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Case Studies in Breast Cancer Vol. 6, No. 5

Release Date: September 29, 2008
Expiration Date: September 29, 2009

Publication Overview

Author

Karen Gelmon, MD, FRCPC

Overview and Purpose

Despite improvements in breast cancer mortality due to early detection and adjuvant therapy, 40,000 patients succumb to breast cancer in the United States each year, primarily due to progression of metastatic disease. As a result, options for the treatment of metastatic breast cancer (MBC) are rapidly evolving, with new therapeutic regimens and improvements on existing therapies continuously emerging. For patients with HER2+ breast cancer, HER2–targeted monoclonal antibody therapy is the standard of care. However, when disease progression on standard therapy occurs, the optimal therapeutic approach is unclear. Proposed strategies include continuation of the same HER2-targeted therapy while switching to a new cytotoxic agent and incorporation of alternative agents targeting HER2 or HER2-related pathways into treatment. Each of these approaches must be carefully weighed against associated toxicities, because quality of life is particularly important in the metastatic setting. Additionally, patients with refractory disease need to be identified to avoid repeating ineffective therapies, suggesting that biomarker studies are needed

The purpose of this activity is to update physicians on clinical data concerning the treatment of patients with HER2+ MBC following progression on standard HER2-targeted therapy.

Target Audience

This activity is intended for 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 efficacy and safety of combining 2 HER2-targeted agents in patients with HER2+ MBC that has progressed on prior HER2-targeted therapy
  • Assess the efficacy of continuing the same HER2-targeted therapy in combination with an alternative cytotoxic agent in patients with HER2+ breast cancer that has progressed on prior HER2-targeted therapy
  • Discuss the efficacy of HER2-targeted tyrosine kinase inhibitors in patients with HER2+ MBC that has progressed on standard HER2-targeted therapy

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 CME test.
  5. Answer the evaluation questions.
  6. After successful completion of the CME test and evaluation, you will receive your certificate of credit online.
  • CME credit will be granted for only 1 form of participation, either online or via the printed publication.

Read all of the conditions in the Activity Terms box below. You must accept the 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.

Karen Gelmon, MD, FRCPC
Research Funding – Roche Pharmaceuticals
Paid Consultant – Array BioPharma; AstraZeneca; Genentech, Inc.; GlaxoSmithKline; Novartis Pharmaceuticals Corporation; Pfizer Inc.; 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 newsletter for FDA-approved dosing, indications, and warnings.

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

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Illustration

Positron emission tomography scans of a patient with HER2+ metastatic breast cancer showing diffuse disease in the liver and nodes pretreatment (left panel) and good response posttreatment (right panel).

Disclaimer

The views and opinions expressed in this activity are those of the authors 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 authors, 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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Editor, Case Studies in Breast Cancer
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