An overview of Clinical Trials for Metastatic HER2-positive Breast Cancer by Dr. Ian Krop, MD, PhD, Chief and Clinical Research Director, Breast Oncology Center at Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute
Audio and slides for this presentation are available on YouTube: http://youtu.be/ozNSEND5PbE
Erica Mayer, MD, MPH, of the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute, discusses triple-negative breast cancer and what makes it different from other forms of breast cancer. Mayer also talks about treatment options for triple-negative breast cancer and what you need to know about clinical trials for the disease.
ALK receptor tyrosine kinase-EM4 gene fusion is an important target for therapy of Lung Cancer. New tyrosine kinase inhibitors are being added to the list of active drugs. In order to look at the activity of Lorlatinib a newly added TKI to the list. This syudy conducted by French investigators looks at the real life effectivity of Lorlatinib in ALK positive lung cancer.
Chair and Presenter, Jonathan D. Spicer, MD, PhD, FRCSC, Sara Najmeh, MD, and Paula A. Ugalde Figueroa, MD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC activity titled “Neoadjuvant, Adjuvant, or Both: How to Solve the Puzzle of Perioperative Immunotherapy, Individualize Treatment Plans, and Improve Cure Rates in Resectable NSCLC.” For the full presentation, downloadable Practice Aids, and complete CME/MOC information, and to apply for credit, please visit us at https://bit.ly/3K8tKH9. CME/MOC credit will be available until June 5, 2024.
This presentation is part of MIU CE Pharmacy Program and is designed primarily for pharmacists with the following learning objectives:
1- Explain the mechanisms of action behind immune response to cancer and the application of immunotherapy in cancer treatment
2- Distinguish new and emerging immunotherapy classes and individual agents efficacy, safety to therapy in cancer treatment
3-Strategies to counsel and assist patients to overcome barriers to therapy, including Treatment side effects to improve adherence to therapy
In this presentation, I discuss a new standard of treatment in cancers which is immunotherapy. I also discuss the few cancers for which it has been approved.
Opportunities for Immune Therapy and Preventionbkling
Dr. Margaret Gatti-Mays of the National Cancer Institute, a Staff Clinician of Laboratory of Tumor Immunology and Biology and the Co-Director of the Clinical Trial Group, explores the future of immunotherapy in breast cancer treatment.
Robert Anders, MD, PhD, Julie R. Brahmer, MD, MSc, and Christopher D. Gocke, MD, prepared useful Practice Aids pertaining to immunotherapy and biomarker testing for this CME/MOC/CC activity titled "Keeping Up With Advances in Cancer Immunotherapy and Biomarker Testing: Implications for Pathologists at the Forefront of the Emerging Precision Immuno-Oncology Era." For the full presentation, monograph, complete CME/MOC/CC information, and to apply for credit, please visit us at http://bit.ly/2L7zlSy. CME/MOC/CC credit will be available until May 2, 2020.
Professor Peter Schmid, FRCP, MD, PhD, Leisha A. Emens, MD, PhD, and Heather L. McArthur, MD, MPH, prepared useful practice aids pertaining to the role of immunotherapy in triple-negative breast cancer for this CME/MOC/CNE activity titled, "On the Cusp of the Era of Immuno-Oncology in Triple-Negative Breast Cancer: Rational Strategies to Make the Most of Immunotherapies and Other Effective Treatment Modalities Throughout the Disease Continuum." For the full presentation, monograph, complete CME/MOC/CNE information, and to apply for credit, please visit us at http://bit.ly/34aGu95. CME/MOC/CNE credit will be available until December 29, 2020.
An overview of Clinical Trials for Metastatic HER2-positive Breast Cancer by Dr. Ian Krop, MD, PhD, Chief and Clinical Research Director, Breast Oncology Center at Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute
Audio and slides for this presentation are available on YouTube: http://youtu.be/ozNSEND5PbE
Erica Mayer, MD, MPH, of the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute, discusses triple-negative breast cancer and what makes it different from other forms of breast cancer. Mayer also talks about treatment options for triple-negative breast cancer and what you need to know about clinical trials for the disease.
ALK receptor tyrosine kinase-EM4 gene fusion is an important target for therapy of Lung Cancer. New tyrosine kinase inhibitors are being added to the list of active drugs. In order to look at the activity of Lorlatinib a newly added TKI to the list. This syudy conducted by French investigators looks at the real life effectivity of Lorlatinib in ALK positive lung cancer.
Chair and Presenter, Jonathan D. Spicer, MD, PhD, FRCSC, Sara Najmeh, MD, and Paula A. Ugalde Figueroa, MD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC activity titled “Neoadjuvant, Adjuvant, or Both: How to Solve the Puzzle of Perioperative Immunotherapy, Individualize Treatment Plans, and Improve Cure Rates in Resectable NSCLC.” For the full presentation, downloadable Practice Aids, and complete CME/MOC information, and to apply for credit, please visit us at https://bit.ly/3K8tKH9. CME/MOC credit will be available until June 5, 2024.
This presentation is part of MIU CE Pharmacy Program and is designed primarily for pharmacists with the following learning objectives:
1- Explain the mechanisms of action behind immune response to cancer and the application of immunotherapy in cancer treatment
2- Distinguish new and emerging immunotherapy classes and individual agents efficacy, safety to therapy in cancer treatment
3-Strategies to counsel and assist patients to overcome barriers to therapy, including Treatment side effects to improve adherence to therapy
In this presentation, I discuss a new standard of treatment in cancers which is immunotherapy. I also discuss the few cancers for which it has been approved.
Opportunities for Immune Therapy and Preventionbkling
Dr. Margaret Gatti-Mays of the National Cancer Institute, a Staff Clinician of Laboratory of Tumor Immunology and Biology and the Co-Director of the Clinical Trial Group, explores the future of immunotherapy in breast cancer treatment.
Robert Anders, MD, PhD, Julie R. Brahmer, MD, MSc, and Christopher D. Gocke, MD, prepared useful Practice Aids pertaining to immunotherapy and biomarker testing for this CME/MOC/CC activity titled "Keeping Up With Advances in Cancer Immunotherapy and Biomarker Testing: Implications for Pathologists at the Forefront of the Emerging Precision Immuno-Oncology Era." For the full presentation, monograph, complete CME/MOC/CC information, and to apply for credit, please visit us at http://bit.ly/2L7zlSy. CME/MOC/CC credit will be available until May 2, 2020.
Professor Peter Schmid, FRCP, MD, PhD, Leisha A. Emens, MD, PhD, and Heather L. McArthur, MD, MPH, prepared useful practice aids pertaining to the role of immunotherapy in triple-negative breast cancer for this CME/MOC/CNE activity titled, "On the Cusp of the Era of Immuno-Oncology in Triple-Negative Breast Cancer: Rational Strategies to Make the Most of Immunotherapies and Other Effective Treatment Modalities Throughout the Disease Continuum." For the full presentation, monograph, complete CME/MOC/CNE information, and to apply for credit, please visit us at http://bit.ly/34aGu95. CME/MOC/CNE credit will be available until December 29, 2020.
Analyzing ASCO 2016: Developments, takeaways, and implications from the confe...Pharma Intelligence
In conjunction with a Key Opinion Leader, Dr. Peter Lee MD Chair, Department of Immuno-Oncology at City of Hope Comprehensive Cancer Center, CA, several Informa analysts discuss the major developments of the conference and key take-aways via a Webinar.
Watch our recording of Biomedtracker's Robert Jeng, Ph,D., Citeline's Allison Bruce, Scrip's Mary Jo Laffler, and Datamonitor Healthcare's Zachary McLellan as they download and debrief following the always-exciting ASCO weekend.
