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Physicians’ Education Resource designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Clinical Considerations Regarding the First-line Treatment of a Patient With HER2-Negative Metastatic Breast Cancer

0.25 AMA PRA Category 1 Credit(s)™
Release Date: January 25, 2010
Expiration Date: January 25, 2011

Clinical Vignette Overview

Although current systemic therapies for breast cancer, such as endocrine therapy and cytotoxic agents, have demonstrated considerable efficacy in the adjuvant setting, many patients will eventually experience disease recurrence with systemic spread. Because therapy in the metastatic setting focuses on prolongation of life and symptom palliation rather than cure, careful attention to prior therapies and to patient and tumor characteristics is necessary to determine the best therapeutic strategy. The decision to use combination chemotherapy, sequential single-agent chemotherapy, or a combination of targeted and cytotoxic agents is complex, and the risks and benefits must be carefully weighed to maintain quality of life. Several combination chemotherapy regimens, including combinations of antimetabolites with taxanes, have demonstrated substantial activity in the first-line setting. Many of these combination regimens have demonstrated activity in patients who received prior anthracycline-based therapy, with some yielding an overall survival advantage. The combination of antiangiogenic therapy with any of several cytotoxic agents as first-line therapy has significantly improved progression-free survival in patients with HER2– metastatic breast cancer (MBC).

The purpose of this activity is to update physicians on clinical considerations regarding and the latest clinical data on first-line therapeutic options for HER2– MBC.

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:

  • Discuss the clinical considerations regarding the use of combination or sequential single-agent chemotherapy for patients with MBC
  • Evaluate the efficacy of combination chemotherapy regimens as first-line therapy for MBC
  • Assess the efficacy of antiangiogenic therapy in combination with cytotoxic agents as first-line therapy for MBC

Instructions for Participation

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

Complete the test(s) and evaluation by January 25, 2011 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.

Mohammad Jahanzeb, MD, FACP
Research Funding – Genentech, Inc., OXiGENE, Inc., Pfizer Inc.; Advisory Board – Abraxis BioScience, LLC, AstraZeneca, Bayer Pharmaceuticals Corporation, Bristol-Myers Squibb Company, Eisai Inc., Eli Lilly and Company, Genentech, Inc., GlaxoSmithKline, ImClone Systems Incorporated, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals, Inc., OXiGENE, Inc., Pfizer Inc., sanofi-aventis U.S.; Speaker’s Bureau – Abraxis BioScience, LLC, AstraZeneca, Genentech, Inc., GlaxoSmithKline, Roche Pharmaceuticals, sanofi-aventis U.S.

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.

Please consult full prescribing information for any drugs or procedures discussed within.

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Editor, Clinical Considerations Regarding the First-line Treatment of a Patient With HER2-Negative Metastatic Breast Cancer
Physicians’ Education Resource
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Suite 700
Dallas, TX 75219
Phone: (214) 367-3400
Fax: (214) 367-3304
E-mail: editor@cancerlearning.com

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Educational Grants

An educational grant for this activity was provided by:


  1. Genentech BioOncology

Mohammad Jahanzeb, MD, FACP
Professor of Medicine
University of Tennessee
Memphis, TN
National Program Director, Care
   Guidelines
Aptium Oncology
Medical Director, Lynn Cancer Institute
   West Campus
Boca Raton Community Hospital
Boca Raton, FL