Second Opinion

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Second OpinionA Continuing Medical Education ProgramO V E R V I E W O F A C T I V I T YBreast cancer is one of the most rapidly evolving fields in medical oncology. Results from numerous ongoing trials lead tothe continual emergence of new therapeutic agents, treatment strategies and diagnostic/prognostic tools. To bridge thegap between research and patient care, these proceedings and interviews from a two-part CME satellite symposia seriesheld at the 31 st annual San Antonio Breast Cancer Symposium utilize the perspectives of clinical investigators, in additionto the interactive exchange between these individuals, to apply evidence-based concepts to routine practice. By providingaccess to the latest research developments and expert opinions on the disease, this activity will assist medical oncologists,hematologists and hematology-oncology fellows in the formulation of up-to-date clinical management strategies for thetreatment of breast cancer.L E A R N I N G O B J E C T I V E S• Use currently available tissue-based genomic assays and biomarkers to assist with the selection of appropriatetreatment for early breast cancer.• Develop an evidence-based algorithm for the initial treatment of postmenopausal patients with localizedER/PR-positive breast cancer.• Outline the existing data and emerging research on the optimal duration and sequence of endocrine therapy.• Communicate the benefits and risks of trastuzumab-containing regimens to patients with HER2-positive earlybreast cancer.• Recognize the acute and chronic side effects that accompany the use of adjuvant systemic therapy, and identifystrategies to address them.• Delineate the clinical evidence supporting the individualized front-line use of anti-angiogenesis therapy for locallyadvanced or metastatic breast cancer.• Construct a rational treatment algorithm integrating anti-HER2 therapy for HER2-positive recurrent orde novo metastatic breast cancer.• Compare and contrast the efficacy, safety and tolerability of taxanes commonly used in the treatment of breastcancer.• Recognize the physical and emotional challenges that accompany the diagnosis and treatment of metastaticbreast cancer.• Counsel appropriately selected patients about the availability of ongoing clinical trial participation.A C C R E D I T A T I O N S T A T E M E N TResearch To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuingmedical education for physicians.C R E D I T D E S I G N A T I O N S T A T E M E N TResearch To Practice designates this educational activity for a maximum of 5.25 AMA PRA Category 1 Credits. Physiciansshould only claim credit commensurate with the extent of their participation in the activity.H O W T O U S E T H I S C M E A C T I V I T YThis CME activity contains both audio and print components. To receive credit, the participant should review the CMEinformation, listen to the CDs and complete the Post-test and Educational Assessment and Credit Form located in theback of this monograph or on our website at ResearchToPractice.com/SABCS_2008. This monograph contains editedcomments, clinical trial schemas, graphics and references that supplement the audio program. ResearchToPractice.com/SABCS_ 2008 includes an easy-to-use, interactive version of this monograph with links to relevant full-textarticles, abstracts, trial information and other web resources indicated here in blue underlined text.This program is supported by educational grants from Abraxis BioScience, AstraZeneca Pharmaceuticals LP,Genentech BioOncology and Genomic Health Inc.Last review date: April 2009; Release date: April 2009; Expiration date: April 2010
Second Opinion: Proceedings from a Two-Part CME Satellite Symposia SeriesHeld at the 31 st Annual San Antonio Breast Cancer Symposium and Interviewswith the Faculty — December 12-13, 2008T A B L E O F C O N T E N T SManagement of Metastatic Breast Cancer3 A 38-year-old premenopausalwoman with a 2-cm, Grade III,ER/PR-positive, HER2-positiveinfiltrating ductal carcinoma (IDC)and a 1.8-cm, biopsy-confirmedhepatic metastasis (from the practiceof Abraham B Schwarzberg, MD)6 A 65-year-old woman with rapidlyprogressive, symptomatic bone andlung metastases during her fifth yearof an adjuvant aromatase inhibitor foran ER/PR-positive, HER2-negative IDC(from the practice of Lowell L Hart, MD)8 A 47-year-old postmenopausalwoman with a 1.8-cm, ER/PRpositive,HER2-negative, nodenegativeIDC who developed bonemetastases after four years of anadjuvant aromatase inhibitor (fromthe practice of Steven P Kanner, MD)Additional Cases on the Audio ProgramA 49-year-old woman with biopsyconfirmedliver and lung metastasesthree years after adjuvant AC for atriple-negative IDC (from the practiceof Michael A Schwartz, MD)A 47-year-old woman who developedmultiple unresectable brain metastaseseight years after adjuvantanthracycline/taxane therapy foran ER/PR-negative, HER2-positiveIDC (from the practice ofKenneth R Hoffman, MD, MPH)A 62-year-old woman with aneglected 6-cm, ER/PR-positive,HER2-positive IDC and biopsyprovenlung metastases (from thepractice of Dr Hoffman)Adjuvant Therapy for Early Breast Cancer10 A 76-year-old woman with a 0.8-cm,ER/PR-positive, HER2-negative,moderately differentiated IDC with twopositive nodes and an Oncotype DX ®Recurrence Score ® of 13 (from thepractice of Samuel N Bobrow, MD)13 A 76-year-old woman who underwenta mastectomy for a 6-cm, ER/PR-positive, HER2-positive, T4b IDCwith skin ulceration and extensivedermal involvement (from the practiceof Isaac Levy, MD)15 A 37-year-old woman with a 0.4-cm,moderately differentiated, ER/PR-negative, HER2-positive, nodenegativeIDC (from the practiceof Dr Bobrow)Additional Cases on the Audio ProgramA 41-year-old woman with longstandingType 1 diabetes who underwentrecent laser therapy for retinopathyand is diagnosed with a 1.8-cm,triple-negative, node-negative IDC(from the practice of Dr Hoffman)A 67-year-old woman with a 2.5-cm,ER/PR-positive, HER2-negative,node-negative IDC who has completedfive years of adjuvant anastrozole(from the practice of Dr Hoffman)A 56-year-old premenopausal womanwith a 2.2-cm, ER/PR-positive,HER2-negative, node-negative IDCwith 88 percent Ki-67 (from thepractice of Dr Hart)18 POST-TEST19 EDUCATIONAL ASSESSMENT AND CREDIT FORM
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