View and listen to the full webinar here https://www.youtube.com/watch?v=7yMsCb3R5X8
Brendon Stiles, MD, prepared useful practice aids pertaining to immunotherapy in earlier stages of lung cancer for this CME/MOC activity titled, "Chair's Take on Immunotherapy as a Component of Multimodal Therapy in Locally Advanced and Earlier Stages of Lung Cancer: Rationale, Evidence, and Implications for the Multidisciplinary Team." For the full presentation, monograph, complete CME/MOC information, and to apply for credit, please visit us at https://bit.ly/3dtEC0y. CME/MOC credit will be available until June 9, 2021.
Brendon Stiles, MD, Jamie E. Chaft, MD, and David H. Harpole Jr., MD, prepared useful Practice Aids pertaining to immunotherapy in earlier stages of lung cancer for this CME/MOC activity titled, "Immunotherapy as a Component of Multimodal Therapy in Locally Advanced and Earlier Stages of Lung Cancer: Rationale, Evidence, and Implications for the Multidisciplinary Team." For the full presentation, complete CME/MOC information, and to apply for credit, please visit us at https://bit.ly/2UnPFkF. CME/MOC credit will be available until June 24, 2021.
Co-Chairs and Presenter Jessica Donington, MD, Jonathan D. Spicer, MD, PhD, FRCSC, and Patrick M. Forde, MD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/CC/AAPA activity titled “A Practical Guide for Making Multidisciplinary Decisions About Neoadjuvant and/or Adjuvant Immunotherapy in Resectable NSCLC.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/CC/AAPA information, and to apply for credit, please visit us at https://bit.ly/3MQVu5l. CME/MOC/CC/AAPA credit will be available until February 27, 2025.
Presentación realizada por la Dra. Dolores Isla del
Servicio de Oncología Médica del Hospital Clínico Universitario Lozano Blesa de Zaragoza, en el marco de la I Jornada de actualización e innovación en Oncología que tuvo lugar en el CIBA en enero de 2015.
How can immunotherapy be used to treat metastatic breast cancer? Ian Krop, MD, PhD, discusses the latest research and treatment options.
This presentation was originally given as part of the 2015 Metastatic Breast Cancer Forum, held on October 17 and hosted by the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute in Boston, Mass.
For more information, visit www.susanfsmith.org
Immunotherapy for Metastatic Triple Negative Breast Cancerbkling
Sylvia Adams, MD, medical oncologist, and associate professor at the NYU School of Medicine, discusses the latest research including the role of immunology in the treatment of triple negative metastatic breast cancer. This webinar was hosted on October 19, 2016.
The Role of Immunity in Chemotherapy-Resistant Patient with Pembrolizumab: A ...daranisaha
Approaches are limited for treating advanced Non-Small-Cell Lung Cancer (NSCLC) with multidrug resistance but without ALK and EGFR mutations. Pembrolizumab (KEYTRUDA)
Here we present a case report of a NSCLC patient had not benefited from Pembrolizumab therapy following chemotherapy. We reviewed the treatment and clinical examination profiles, especially the Immunological indicators. In the ending stage, the patient appeared
pneumonia, respiratory failure, septicemia, gastrointestinal hemorrhage, and hypoproteinemia.
The percentage of CD4+ and CD8+ T cell in peripheral blood were decreased companion the
expression of PD-1. However, the percentage of MDSC (myeloid-derived suppressor cells) was
increased continuously. We also detected the expression of PD-1 on T cell in pleural effusion
that was under the average value of 24 cases and in the tumor site that was the same with the
pleural effusion. Besides the detected CD8+ T lymphocyte infiltration was very low. The overall
survival was 6 mouths.
The Role of Immunity in Chemotherapy-Resistant Patient with Pembrolizumab: A ...ClinicsofOncology
Approaches are limited for treating advanced Non-Small-Cell Lung Cancer (NSCLC) with multidrug resistance but without ALK and EGFR mutations. Pembrolizumab (KEYTRUDA) brings on unprecedented clinical benefit in various cancer types
Similar to New Thinking, New Strategies in the Treatment of Advanced NSCLC Without Driver Mutations (20)
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Exploring Novel Treatments for Rett Syndromei3 Health
This slide deck, led by Timothy John Feyma, MD, Pediatric Neurologist at Gilette Children’s Hospital, will explore novel treatments and quality-of-life improvement strategies for children and adults with Rett syndrome.
STATEMENT OF NEED
Rett syndrome is a rare, debilitating neurodevelopmental disorder almost always associated with a spontaneous mutation in the methyl-CpG-binding protein 2 (MECP2) gene on the X-chromosome. Affected individuals experience loss of purposeful hand skills, abnormalities in gait, loss of spoken language, and stereotypic hand movements, with more severe manifestations including seizures, autistic features, autonomic nervous system dysfunction, breathing abnormalities, sleep disturbances, and cardiac abnormalities. While therapies for Rett syndrome are being investigated in clinical trials and have demonstrated modest benefit, no curative or effective disease-modifying treatments currently exist (Petriti et al, 2023). Therefore, the multidisciplinary team is challenged with the optimal management of complex comorbidities that persist throughout patients’ lives. This activity chaired by Timothy John Feyma, MD, Pediatric Neurologist at Gilette Children’s Hospital, will explore novel treatments and quality-of-life improvement strategies for children and adults with Rett syndrome.
TARGET AUDIENCE
Pediatric and adult neurologists, pediatricians, internists, family physicians, child and adult psychiatrists, nurse practitioners, physician assistants, nurses, and other health care professionals involved in the treatment of children and adults with Rett syndrome.
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to
Identify distinguishing features of Rett syndrome that can inform early and accurate diagnosis
Evaluate the safety, efficacy, and clinical utility of novel and emerging treatments for Rett syndrome in children and adults
Devise strategies to monitor and manage Rett syndrome symptoms in children and adults
Leveraging the Growing Arsenal of Adjuvant Therapies for Early-Stage NSCLCi3 Health
3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by, Dr. Helena A. Yu, Associate Attending Physician at Memorial Sloan Kettering Cancer Center, will provide insights into strategies for leveraging the growing arsenal of adjuvant therapies for early-stage non–small cell lung cancer (NSCLC), including treatment selection and adverse event management.
STATEMENT OF NEED
Lung cancer is the second most commonly diagnosed cancer and the leading cause of death for men and women worldwide. In the United States, non–small cell lung cancer (NSCLC) accounts for 81% of all lung cancer diagnoses (Cancer.net, 2023). Therapeutic options, survival rates, and outcomes for NSCLC are dramatically impacted by disease stage. For patients with early-stage disease, radical surgery is the mainstay of treatment; however, patients have a significant risk of relapse following surgery and local treatment. Numerous novel therapeutic approaches, including the use of molecular biomarkers and the development of targeted agents and immune checkpoint inhibitors, are under investigation for early-stage NSCLC, contributing to a growing arsenal of treatment options for this disease (Indini et al, 2020). In this visiting faculty meeting series chaired by Helena A. Yu, MD, Associate Attending Physician at Memorial Sloan Kettering Cancer Center, speakers will provide expert perspectives on diagnosis, identification of biomarkers, and efficacy and safety data of novel adjuvant therapies to improve survival outcomes for patients with early-stage NSCLC.
TARGET AUDIENCE
Medical oncologists, radiation oncologists, surgical oncologists, pulmonologists, nurse practitioners, physician assistants, oncology nurses, and other health care professionals involved in the treatment of patients with non–small cell lung cancer (NSCLC).
