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Advances in Lung Cancer Vol. 8, No. 1

Release Date: October 27, 2008
Expiration Date: October 27, 2009

Publication Overview

Authors

Corey Langer, MD, FACP; Rebecca Suk Heist, MD, MPH; Sarita Dubey, MD; Sunny Wang, MD; Tracey Evans, MD

Overview and Purpose

Both chemotherapy and targeted therapy have modestly improved survival in patients with metastatic non–small-cell lung cancer (NSCLC). For patients with resected early-stage NSCLC, platinum-based adjuvant chemotherapy provides a modest survival benefit. Research is continuing to identify biomarkers that can be used to stratify patients based on risk of recurrence and predicted benefit in order to determine the appropriate treatment regimen. Similarly, targeted agents, including vaccines, monoclonal antibodies (MoAbs), and tyrosine kinase inhibitors (TKIs) that block angiogenesis or growth factor signaling are being tested in the adjuvant setting in operable NSCLC as well as in combination with chemoradiation therapy in locally advanced inoperable NSCLC. For patients with advanced NSCLC, therapy with a MoAb to vascular endothelial growth factor has proven beneficial to outcomes; however, less than half of those patients are eligible to receive this treatment due to early concerns of hemorrhage in patients with squamous cell histology, central nervous system metastases, or a history of hemoptysis. Similar adverse events have also been reported with antiangiogenic TKIs. Several ongoing trials are more thoroughly examining the safety of these antiangiogenic therapies in these restricted patient populations.

The purpose of this activity is to update physicians on the latest developments regarding the use of cytotoxic and targeted agents in NSCLC.

Target Audience

This activity is intended for medical oncologists involved in the care of patients with non–small-cell lung 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 rationale for and early clinical data on regimens incorporating targeted agents in the treatment of early-stage and locally advanced NSCLC
  • Discuss the safety of antiangiogenic agents in different subgroups of patients with NSCLC
  • Evaluate the efficacy of adjuvant/neoadjuvant therapy for early-stage NSCLC

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.

Rebecca Suk Heist, MD, MPH
No relevant relationships to disclose.

Tracey Evans, MD
Speaker’s Bureau – Eli Lilly and Company; Genentech, Inc.; sanofi-aventis U.S.

Corey Langer, MD, FACP
Research Funding – Active Biotech AB; Amgen; AstraZeneca; Bristol-Myers Squibb Company; Celgene Corporation; Cell Therapeutics, Inc.; Eli Lilly and Company; Genentech, Inc.; MedImmune, Inc.; Millennium Pharmaceuticals, Inc.; Ortho Biotech Products, L.P.; Pfizer Inc.; sanofi-aventis U.S.; Schering-Plough Corporation; Vertex Pharmaceuticals Incorporated
Paid Consultant – Amgen; AstraZeneca; Bayer Pharmaceuticals Corporation; Bristol-Myers Squibb Company; Genentech, Inc.; GlaxoSmithKline; ImClone Systems Incorporated; IntraBiotics Pharmaceuticals, Inc.; Millennium Pharmaceuticals, Inc.; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Pharmacyclics; sanofi-aventis U.S.
Speaker’s Bureau – Bristol-Myers Squibb Company; Eli Lilly and Company; Genentech, Inc.; Ortho Biotech Products, L.P.; sanofi-aventis U.S.

Sunny Wang, MD Hallek, MD
No relevant relationships to disclose

Sarita Dubey, MD
Research Funding – Genentech, Inc.; OSI Pharmaceuticals; Pfizer Inc.; 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

Antiangiogenic agents, particularly antibodies to vascular endothelial growth factor (VEGF), are the first targeted agents to prolong survival when combined with frontline chemotherapy in metastatic non–small-cell lung cancer. The adverse event profile of these agents includes hypertension, proteinuria, and bleeding. Bleeding events, such as pulmonary hemorrhage, have been associated with tumor cavitation, as illustrated on the cover. Other potential sites of bleeding, such as brain metastases, have been explored, and preliminary evidence suggests that patients with treated brain metastases might be safely treated with anti-VEGF antibodies. For further details, please refer to the article by Drs. Evans and Langer in this issue of Advances in Lung Cancer.

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.

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

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All rights reserved. No part of this activity may be translated, reproduced, stored, or transmitted by any means or in any type of media form including electronic, mechanical photocopying, recording, broadcasting, or otherwise without prior permission from the publisher.

©Copyright 2008 by Physicians’ Education Resource. No material may be reproduced in whole or in part, in any form, without written permission from the publisher.

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Editor, Advances in Lung Cancer
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