratories Inc, SFJ Pharmaceuticals Group, Vertex Pharmaceuticals Incorporated; Contracted Research: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, SFJ Pharmaceuticals Group; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, GlaxoSmithKline, Lilly, Merck, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc.

Joel W Neal, MD, PhD
Assistant Professor of Medicine
Division of Oncology
Stanford Cancer Institute
Stanford University
Palo Alto, California

Consulting Agreements: ARIAD Pharmaceuticals Inc, ARMO BioSciences, Boehringer Ingelheim Pharmaceuticals Inc, CARET/Physicians Resource Management, Clovis Oncology, Nektar; Contracted Research: ARIAD Pharmaceuticals Inc, ArQule Inc, Boehringer Ingelheim Pharmaceuticals Inc, Exelixis Inc, Genentech BioOncology, Merck, Nektar, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc.

Martin Reck, MD, PhD
Head of Department of Thoracic Oncology
Head of Clinical Trial Department
LungenClinic Grosshansdorf
Grosshansdorf, Germany

Advisory Committee: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Lilly, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Lilly, Pfizer Inc, Roche Laboratories Inc.

EDITOR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Agendia Inc, Amgen 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, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Teva Oncology, Tokai Pharmaceuticals Inc and VisionGate Inc.

RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and 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 Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Clovis Oncology, Foundation Medicine, Genentech BioOncology, Lilly and Novartis Pharmaceuticals Corporation.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
Adobe Flash Player 10.2 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Last review date: August 2016
Expiration date: August 2017