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to
Identify the correct tumor stage and appropriate management approach for NSCLC based on the latest evidence
Distinguish biomarkers for early-stage NSCLC that can inform individualized treatment strategies
Appraise efficacy and safety data of novel adjuvant therapies for patients with NSCLC as elucidated by recent clinical trials
Apply strategies to prevent and mitigate adverse events associated with novel adjuvant therapies for early-stage NSCLC
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Leveraging the Growing Arsenal of Adjuvant
Therapies for Early-Stage NSCLC
Helena A. Yu, MD
Associate Attending Physician
Memorial Sloan Kettering Cancer Center
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Disclosures
Advisory board/panel: AbbVie, AstraZeneca, Black Diamond,
Blueprint, C4 Therapeutics, Cullinan, Daiichi Sankyo, Janssen, Taiho,
Takeda
Grants/research support: AstraZeneca, Black Diamond, Blueprint,
Cullinan, Daiichi Sankyo, Erasca, Janssen, Novartis, Pfize
Exploring Advances in the Early Diagnosis and Treatment of Alzheimer Disease ...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
In this slide deck, discover new insights into early diagnosis, emerging treatment modalities, and supportive care services for Alzheimer disease. An expert faculty member will discuss biological and clinical distinctions between mild cognitive impairment, dementia, and Alzheimer disease; methods for timely diagnosis; clinical trial data on novel monoclonal antibody therapies; prevention and management of side effects associated with monoclonal antibody therapies, including ARIA, and interdisciplinary support services for improving quality of life.
STATEMENT OF NEED
Alzheimer disease, the most common form of dementia among older adults, is a slowly progressive neurogenerative disease that affects approximately 6 million Americans aged 65 and older (Rajan et al, 2021). Symptoms of Alzheimer disease include memory loss, confusion, impulsive behavior, difficulty with language, mood and personality changes, hallucinations, and increased anxiety or aggression, with severe symptoms such as physical decline, difficulty swallowing, and inability to communicate developing as the disease progresses into its final stages (NIA, 2023). While new therapeutic agents have recently emerged to slow the progression of Alzheimer disease by targeting its underlying causes, the disease remains incurable, and the demands of day-to-day care place significant strain on both patients and their families and caregivers. Therefore, it is critical that clinicians remain up to date on early diagnosis, emerging treatment modalities, and supportive care services in order to provide optimal care for their patients. In this live webinar chaired by Nathaniel Chin, MD, Associate Professor of Medicine in the Division of Geriatrics and Gerontology at the University of Wisconsin-Madison, speakers will explore advances in the diagnosis and treatment of Alzheimer disease.
TARGET AUDIENCE
Geriatricians, neurologists, primary care physicians, psychiatrists, psychogeriatricians, nurse practitioners, physician assistants, nurses, and other health care professionals (HCPs) involved in the treatment of patients with Alzheimer disease (AD).
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to:
Utilize diagnostic methods that enable the timely identification of early Alzheimer disease (AD)
Evaluate the clinical utility of novel and emerging DMTs for the treatment of individual patients with early AD
Apply strategies to enhance interdisciplinary care for patients with early AD
Enhancing MRD Testing in Hematologic Malignancies: When Negativity is a Posit...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This expert CME-approved slide deck, presented by Noopur Raje, MD, Director of the Center for Multiple Myeloma at Massachusetts General Cancer Center, will explore the current and emerging roles of MRD testing in hematologic malignancies. She presents the ongoing questions and latest data regarding the clinical utility of MRD testing in prognosis and treatment.
STATEMENT OF NEED
Measurable residual disease (MRD) is defined as the persistence of cancer cells at levels below morphologic detection after treatment. For patients with hematologic malignancies, MRD testing is increasingly being used to predict disease progression, monitor disease status, and evaluate treatment options (Dekker et al, 2023). Questions about current and future roles of MRD testing abound, including validation of assays, such as next-generation sequencing, machine learning, and flow cytometry; standardization of collection methods and modalities; considerations for clinical trial design and statistical analyses; and improved understanding of the roles of MRD status and depth of response across hematologic malignancies (Dekker et al, 2023; Baines et al, 2023). It is critical for members of the multidisciplinary cancer care team to stay up-to-date on the latest data regarding the clinical utility of MRD testing in prognosis and treatment. In this CME-approved activity, Noopur Raje, MD, Director of the Center for Multiple Myeloma at Massachusetts General Cancer Center, will explore the current and emerging roles of MRD testing in hematologic malignancies.
TARGET AUDIENCE
Medical oncologists, hematologists, pathologists, and other health care professionals involved in the treatment of patients with hematologic malignancies.
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to:
Distinguish the advantages and limitations of current MRD detection methods
Evaluate consensus recommendations on indications for MRD testing in hematologic malignancies
Explain the current and potential roles of MRD status and depth of response as a biomarker in clinical trials
Describe mechanisms of drug resistance/loss of response to BCMA-directed therapies
Assess the clinical utility of MRD in prognosis and treatment of selected hematologic malignancies, including acute lymphoblastic leukemia, chronic lymphocytic leukemia, and multiple myeloma
Recurrent/Metastatic HNSCC: Harnessing Immunotherapy in Comprehensive Carei3 Health
i3 Health is pleased to make this slide deck from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck, presented by Glenn J. Hanna, MD, Director, Center for Cancer Therapeutic Innovation (Early Drug Development Program)
Medical Oncologist, Center for Head & Neck Oncology
Dana-Farber Cancer Institute, and Deborah Wong, MD, PhD, Associate Clinical Professor of Medicine, Division of Hematology-Oncology, UCLA Medical Center, was presented at a live educational event at the 2024 Multidisciplinary Head and Neck Cancers Symposium. It will provide expert perspectives on harnessing immunotherapy in recurrent/metastatic HNSCC to provide comprehensive care.
Slowing Progression of Chronic Kidney Disease Through Value-Based Carei3 Health
i3 Health is pleased to make this infographic from this activity available for use as a non-accredited self-study or teaching resource.
This two module CPE activity brings two leading pharmacists together to discuss the slowing progression of Chronic Kidney disease through value-based care.
In Module 1 of this activity, Jeff Sperry, PharmD, BCPS, Clinical Pharmacist at UCHealth Memorial Hospital, will explore risk factors contributing to CKD, efficacy and safety of novel therapies for slowing kidney function decline, and evidence-based strategies for management of CKD complications.
In Module 2 Justin J. Bioc, PharmD, BCPS, BCGP, RPh, Head of Clinical Pharmacy at Devoted Health, will explore the cost-effectiveness of novel therapies indicated to slow kidney function decline and strategies that maximize collaboration between payers and providers to optimize the care of patients with CKD.
Managing Immune-Related Adverse Events to Ensure Optimal Cancer Immunotherapy...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck, presented by Blanca Ledezma, MSN, NP, AOCNP® Nurse Practitioner
Hematology/Oncology
University of California, Los Angeles (UCLA) Health, will provide insight into the nurse’s view on managing immune-related adverse events to ensure optimal cancer immunotherapy outcomes.
Immune checkpoint inhibitors, which alter immune regulatory pathways and promote cell-mediated destruction of tumor cells, have revolutionized the treatment of cancer in recent years, with numerous therapeutic agents approved and several targets under investigation (Chennamadhavuni et al, 2022). However, up to 90% of patients receiving immune checkpoint inhibitors experience immune-related adverse events, which can affect a wide variety of organ systems and can occur at any time during treatment or even after treatment completion (NCCN, 2023). Immune-related adverse events are associated with significant morbidity as well as the risk of therapy discontinuation, which can have an unpredictable impact on patients’ disease course. Therefore, it is critical for nurses to understand the mechanism, identification, and timely management of immune-related adverse events (Shankar et al, 2022). In this activity presented by Blanca Ledezma, MSN, NP, AOCNP®, Nurse Practitioner at the University of California, Los Angeles (UCLA) Health, will provide insight into the nurse’s view on managing immune-related adverse events to ensure optimal cancer immunotherapy outcomes.
