TARGET AUDIENCE
This educational activity has been designed to meet the educational needs of medical oncologists, hematology-oncology fellows and other allied cancer professionals 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. In the year 2017, it is estimated that more than 222,500 individuals will be diagnosed and more than 155,870 will die from the disease. Today, however, this field is seeing renewed optimism as recent research advances have led to an explosion in lung cancer genetic and biologic knowledge among scientists and clinicians working in this area of cancer medicine. Over the past several years major clinical trials in advanced lung cancer have witnessed a host of promising successes, many of which are already being operationalized in clinical practice. Even so, these achievements will doubtlessly continue to be dissected and will further challenge the collective understanding of the biology and optimal management of this disease. 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, but despite the existence of these tools, many areas of controversy persist within academic and community settings.

This CME activity will use the perspectives of a multidisciplinary panel of clinical investigators on key challenges and controversies in the treatment of lung cancer to address the existing management uncertainties of clinician learners and help keep them up to date in a continuously evolving therapeutic environment.

LEARNING OBJECTIVES

• Develop an evidence-based strategy for the treatment of localized non-small cell lung cancer (NSCLC), exploring the role of (neo)adjuvant systemic therapy.
• Apply the results of emerging clinical research to optimize the multimodality management of Stage III NSCLC.
• Employ an understanding of personalized medicine to individualize the use of available EGFR inhibitors in the treatment of NSCLC.
• Describe mechanisms of tumor resistance to EGFR tyrosine kinase inhibitors, and identify investigational therapeutic opportunities to circumvent this process.
• Communicate the efficacy and safety of crizotinib, ceritinib, alectinib, brigatinib and emerging ALK inhibitors to appropriate patients with NSCLC, considering the predictive utility of ALK and ROS1 mutation testing.
• Devise an evidence-based approach to the selection of induction and maintenance systemic therapy for patients with NSCLC without a targetable mutation.
• Consider biologic and patient-related factors in the selection of second- and later-line therapy for patients with progressive NSCLC without a targetable mutation.
• Describe available and emerging data on the efficacy and safety of tumor immunotherapy directed at the PD-1/PD-L1 pathway in lung cancer, and consider this information when counseling patients regarding protocol and nonresearch options.
• Assess new oncogenic pathways mediating the growth of unique NSCLC tumor subsets, and recall emerging data with experimental agents exploiting these targets.
• Formulate management strategies for small cell lung cancer, considering the contributory roles of local and systemic therapy.
• Consider the use of multimodality therapy for appropriate patients with mesothelioma who may potentially be cured with this approach, and devise optimal management strategies for advanced disease.
• Recall the design of ongoing clinical trials evaluating novel investigational agents in lung cancer, and counsel appropriately selected patients about availability and 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 THIS CME ACTIVITY
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 their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

Paul A Bunn Jr, MD
Distinguished Professor and James Dudley Chair in Cancer Research
University of Colorado Cancer Center
Aurora, Colorado

Advisory Committee: Genentech BioOncology, Lilly; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Celgene Corporation, EMD Serono Inc, Genentech BioOncology, Lilly, Merck, Novartis, Pfizer Inc.

Roy H Decker, MD, PhD
Associate Professor of Therapeutic Radiology
Clinical Research Program Leader, Therapeutic Radiology
Director, Residency Training Program
Director, Thoracic/Stereotactic Body Radiotherapy Program
Vice Chair for Clinical Research
Yale Comprehensive Cancer Center
Yale School of Medicine
New Haven, Connecticut

Contracted Research: Merck.

Roy S Herbst, MD, PhD
Ensign Professor of Medicine (Oncology)
Professor of Pharmacology
Chief of Medical Oncology
Director, Thoracic Oncology Research Program
Associate Director for Translational Research
Yale Comprehensive Cancer Center
Yale School of Medicine
New Haven, Connecticut

Consulting Agreements: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Kolltan Pharmaceuticals Inc, Lilly, Merck, Pfizer Inc; Contracted Research: Genentech BioOncology, Merck.

Karen Kelly, MD
Professor of Medicine
Associate Director for Clinical Research
Jennifer Rene Harmon Tegley and Elizabeth Erica Harmon
Endowed Chair in Cancer Clinical Research
UC Davis Comprehensive Cancer Center
Sacramento, California

Advisory Committee: Ariad Pharmaceuticals Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, G1 Therapeutics, Genentech BioOncology, Lilly; Contracted Research: AbbVie Inc, Celgene Corporation, EMD Serono Inc, Five Prime Therapeutics Inc, Genentech BioOncology, Gilead Sciences Inc; Data Monitoring Committee: AstraZeneca Pharmaceuticals LP, Genentech BioOncology; Other Remunerated Activities: UpToDate Inc.

