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Case Studies in Oncology Vol. 9, No. 3

Release Date: October 31, 2008
Expiration Date: October 31, 2009

Publication Overview

Authors

Lauren E. Abrey, MD; Thomas J. Kaley, MD

Overview and Purpose

Gliomas comprise approximately 2% of all cancers but have been increasing in incidence over the past 50 years. They result in considerable patient morbidity, and until recently, median overall survival (OS) for patients with glioblastoma multiforme (GBM), the most aggressive form of glioma, was generally < 1 year, with almost all patients succumbing to their disease within 2 years of diagnosis. The combination of an orally available alkylating agent and radiation therapy in a phase III trial yielded a median OS exceeding 14 months in patients with newly diagnosed GBM. Management of recurrent GBM is an unmet medical need, with no standard treatment options and a 6-month progression-free survival (PFS) rate of only 15%. Because GBM is a highly vascularized tumor, antiangiogenic approaches have been explored. Recent trials of antibodies to vascular endothelial growth factor (VEGF) alone or in combination with chemotherapy have demonstrated 6-month PFS rates of 25%-50%. Other antiangiogenic approaches, such as decoy receptors of VEGF, VEGF receptor (VEGFR) tyrosine kinase inhibitors, and VEGFR-binding agents, have also been investigated. Several ongoing clinical trials are further investigating the use of angiogenesis inhibitors in the treatment of GBM.

The purpose of this activity is to update physicians on new developments with chemotherapy and targeted agents in the treatment of GBM.

Target Audience

This activity is intended for medical oncologists involved in the care of patients with gliomas. 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 treatment approaches for patients with newly diagnosed GBM
  • Describe the tumor biology of gliomas with respect to the use of antiangiogenic agents
  • Assess the clinical activity of treatment regimens with antiangiogenic agents in patients with recurrent gliomas

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.

Thomas J. Kaley, MD
No relevant relationships to disclose

Lauren E. Abrey, MD
Research Funding – Adnexus; Genentech, Inc.; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Schering-Plough Corporation
Paid Consultant – Enzon Pharmaceuticals, Inc.; Genentech, Inc.; Merck & Co., Inc.; Myriad Genetics, Inc.; Novartis Pharmaceuticals Corporation

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

Magnetic resonance imaging scan of a patient with recurrent glioblastoma multiforme (3 prior therapies) showing peripheral enhancement before and after treatment with bevacizumab/irinotecan.

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 Oncology
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