TARGET AUDIENCE
Oncology nurses, nurse practitioners, clinical nurse specialists, and other health care professionals involved in the management of patients with immune-related adverse events (IRAEs).
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to:
Discuss how the mechanisms of action of immunotherapies influence their safety profile
Identify risk factors predisposing patients to IRAEs
Distinguish IRAEs from chemotherapy- and targeted therapy-related adverse events
Coordinate with the interdisciplinary health care team to apply evidence-based guidelines and best practices in personalized nursing management plans for patients with IRAEs
Develop patient counseling strategies promoting awareness, self-monitoring, and escalated reporting of IRAEs
Putting the Freeze on Cold Agglutinin Diseasei3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by, Catherine M. Broome, MD, Associate Professor of Medicine at Georgetown University School of Medicine, will provide expert guidance on diagnostic features, current treatment standards, emerging therapies, and supportive care strategies for patients with cold agglutinin disease (CAD). Start the activity now!
STATEMENT OF NEED
Cold agglutinin disease (CAD) is a rare subtype of autoimmune hemolytic anemia (AIHA) in which antibodies cause hemolysis at cold temperatures, generally between 37º to 39º Fahrenheit. Approximately 1 in a million people are affected by CAD annually, with onset usually occurring between the ages of 40 and 80 years. Individuals commonly experience fatigue, dizziness, palpitations, and shortness of breath caused by the anemia; jaundice caused by degradation of hemoglobin into bilirubin; and sweating, coldness, or painful discoloration of their fingers, toes, ankles, and wrists triggered by exposure to cold (NORD, 2020). While progress has been made in recent years in understanding the pathogenesis of CAD, consensus recommendations based on randomized trials are needed for improving treatment outcomes and reducing symptom burden (Berentsen, 2021). In this Hematology/Oncology Fellows Lecture Series chaired by Catherine Broome, MD, Associate Professor of Medicine at Georgetown University School of Medicine, faculty will provide expert perspectives on optimizing the diagnosis, treatment, and supportive care of CAD.
TARGET AUDIENCE
Hematology fellows, attending faculty, and other health care professionals involved in the treatment of patients with cold agglutinin disease (CAD).
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to:
Evaluate the clinical and laboratory features of CAD that can inform timely and accurate diagnosis
Discuss the pathophysiology of CAD and the scientific rationale for targeting the classical complement pathway
Appraise the efficacy and safety of novel complement inhibitors for CAD as elucidated by recent studies
Assess strategies for managing anemia, cold-induced circulatory symptoms, and treatment-related adverse events to optimize the clinical outcomes of patients with CAD
Faculty
Catherine M. Broome, MD
Professor of Medicine
Georgetown University School of Medicine
Virtual Tumor Board: Multidisciplinary Management of Advanced Soft Tissue Sar...i3 Health
i3 Health is pleased to make the Clinical Decision Aid from this activity available for use as a non-accredited self-study or teaching resource.
Gain insights and perspectives from this multidisciplinary panel of experts as they discuss cases and explore strategies to optimize treatment outcomes for patients with advanced soft tissue sarcoma. This distinguished Virtual Tumor Board features Shreyaskumar R. Patel, MD, Medical Director of the Sarcoma Center at the University of Texas MD Anderson Cancer Center; Kathleen Polson, NP, Nurse Practitioner at Dana-Farber Cancer Institute; and Brian Rubin, MD, PhD, Professor of Pathology at Cleveland Clinic Cancer Center
STATEMENT OF NEED
Sarcomas, which represent 1% to 2% of adult cancers, are a rare, heterogeneous group of neoplasms originating in the connective tissue. Soft tissue sarcomas, which begin in the muscle, tendons, fat, lymph, blood vessels, and nerves, encompass more than 80 histological subtypes. Approximately 25% of patients develop metastatic disease after curative-intent surgery, and for these patients, treatment options are limited and prognosis is very poor. In recent decades, the identification of genetic alterations in soft tissue sarcoma has led to the rise of targeted therapy, significantly expanding the therapeutic landscape. Remaining up to date on pathological characteristics and emerging data on novel therapies is crucial (Riskjell et al, 2023; NCI, 2023). In this Virtual Tumor Board, Shreyaskumar R. Patel, MD, Medical Director of the Sarcoma Center at the University of Texas MD Anderson Cancer Center; Kathleen Polson, NP, Nurse Practitioner at Dana-Farber Cancer Institute; and Brian Rubin, MD, PhD, Professor of Pathology at Cleveland Clinic Cancer Center, will present cases and explore multidisciplinary strategies to optimize treatment outcomes for patients with advanced soft tissue sarcoma.
TARGET AUDIENCE
Medical/surgical/radiation oncologists, pathologists, nurse practitioners, physician assistants, oncology nurses, and other health care professionals involved in the treatment of patients with soft tissue sarcoma.
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to
Distinguish patient and tumor characteristics that can inform personalized therapeutic approaches in soft tissue sarcoma
Evaluate emerging data on novel therapies for soft tissue sarcoma
Appraise multidisciplinary strategies to optimize treatment outcomes of patients with advanced soft tissue sarcoma
FACULTY
Shreyaskumar R. Patel, MD
Robert R. Herring Distinguished Professor of Medicine
Center Medical Director, Sarcoma Center
The University of Texas
MD Anderson Cancer Center
Kathleen Polson, NP
Nurse Practitioner
Dana-Farber Cancer Institute
Brian Rubin, MD, PhD
Professor of Pathology
Chairman, Robert J. Tomsich Pathology and Laboratory Medicine Institute
Cleveland Clinic Cancer Center
Pathology and Oncology Expert Perspectives in the Management of Triple-Negati...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck, presented by Dr. Ira Bleiweiss, Chief of Breast Pathology at the University of Pennsylvania, and Dr. Sara Tolaney, Chief of the Division of Breast Oncology at Dana-Farber Cancer Institute, will feature expert pathology and oncology perspectives on the management of triple-negative breast cancer (TNBC), including case explorations and insights into frequently asked questions. Register today to hear these expert perspectives!
Statement of Need
Triple-negative breast cancer (TNBC) is an aggressive disease that accounts for approximately 10% to 15% of breast cancer diagnoses and is characterized by the absence of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2). TNBC is more common in Black women and in women under the age of 40 (ACS, 2023). Compared with other subtypes of invasive breast cancer, TNBC has high rates of metastasis and a poor prognosis. Due to the lack of hormone and receptor targets, therapeutic options are limited, and prognostication and treatment selection are complicated by the heterogeneity of the disease (Yang et al, 2022). In this live webinar, Dr. Sara Tolaney, Chief of the Division of Breast Oncology at Dana-Farber Cancer Institute, and Dr. Ira Bleiweiss, Chief of Breast Pathology at the Hospital of the University of Pennsylvania, will provide expert oncology and pathology perspectives on evidence-based strategies for diagnosis, treatment, and adverse event management for patients with TNBC.
TARGET AUDIENCE
Medical oncologists, surgical oncologists, radiation oncologists, pathologists, nurse practitioners, physician assistants, oncology nurses, and other health care professionals involved in the treatment of patients with triple-negative breast cancer (TNBC).
