Interactive Case Studies - Overview

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Physicians' Education Resource designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Neoadjuvant and Adjuvant Treatment of a Patient With Stage IIB HER2-Positive Breast Cancer

1 AMA PRA Category 1 Credit(s)™
Release Date: June 29, 2009
Expiration Date: June 29, 2010

Interactive Case Study Overview

Neoadjuvant therapy has become a standard option for patients with stage III invasive breast cancer and is commonly utilized in patients with stage II disease as well. Neoadjuvant therapy can decrease tumor burden in locally advanced breast cancer so that surgical resection is possible, improve the safety of breast-conserving surgery, and reduce micrometastatic disease to lower the risk of recurrence following surgery. The recent increase in the use of preoperative therapy has illuminated several controversies concerning surgical management, axillary lymph node assessment, and radiation therapy. Should axillary lymph node dissection or sentinel lymph node biopsy be performed in patients undergoing neoadjuvant therapy? What is the optimal timing for sentinel lymph node biopsy? Patient selection for breast-conserving surgery versus mastectomy and the surgical placement of tumor markers prior to neoadjuvant therapy are also areas of debate. Additionally, there is no standard neoadjuvant regimen, and the optimal combinations of cytotoxic and targeted agents are under investigation. For patients with HER2+ breast cancer, both HER2-targeted monoclonal antibody therapy and tyrosine kinase inhibitors have demonstrated efficacy in the neoadjuvant setting, although the most effective sequence and duration of therapy is still under debate. Ongoing trials are exploring the appropriate therapeutic strategies for this patient population as well as the optimal timing for incorporation of radiation therapy into HER2-targeted therapy.

The purpose of this activity is to update physicians on the latest clinical data and treatment options concerning the staging of and neoadjuvant therapy for patients with HER2+ breast cancer.

Target Audience

This educational activity is intended for medical oncologists involved in the care of patients with breast cancer. No specific skills or knowledge other than a basic training in oncology is required for successful participation in this activity.

Learning Objectives

 Upon completion of this educational activity, you should be able to:

  • Evaluate the role of neoadjuvant HER2-targeted therapy in patients with HER2+ breast cancer
  • Examine the options for surgical lymph node assessment in patients undergoing neoadjuvant therapy
  • Discuss the optimal incorporation of radiation therapy into HER2-targeted treatment strategies

Instructions for Participation

  1. Read the following information before entering the educational activity.
  2. Complete the Pretest.
  3. Study the educational activity.
  4. Complete the Posttest.
  5. Answer the evaluation questions.
  6. After completion of the Pretest and successful completion of the Posttest and evaluation, you will receive your certificate online.

You will be permitted 2 attempts to successfully complete the Posttest.

The tests and evaluation must be completed by June 29, 2010, in order for you to receive your certificate.

Complete the test(s) and evaluation by June 29, 2010 to receive your certificate online.

Read all of the conditions in the Activity Terms box below. You must accept the CME Activity Terms in order to continue:

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It is the policy of Physicians’ Education Resource to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME), Physicians’ Education Resource requires everyone who is in a position to control the content of an educational activity, including spouses/partners, to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Physicians’ Education Resource has implemented a mechanism to identify and resolve all conflicts of interest prior to the activity.

Aman Buzdar, MD
Research Funding – AstraZeneca; Eli Lilly and Company; Genentech, Inc.; Pfizer Inc.; Roche Pharmaceuticals; Taiho Pharmaceutical Company, LTD.
Other Remuneration – Amgen; AstraZeneca; Genentech, Inc.; Pfizer, Inc.

PER Editorial Staff
No relevant relationships to disclose

This CME activity might include discussion of investigational and/or unlabeled uses of drugs. If the activity includes discussion of investigational and/or unlabeled uses of a drug, specific information is located on the title page. Please refer to the full prescribing information for each drug discussed in this activity for FDA-approved dosing, indications, and warnings.

Commercial Support
An educational grant for this activity was provided by Genentech BioOncology.

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Banner Illustration
Illustrator: Erin Moore

Disclaimer
The views and opinions expressed in this activity are those of the author and do not necessarily reflect the views of the sponsor, supporter, or publisher. Although great care has been taken in compiling and checking the information given in this activity to ensure accuracy, the author and Physicians’ Education Resource and its servants or agents shall not be responsible or in any way liable for the continued currency of the information or for any errors, omissions, or inaccuracies in this activity, whether arising from negligence or otherwise howsoever or for any consequences arising therefrom.

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©Copyright 2009 by Physicians’ Education Resource. No material may be reproduced in whole or in part, in any form, without written permission from the publisher.

All correspondence should be directed to:
Editor, Interactive Case Study: Neoadjuvant and Adjuvant Treatment of a Patient With Stage IIB HER2-Positive Breast Cancer
Physicians’ Education Resource
3500 Maple Ave.
Suite 700
Dallas, TX 75219
Phone: (214) 367-3400
Fax: (214) 367-3304
E-mail: editor@cancerlearning.com

Educational Grants

An educational grant for this activity was provided by:


  1. Genentech BioOncology

Aman Buzdar, MD
Professor of Medicine
Department of Breast Medical Oncology
The University of Texas M. D. Anderson Cancer Center
Houston, TX