Mark G Kris, MD
William and Joy Ruane Chair in Thoracic Oncology
Attending Physician, Thoracic Oncology Service
Memorial Sloan Kettering Cancer Center
New York, New York

No relevant conflicts of interest to disclose.

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, 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, Pfizer Inc; Contracted Research: Advantagene Inc, Celgene Corporation, GlaxoSmithKline, Merck, Inovio Pharmaceuticals Inc; Data and Safety Monitoring Board: Abbott Laboratories, Amgen Inc, Lilly, Peregrine Pharmaceuticals Inc, Synta Pharmaceuticals Corp.

Rogerio C Lilenbaum, MD (Co-Chair and Moderator)
Professor of Medicine
Yale School of Medicine
Chief Medical Officer
Smilow Cancer Hospital
Yale Cancer Center
New Haven, Connecticut

Advisory Committee: AstraZeneca Pharmaceuticals LP, Celgene Corporation, Genentech BioOncology; Consulting Agreement: Roche Laboratories Inc; Contracted Research: Celgene Corporation.

Barbara L McAneny, MD
Member, Board of Trustees
American Medical Association
CEO of New Mexico Oncology Hematology Consultants Ltd
Albuquerque, New Mexico

No relevant conflicts of interest to disclose.

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/Physician Resource Management, Clovis Oncology, Nektar; Contracted Research: Ariad Pharmaceuticals Inc, ArQule Inc, Boehringer Ingelheim Pharmaceuticals Inc, Exelixis Inc, Genentech BioOncology, Merck, Nektar, Novartis, Roche Laboratories Inc.

Geoffrey R Oxnard, MD
Lowe Center for Thoracic Oncology
Dana-Farber Cancer Institute
Assistant Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Advisory Committee: Ariad Pharmaceuticals Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Genentech BioOncology, Inivata, Takeda Oncology; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc.

Nathan A Pennell, MD, PhD
Associate Professor, Hematology and Medical Oncology
Cleveland Clinic Lerner College of Medicine
of Case Western Reserve University
Director, Cleveland Clinic Lung Cancer Medical Oncology Program
Cleveland, Ohio

Advisory Committee: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc; Contracted Research: AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Celgene Corporation, Genentech BioOncology, Merck, Pfizer Inc.

Naiyer Rizvi, MD
Professor of Medicine
Director of Thoracic Oncology and Phase I Immunotherapeutics
Price Chair in Clinical Translational Research
Columbia University Medical Center
New York, New York

Advisory Committee and Consulting Agreements: AstraZeneca Pharmaceuticals LP, Merck, Novartis, Roche Laboratories Inc; Ownership Interest: Gritstone Oncology.

Alice Shaw, MD, PhD
Associate Professor of Medicine
Harvard Medical School
Center for Thoracic Cancers
Massachusetts General Hospital
Boston, Massachusetts

Advisory Committee: EMD Serono Inc, Genentech BioOncology, Novartis, Pfizer Inc, Roche Laboratories Inc; Consulting Agreements: Blueprint Medicines, Daiichi Sankyo Inc, EMD Serono Inc, Ignyta Inc, Novartis, Pfizer Inc, Roche Laboratories Inc, Taiho Oncology Inc.

Mark A Socinski, MD (Co-Chair and Moderator)
Executive Medical Director
Member, Thoracic Oncology Program
Florida Hospital Cancer Institute
Orlando, Florida

Advisory Committee: Bristol-Myers Squibb Company, Takeda Oncology; Contracted Research: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology, GlaxoSmithKline, Lilly, Pfizer Inc; Speakers Bureau: Bristol-Myers Squibb Company, Celgene Corporation, Genentech BioOncology.

Thomas E Stinchcombe, MD
Co-Director, Multidisciplinary Thoracic Oncology Program
Duke University School of Medicine
Durham, North Carolina

Consulting Agreements: Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Lilly; Contracted Research: Bristol-Myers Squibb Company, EMD Serono Inc, Genentech BioOncology.

Eric Vallières, MD
Surgical Director, Lung Cancer Program
Medical Director, Division of Thoracic Surgery
Swedish Cancer Institute
Seattle, Washington

Consulting Agreements: Genentech BioOncology, GlaxoSmithKline, Spiration Inc.

MODERATOR AND CO-CHAIR — 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, Adaptive Biotechnologies, Agendia 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 BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, 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, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, 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 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 AbbVie Inc, Ariad Pharmaceuticals, Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Lilly, Merck, Myriad Genetic Laboratories Inc, Novartis and Regeneron Pharmaceuticals Inc.

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: June 2017
Expiration date: June 2018