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to:
Evaluate receptor and expression status for prognostication and treatment selection in TNBC
Differentiate the pathological characteristics of the various types of TNBC
Select optimal therapy for TNBC based on shared goals, biomarker testing, and clinical data on novel therapies
Discuss strategies for timely recognition and mitigation of adverse events associated with novel TNBC therapies
Current Standards and New Directions in the Treatment of Acquired Thrombotic ...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
Gain insight and expertise in this presentation on acquired thrombotic thrombocytopenic purpura. Spero Cataland, MD, Professor of Clinical Internal Medicine and Director of Benign Hematology at The Ohio State University, will provide guidance on current treatment standards and will discuss emerging therapies with the potential to improve patient outcomes in aTTP.
STATEMENT OF NEED
Acquired thrombotic thrombocytopenic purpura (aTTP) is a rare, life-threatening thrombotic microangiopathy with a rapid onset and progression and a mortality rate of 10% to 20% with prompt treatment. Onset of aTTP is characterized by severe thrombocytopenia, microangiopathic hemolytic anemia, and a constellation of associated symptoms including hemorrhage, neurologic and renal manifestations, cardiac abnormalities, and mesenteric ischemia (Joly et al, 2017). Survivors of first aTTP events tend to have relapse events which need to be controlled. Rapid recognition and immediate appropriate treatment are critical for achieving optimized outcomes in aTTP. In this activity chaired by Spero Cataland, MD, Professor of Clinical Internal Medicine and Director of Benign Hematology at The Ohio State University, expert faculty will provide insightful guidance on current treatment standards and will discuss emerging therapies with the potential to improve patient outcomes in aTTP.
TARGET AUDIENCE
Hematology fellows, attending faculty, and other health care professionals involved in the treatment of patients with acquired thrombotic thrombocytopenic purpura (aTTP).
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to
Evaluate the clinical and laboratory features of aTTP that can inform timely and accurate diagnosis
Discuss how ADAMTS13 activity can be used to guide the management of aTTP
Assess the mechanism of action, efficacy, and safety of novel anti-von Willebrand factor nanobodies in aTTP as elucidated by recent clinical trials
Evaluate novel treatment combinations and sequences with the potential to improve the outcomes of patients with aTTP
Expert Guidance on Current Standards and New Directions in Newly Diagnosed Mu...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
Presented by leading expert Urvi Shah, MD, Assistant Attending in the Myeloma Service at Memorial Sloan Kettering Cancer Center, this slide deck will explore guidance on current standards and new directions in newly diagnosed multiple myeloma.
STATEMENT OF NEED
An estimated 35,730 new cases of multiple myeloma are diagnosed in the United States annually, and 12,590 people die of the disease (Siegel et al, 2023). Characterized by clonal proliferation of malignant plasma cells in the bone marrow, multiple myeloma is associated with anemia, renal insufficiency, bone destruction, and hypercalcemia, all of which significantly impact patients’ quality of life. The development of novel therapies and combinations in recent years, including anti-CD38 antibodies, has provided numerous therapeutic options for newly diagnosed multiple myeloma. However, the optimal selection of induction therapy and subsequent treatment sequencing for individual patients remains a challenge. Additionally, factors including age, frailty, comorbidities, transplant eligibility, treatment-related toxicities, and supportive care needs complicate treatment decisions (Costello et al, 2022). This hematology/oncology fellows lecture series will explore expert guidance on current standards and new directions in newly diagnosed multiple myeloma.
TARGET AUDIENCE
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with multiple myeloma.
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to:
Assess guideline-recommended treatment combination and sequencing strategies in NDMM
Evaluate the role of minimal residual disease (MRD) assessment in NDMM treatment
Review the mechanism of action, efficacy, and safety of anti-CD38 monoclonal antibodies in the treatment of NDMM
Discuss strategies to monitor and manage treatment-related toxicities and optimize survivorship care
Hitting the Target in HER2-Positive Metastatic Colorectal Canceri3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck will share the latest data and strategies for hitting the target in HER2-positive metastatic colorectal cancer. Dr. Christopher Lieu, Associate Professor at the University of Colorado Cancer Center, explores actionable targets to inform personalized care plans, guideline-recommended combination and sequencing strategies, adverse event monitoring and management, and more.
STATEMENT OF NEED
An estimated 153,020 new cases of colorectal cancer (CRC) are diagnosed annually, and 52,550 people die of the disease (Siegel et al, 2023). Approximately 22% of patients present with metastatic disease, which is associated with a dismal 5-year survival rate of 15% (SEER, 2022). Targeting biomarkers is a key strategy for expanding therapeutic options and improving outcomes in metastatic CRC. Human epidermal growth factor receptor 2 (HER2) amplification status and treatments targeting HER2 are some of the most recent additions to the arsenal of targeted therapy for this disease. This activity chaired by Christopher Lieu, MD, Associate Director of Clinical Research at the University of Colorado Cancer Center, will provide expert perspectives and practical guidance on treating HER2-positive metastatic CRC.
TARGET AUDIENCE
Oncologists, gastroenterologists, nurse practitioners, physician assistants, oncology nurses, and other health care professionals involved in the treatment of patients with colorectal cancer (CRC).
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to
Distinguish actionable targets that can inform personalized care plans in metastatic CRC
Evaluate practice guidelines on treatment combinations and sequences for patients with metastatic CRC
Appraise emerging efficacy and safety data on novel targeted therapies for patients with HER2-positive metastatic CRC
Assess strategies for optimizing the safety and tolerability of novel targeted therapies for HER2-positive metastatic CRC
Leveraging BCMA-Directed Therapies for Improved Patient Outcomes in Relapsed/...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Rahul Banerjee, Assistant Professor at the University of Washington and Fred Hutchinson Cancer Center, will provide a case-based discussion on leveraging BCMA-directed antibody-drug conjugates, CAR T-cell therapies, and bispecific T-cell engagers to improve outcomes for patients with multiple myeloma in need of additional treatment options.
STATEMENT OF NEED
Multiple myeloma is a disease that remains incurable for most patients, many of whom become refractory to the majority of available treatments (Kumar et al, 2022). It is estimated that 35,730 new cases of multiple myeloma are diagnosed in the United States annually, and 12,590 people die of the disease (Siegel et al, 2023). Agents targeting B-cell maturation antigen (BCMA), including antibody-drug conjugates (ADCs), chimeric antigen receptor (CAR) T-cell therapies, and bispecific T-cell engagers, represent a promising therapy class for patients in need of additional treatment options, including those with higher genetic risk and heterogeneity (Kumar et al, 2022). This activity led by Rahul Banerjee, MD, FACP, Assistant Professor in the Division of Medical Oncology at the University of Washington and Fred Hutchinson Cancer Center, will provide strategies for leveraging BCMA-directed therapies for improved patient outcomes in relapsed/refractory multiple myeloma.
TARGET AUDIENCE
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with multiple myeloma (MM).
LEARNING OBJECTIVES
Upon completion of this activity, participants should be able to:
Evaluate the mechanisms of action, efficacy, and safety of BCMA-directed therapies in relapsed/refractory MM
Assess guideline-recommended combination and sequential treatment strategies for relapsed/refractory MM
Identify risk factors for the development of treatment-specific adverse events with different classes of BCMA-directed therapies
Describe mechanisms of drug resistance/loss of response to BCMA-directed therapies
Examine the roles of gene expression profiling, soluble BCMA, and measurable residual disease (MRD) in clinical practice.
Optimizing Therapeutic Strategies in Castration-Resistant Prostate Canceri3 Health
This activity will discuss emerging efficacy and safety data on novel therapies for nmCRPC and mCRPC, strategies to manage adverse events, and the role of imaging studies and PSA testing in evaluating treatment response.
Optimizing Treatment Sequencing for Patients With Relapsed/ Refractory Multi...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Shaji Kumar, MD, Professor of Hematological Malignancies
Mayo Clinic Cancer Center, offers expert insight on the assessment of MM, emerging and current therapies, cutting edge approaches to personalized treatments plans, and much more.
Tailoring Therapy for Follicular Lymphoma Based on the Latest Evidencei3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This live or zoom broadcasted hematology/oncology fellowship program will bring an expert faculty member to your institution to discuss the latest developments and expert perspectives in the treatment of follicular lymphoma.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
New Thinking, New Strategies in the Treatment of Advanced NSCLC Without Driver Mutations
1. New Thinking, New Strategies in the Treatment of
Advanced NSCLC Without Driver Mutations
Jamie E. Chaft, MD
Associate Attending Physician
Memorial Sloan Kettering Cancer Center
2. Provided by i3 Health
ACCREDITATION
i3 Health is accredited by the ACCME to provide continuing medical education for physicians.
i3 Health designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit ™. Physicians should claim only the credit commensurate
with the extent of their participation in the activity.
INSTRUCTIONS TO RECEIVE CREDIT
An activity evaluation form has been distributed. To claim credit, you must turn in a completed and signed evaluation form at the conclusion of the
program. Your certificate of attendance will be mailed or emailed to you in approximately 2 weeks.
UNAPPROVED USE DISCLOSURE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners
of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer
to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
DISCLAIMER
The information provided at this CME activity is for continuing education purposes only and is not meant to substitute for the independent
medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.
COMMERCIAL SUPPORT
This activity is supported by an independent educational grant from Lilly.
3. Disclosures
Dr. Chaft discloses the following commercial relationships:
Research support: AstraZeneca, Bristol-Myers Squibb, Genentech, and Merck
4. Learning Objectives
NSCLC = non-small cell lung cancer.
Assess molecular and clinical factors that can refine personalized care
plans for patients with advanced NSCLC without driver mutations
Evaluate efficacy and safety data on first- and second-line treatment
strategies for patients with advanced NSCLC without driver mutations
Discuss the rationale supporting angiogenesis as a therapeutic target
in advanced NSCLC
5. Lung Cancer Treatment Over Two Years Ago
EGFR = epidermal growth factor receptor; ALK = anaplastic lymphoma kinase; PD-L1 = programmed death-ligand 1; IO = immuno-oncology.
Image courtesy of Jamie Chaft, MD.
Test for EGFR, ALK, ROS1
Targeted
therapy
Platinum-based chemotherapy
Docetaxel
or targeted
therapy
Newly
diagnosed
Supportive care
Pembrolizumab
Nivolumab
atezolizumab
6. Case Study 1
CT = computed tomography; TTF1+ = thyroid transcription factor 1-positive.
68-year-old man, former smoker, was found to have a right apical
mass and bilateral pulmonary metastases on a screening chest
CT
CT-guided core needle biopsy of the lung demonstrates a TTF1+
adenocarcinoma
7. Case Study 1 (cont.)
He feels well and relays that he wants the best therapy with the least
toxicity. You advise which of the following:
a. Start cisplatin + pemetrexed
b. Await results of testing for PD-L1
c. Await results of PD-L1, EGFR, ALK, ROS1, and BRAF testing
d. Start pembrolizumab + carboplatin + pemetrexed
e. Start pembrolizumab
9. Genomic Landscape of Lung Adenocarcinoma
MSK-IMPACT™ = Memorial Sloan Kettering—Integrated Mutation Profiling of Actionable Cancer Targets.
Jordan et al, 2016.
915 tumor samples from
patients with lung
adenocarcinoma
sequenced on MSK-
IMPACT™
10. Case Study 1 (cont.)
Genomics testing revealed a KRAS G12C, but PD-L1 wasn’t ordered
properly. He still feels well. You recommend:
a. Start cisplatin and pemetrexed
b. Await results of testing for PD-L1
c. Start carboplatin + paclitaxel + bevacizumab
d. Start pembrolizumab + carboplatin + pemetrexed
e. Start pembrolizumab
11. Pembrolizumaba
(Anti PD-1)
Nivolumaba
(Anti PD-1)
Durvalumab
(Anti PD-L1)
Atezolizumab
(Anti PD-L1)
Diagnostic partner Dako Dako Ventana Ventana
Clones 22C3 28-8 SP263 SP142
Machines utilized Link 48 Link 48 BenchMark ULTRA BenchMark ULTRA
Compartment TM TM TM TC/IC
Variables % of cells % of cells % of cells % of cells
Definition of positive
PD-L1(+): >1%
Strong(+): >50%
PD-L1(+): >1%
Strong(+): >5%
PD-L1(+): ≥25%
TC / IC 3(+)
TC / IC 2(+)
TC / IC 1(+)
TC / IC 0(−)
PD-L1 IHC Assays
aFDA-approved assays.
IHC = immunohistochemistry; TM = tumor cell membrane; TC = tumor cell; IC = immune cell.
Roach et al, 2016; Phillips et al, 2015; Diggs & Hsueh, 2017; Vennapusa et al, 2019.
12. Blueprint PD-L1 IHC Assay Comparison Project
Tumor proportion score by case (n=39)
for each assay
Data points represent the mean score
from three pathologists for each assay
on each case
Superimposed lines/points indicate
identical TPS values
TPS = tumor proportion score; pembro = pembrolizumab; nivo = nivolumab; atezo = atezolizumab; durva = durvalumab.
Hirsch et al, 2017.
Phase 1
100
80
60
40
20
0
1 3 5 7 9 1113151719
%TumorCellStaining
232527293133353721 39
Cases
22C3 (pembro)
28-8 (nivo)
SP142 (atezo)
SP263 (durva)
13. Case Study 1 (cont.)
bx = biopsy; TMB = tumor mutational burden; mut/Mb = mutations per megabase; AE = adverse event.
You start folic acid, order carboplatin + pemetrexed + pembrolizumab to
begin next week while awaiting PD-L1
His tumor bx returns: PD-L1 90%, TMB 8 mut/Mb. What do you do?
a. Switch the treatment plan to pembrolizumab alone
b. Proceed with carboplatin + pemetrexed + pembrolizumab
c. Suggest carboplatin + pemetrexed without pembrolizumab due to increased AE of
combination
d. Suggest nivolumab monotherapy
e. Discuss ipilimumab + nivolumab
14. First-Line Pembro Versus Chemotherapy in PD-L1 High
ECOG = Eastern Cooperative Oncology Group; PS = performance status; pts = patients; IV = intravenous; q3w = every three weeks; PD = progressive disease;
PFS = progression-free survival; ORR = overall response rate; OS = overall survival.
Reck et al, 2016.
Primary end point: PFS
Secondary end points: ORR, OS, and safety
KEYNOTE-024
Pts with stage IV NSCLC
and ECOG PS 0/1, no
previous systemic therapy,
no actionable EGFR/ALK
mutations, and
PD-L1 TPS ≥50%
(N=305)
Pembrolizumab 200 mg IV q3w
for up to 35 cycles
(n=154)
Chemotherapy (histology-
based) for up to 6 cycles
(n=151)
Until PD or
unacceptable
toxicity
Stratified by ECOG PS (0 vs 1),
histology (squamous vs
nonsquamous), and enrollment
region
Until PD (crossover
to pembrolizumab
allowed)
15. Increased PFS With Pembrolizumab in PD-L1 High
HR = hazard ratio; CI = confidence interval.
Reck et al, 2016.
KEYNOTE-024
PFS(%)
100
80
60
40
20
0
Months
180 3 6 9 12 15
Pembrolizumab
(n=154)
Chemotherapy
(n=151)
Median PFS, months 10.3 6.0
HR (95% CI) 0.50 (0.37-0.68); P<0.001
16. Increased OS With Pembrolizumab in PD-L1 High
NR = not reached.
Reck et al, 2016.
KEYNOTE-024
Pembrolizumab
(n=154)
Chemotherapy
(n=151)
Median OS NR NR
HR (95% CI) 0.60 (0.41-0.89); P=0.005
17. First-Line Nivolumab Versus Chemotherapy
Primary end point: PFS (≥5% PD-L1 positive)
Secondary end points: PFS (≥1% PD-L1 positive), ORR, OS
Pts with stage IV/recurrent
NSCLC, no previous systemic
therapy, no actionable
EGFR/ALK mutations,
PD-L1 expression ≥1%
(N=541)
Nivolumab 3 mg/kg IV q2w
(n=271)
Chemotherapy (histology-
based) for up to 6 cycles
(n=270)
Until PD or
unacceptable
toxicity
Stratified by PD-L1 expression (<5% vs ≥5%)
and histology (squamous vs nonsquamous)
Until PD (crossover
to nivolumab
allowed)
q2w = every two weeks.
Socinski et al, 2016.
18. Patients Positive ≥5%: No PFS Benefit With Nivolumab
No = number.
Socinski et al, 2016.
CheckMate-026
19. Treatment With Pembrolizumab
DCB = durable clinical benefit; NDB = no durable benefit.
Rizvi et al, 2015.
More Mutations/Tumor Predicted Durable Clinical Benefit
23. First-Line NSCLC: PD-L1–High
NCCN, 2019.
The personalized therapy choice for PD-L1–high tumors in the
absence of severe cancer symptoms or contraindications is
pembrolizumab
There is no data in PD-L1 >50% comparing pembrolizumab to pembrolizumab +
chemotherapy
25. Case Study 1 (cont.)
Instead, the tumor is PD-L1 low (1%), KRAS mutant, and TMB 14 mut/Mb
on FoundationOne. What do you suggest?
a. Pembrolizumab
b. Carboplatin + pemetrexed + pembrolizumab
c. Carboplatin + pemetrexed without pembrolizumab due to increased AEs
of combination
d. Nivolumab monotherapy
e. Ipilimumab + nivolumab
26. Pembrolizumab vs Platinum-Based Chemo
CNS = central nervous system; AUC = area under the concentration; mo = months.
Lopes et al, 2018.
First-Line Advanced NSCLC TPS ≥1%
27. Pembrolizumab vs Platinum-Based Chemo
Lopes et al, 2018.
First-Line Advanced NSCLC TPS ≥1% (cont.)
OS: TPS ≥50% OS: TPS ≥1% OS: TPS ≥1% to 49%
(Exploratory Analysis)*
28. KEYNOTE-189: Carboplatin + Pemetrexed +/- Pembrolizumab
aPercentage of tumor cells with membranous PD-L1 staining assessed using the PD-L1 IHC 22C3 pharmDx assay.
bPatients could cross over during the induction or maintenance phases. To be eligible for crossover, PD must have been verified by blinded, independent central radiologic review, and all safety
criteria had to be met.
Gandhi et al, 2018.
• Untreated stage IV
nonsquamous NSCLC
• No sensitizing EGFR or
ALK alteration
• ECOG PS 0 or 1
• Provision of a sample for
PD-L1 assessment
• No symptomatic brain
metastases
• No pneumonitis requiring
systemic steroids
Pembrolizumab 200 mg +
pemetrexed 500 mg/m2 +
carboplatin AUC 5 OR
cisplatin 75 mg/m2
q3w for 4 cycles
Placebo (normal saline) +
pemetrexed 500 mg/m2 +
carboplatin AUC 5 OR
cisplatin 75 mg/m2
q3w for 4 cycles
R
(2:1)
n=410
n=206
Pembrolizumab
200 mg q3w for
up to 31 cycles
+
pemetrexed
500 mg/m2 q3w
Placebo (normal
saline) for up to 31
cycles
+
pemetrexed
500 mg/m2 q3w
• PD-L1 expression
(TPSa <1% vs ≥1%)
• Platinum
(cisplatin vs carboplatin)
• Smoking history
(never vs former/current)
Pembrolizumab
200 mg q3w
for up to 35 cycles
PDb
Stratification
Factors
Key Eligibility
Criteria
29. Response Rate by PD-L1 TPS
32.3% 14.3% 48.4% 20.7% 61.4% 22.9%
0
10
20
30
40
50
60
70
80
90
100
TPS <1% P TPS <1% C TPS 1-49% P TPS 1-49% C TPS ≥50% P TPS ≥50% C
ORR,%(95%CI)
aNominal and one-sided. Data cutoff date: Nov 8, 2017.
RECIST = Response Evaluation Criteria in Solid Tumors; BICR = blinded, independent central review; plat = platinum.
Gandhi et al, 2018.
RECIST v1.1, BICR
Pa = 0.0055
Pa = 0.0001
Pa < 0.0001
Pembro/peme/plat (P)
Placebo/peme/plat (C)
30. Progression-Free Survival by PD-L1
RECIST v1.1
Events
HR
(95% CI) Pa
Pembro/peme/plat 72.4%
0.75
(0.53-1.05)
0.0476
Placebo/peme/plat 85.7%
TPS <1% 19.1%
15.7%
aNominal and one-sided. BICR. Data cutoff date: Nov 8, 2017.
Gandhi et al, 2018.
31. Progression-Free Survival by PD-L1 (cont.)
aNominal and one-sided. BICR. Data cutoff date: Nov 8, 2017.
Gandhi et al, 2018.
RECIST v1.1
TPS 1-49% 37.5%
19.6%
Events
HR
(95% CI) Pa
Pembro/peme/plat 54.7%
0.55
(0.37-0.81)
0.0010
Placebo/peme/plat 75.9%
32. Progression-Free Survival by PD-L1 (cont.)
aNominal and one-sided. BICR. Data cutoff date: Nov 8, 2017.
Gandhi et al, 2018.
RECIST v1.1
TPS ≥50% 44.9%
15.4%
Events
HR
(95% CI) Pa
Pembro/peme/plat 51.5%
0.36
(0.25-0.52)
<0.0001
Placebo/peme/plat 80.0%
35. Overall Survival, ITT
aNominal and one-sided. Data cutoff date: Nov 8, 2017.
ITT = intention to treat; NE = not estimable.
Gandhi et al, 2018.
Events HR (95% CI) Pa
Pembro/peme/plat 31.0% 0.49
(0.38-0.64) <0.00001
Placebo/peme/plat 52.4% 69.2%
49.4%
Median (95% CI)
NR (NE-NE)
11.3 mo (8.7-15.1)
Pembro/peme/plat
Placebo/peme/plat
36. Overall Survival by PD-L1 TPS
aNominal and one-sided. Data cutoff date: Nov 8, 2017.
Gandhi et al, 2018.
TPS <1%
Events
HR
(95% CI) Pa
Pembro/peme/plat 38.6% 0.59
(0.38-0.92)
0.0095
Placebo/peme/plat 55.6%
61.7%
52.2%
Pembro/peme/plat
Placebo/peme/plat
37. Overall Survival by PD-L1 TPS (cont.)
aNominal and one-sided. Data cutoff date: Nov 8, 2017.
Gandhi et al, 2018.
TPS 1%-49%
71.5%
50.9%
Pembro/peme/plat
Placebo/peme/plat
Events
HR
(95% CI) Pa
Pembro/peme/plat 28.9% 0.55
(0.34-0.90)
0.0081
Placebo/peme/plat 48.3%
38. Overall Survival by PD-L1 TPS (cont.)
aNominal and one-sided. Data cutoff date: Nov 8, 2017.
Gandhi et al, 2018.
TPS ≥50%
Events
HR
(95% CI) Pa
Pembro/peme/plat 25.8% 0.42
(0.26-0.68)
0.0001
Placebo/peme/plat 51.4%
Pembro/peme/plat
Placebo/peme/plat
39. Adverse Events of Interest in the As-Treated Population
Gandhi et al, 2018.
43. Co-Primary End Point: PFS With Nivo/Ipi vs Chemo
Ipi = ipilumumab.
Hellmann et al, 2018a.
Patients With High TMB (≥10 mut/Mb)
Nivo + Ipi
(n=139)
Chemo
(n=160)
Median PFS, mo 7.2 5.4
HR
97.5% CI
0.58
0.41, 0.81
P=0.0002
In patients withTMB <10 mut/Mb treated with
nivolumab/ipilumumab versus chemotherapy,
the HR was 1.07 (95% CI: 0.84, 1.35)
44. Patients With High TMB (≥10 mut/Mb)
CR = complete response; PR = partial response.
Hellmann et al, 2018b.
Overall Response Rate
Median time to response:
2.7 months with nivolumab + ipilimumab
1.5 months with chemotherapy
41.7
26.3
45. Patients With High TMB (≥10 mut/Mb)
DOR = duration of response.
Hellman et al, 2018b.
Duration of Response
Nivo + Ipi
(n=63)
Chemo
(n=43)
Median DOR, mo
(95% CI)
NR
(12.2, NR)
5.4
(4.2, 6.9)
47. Is There a Case for TMB?
The bottom line on TMB:
Biomarker testing still not standardized
OS data failed to support an indication for ipilimumab + nivolumab
The future of TMB?
Blood-based TMB being used as a biomarker for first-line durvalumab
+ tremelimumab phase 3 studies, more to come
Clinicaltrials.gov, 2019.
50. IMpower150
Socinski et al, 2018a.
Carboplatin/Paclitaxel +/- Bevacizumab +/- Atezolizumab
Arm A
Atezolizumab + carboplatin/paclitaxel
4 or 6 cycles
Atezolizumab
Arm C (control)
Carboplatin/paclitaxel
+ bevacizumab
4 or 6 cycles
Bevacizumab
Survivalfollow-up
Stage IV or
recurrent metastatic
nonsquamous NSCLC
Chemotherapy-naive
Tumor tissue available for
biomarker testing
Any PD-L1 IHC status
Stratification factors:
• Sex
• PD-L1 IHC expression
• Liver metastases
N=1,202
R
1:1:1
Arm B
Atezolizumab + carboplatin/paclitaxel
+ bevacizumab
4 or 6 cycles
Atezolizumab
+
bevacizumab
Maintenance therapy
(no crossover permitted)
Treated with
atezolizumab until PD
by RECIST v1.1
or loss of clinical
benefit
AND/OR
Treated with
bevacizumab until PD
by RECIST v1.1
51. IMpower150 (cont.)
Socinski et al, 2018a.
Carboplatin/Paclitaxel +/- Bevacizumab +/- Atezolizumab
Patients with a sensitizing EGFR mutation or ALK translocation must have
disease progression or intolerance of treatment with one or more approved
targeted therapies:
Atezolizumab: 1,200 mg IV q3w
Carboplatin: AUC 6 IV q3w
Paclitaxel: 200 mg/m2 IV q3w
Bevacizumab: 15 mg/kg IV q3w
52. IMpower150 (cont.)
WT = wild type; CXCL9 = chemokine (C-X-C motif) ligand 9; IFNγ = interferon gamma.
Socinski et al, 2018a.
Carboplatin/Paclitaxel +/- Bevacizumab +/- Atezolizumab
WT refers to patients without EGFR or ALK genetic alterations
The T-effector (Teff) gene signature is defined by expression of PD-L1,
CXCL9, and IFNγ and is a surrogate of both PD-L1 IHC expression and pre-
existing immunity
53. IMpower150: Overall Survival (Intent-to-Treat)
aUnstratified HR. Data cutoff: January 22, 2018
Bev = bevacizumab; CP = carboplatin/paclitaxel.
Socinski et al, 2018b.
Clinically meaningful survival benefit observed with atezolizumab + bevacizumab + chemo vs
bevacizumab + chemo in all patients
Landmark
OS, %
Arm B:
Atezo + Bev + CP
Arm C:
Bev + CP
12-month 68% 61%
18-month 54% 42%
24-month 45% 36%
HRa, 0.77
(95% CI: 0.63, 0.93)
Median follow-up: ~20 mo
54. Atezolizumab + Carboplatin/Paclitaxel + Bevacizumab
Statistically significant and clinically
meaningful OS benefit with atezolizumab
+ bevacizumab + chemotherapy vs
bevacizumab + chemotherapy was
observed
aStratified HR. Data cutoff: January 22, 2018.
Socinski et al, 2018a.
IMpower150: OS in the ITT-WT (Arm B vs Arm C)
Landmark
OS, %
Arm B:
Atezo + Bev + CP
Arm C:
Bev + CP
12-month 67% 61%
18-month 53% 41%
24-month 43% 34%
HRa, 0.780
(95% CI: 0.636, 0.956)
P=0.0164
Median follow-up: ~20 mo
59. Case Study 2
COPD = chronic obstructive pulmonary disease.
72-year-old woman with COPD, diagnosed with advanced lung
adenocarcinoma involving the bilateral lungs and lymph nodes. Her tumor is
driver negative and PD-L1 low
She is treated with carboplatin, pemetrexed, and pembrolizumab with
stable disease for 6 months
She develops hip pain and is found to have new bone metastases
60. Case Study 2 (cont.)
After hip RT, how would you treat this patient?
a. Ipilimumab + nivolumab
b. Docetaxel + ramucirumab
c. Paclitaxel + bevacizumab
d. Single-agent chemotherapy
RT = radiotherapy.
61. REVEL: Study Design
Y = yes; N = no.
Garon et al, 2014.
Ramucirumab in Second-Line
Inclusion Criteria
• Stage 4 NSCLC progressing on or after 1
platinum-based regimen
• Prior bevacizumab allowed
• Squamous or nonsquamous histologies
• ECOG PS 0/1
Stratification
• Geography (East Asia or other)
• ECOG PS
• Sex
• Prior maintenance therapy (Y or N)
R
A
N
D
O
M
I
Z
E
1:1
S
C
R
E
E
N
Ramucirumab 10 mg/kg
+
Docetaxel 75 mg/m2
n=628
Placebo
+
Docetaxel 75 mg/m2
n=625
Every
3 weeks
Treatment until
disease
progression or
unacceptable
toxicity
N=1,253
End Points
Primary Overall survival
Secondary Progression-free survival, overall response rate, safety, patient-reported outcomes
Study Design:
Phase 3 randomized,
multisite study of
ramucirumab or placebo
plus docetaxel following
progression on or after a
platinum-based regimen
67. Key Takeaways
Biomarker testing for PD-L1 and oncogene driver mutations is essential
in NSCLC
Immunotherapy is superior to chemotherapy in patients with PD-L1–high
tumors
Chemotherapy and immunotherapy is better than chemotherapy in PD-
L1–low/negative tumors
Anti-angiogenesis agents have a role in first- and second-line
management for some patients
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