STATEMENT OF NEED/TARGET AUDIENCE

It is important for practicing oncologists to be aware of similarities and differences between his or her practice patterns and those of others in community practice. It is also important for oncologists to recognize that heterogeneity exists in the oncology community, especially in clinical situations for which there is suboptimal research evidence.

This program focuses on the self-described practice patterns of randomly selected medical oncologists on a variety of key clinical issues in cancer. This CME program will provide medical oncologists with information on national cancer patterns of care to assist with the development of clinical management strategies.

GLOBAL LEARNING OBJECTIVES FOR THE PATTERNS OF CARE SERIES

Upon completion of this activity, participants should be able to:

• Compare and contrast management strategies of his or her clinical practice with those of other community oncologists for the treatment of cancer.
• Discuss cancer management issues for which relative agreement and heterogeneity exist in patterns of care.
• Counsel cancer patients about multiple acceptable treatment options when they exist.

SPONSORSHIP STATEMENT

The purpose of this issue of Patterns of Care is to support these objectives by comparing the perspectives of 103 randomly selected community medical oncologists interviewed in depth in August 2005 and to offer in-depth commentary from faculty regarding their practice patterns in the management of colorectal cancer.

ACCREDITATION STATEMENT

Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT

Research To Practice designates this educational activity for a maximum of 2.00 category 1 credits toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity. HOW TO USE THIS MONOGRAPH This monograph is one issue of a CME series activity. To receive credit for this activity, the participant should read the monograph and complete the evaluation located in the back of this book or on our website PatternsofCare. com. PowerPoint files of the graphics contained in this document can be downloaded at PatternsofCare.com.

PHARMACEUTICAL AGENTS DISCUSSED IN THIS PROGRAM

This educational activity includes discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantor.

CONTENT VALIDATION AND DISCLOSURES

Research To Practice is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent conflicts of interest are identified and resolved by a peer review content validation process. The content of each activity is reviewed by both a member of the scientific staff and an external independent reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

The scientific staff and consultants for Research To Practice are involved in the development and review of content for educational activities and report the following real or apparent conflicts of interest for themselves (or their spouses/ partners) that have been resolved through a peer review process: Richard Kaderman, PhD, Neil Love, MD, Douglas Paley, Michelle Paley, MD, Margaret Peng, Lilliam Sklaver Poltorack, PharmD and Kathryn Ault Ziel, PhD – no real or apparent conflicts of interest to report; Sally Bogert, RNC, WHCNP – ownership interest in Amgen Inc; Terry Ann Glauser, MD, MPH – Speakers Bureau: AstraZeneca Pharmaceuticals LP, Biogen Idec, Genentech BioOncology, Sanofi-Aventis. Research To Practice receives education grants from Abraxis Oncology, Amgen Inc, AstraZeneca Pharmaceuticals LP, Biogen Idec, Genentech BioOncology, Genomic Health Inc, Roche Laboratories Inc and Sanofi-Aventis, which have no influence on the content development of our educational activities.

In addition, the following faculty (and their spouses/partners) has reported real or apparent conflicts of interest that have been resolved through a peer review process:

James Cassidy, MD: Professor of Oncology and Head of Department, Cancer Research UK Department of Medical Oncology, University of Glasgow, Bearsden, Glasgow. Grants/Research Support, Consulting Fees and Honorarium: AstraZeneca Pharmaceuticals LP, Novartis Pharmaceuticals, Roche Laboratories Inc, Sanofi- Aventis; Speakers Bureau: Roche Laboratories Inc, Sanofi-Aventis. Christopher H Crane, MD: Associate Professor, Program Director and Section Chief, Gastrointestinal Section, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Contracted Research: Genentech BioOncology; Consulting Fees: Sanofi-Aventis; Speakers Bureau: Roche Laboratories Inc. Robert B Diasio, MD: Professor of Medicine (Hematology/Oncology) and Pharmacology/Toxicology and Genetics, Associate Director for Basic Sciences, UAB Comprehensive Cancer Center, Chairman, Department of Pharmacology and Toxicology, Newman H Waters Professor and Director, Division of Clinical Pharmacology, Birmingham, Alabama. Grants/Research Support: Roche Laboratories Inc, Sanofi-Aventis; Consulting Fees, Honorarium and Speakers Bureau: Bristol-Myers Squibb Company, Genentech BioOncology, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis. Peter C Enzinger, MD: Instructor in Medicine, Harvard Medical School, Clinical Director, Gastrointestinal Cancer Center, Dana-Farber Cancer Institute, Boston, Massachusetts. Consulting Fees: Daiichi Pharmaceutical Co Ltd, Genentech BioOncology, Pfizer Inc, Sanofi-Aventis. George A Fisher, MD, PhD: Associate Professor of Medicine, Stanford University School of Medicine, Director, Clinical Trials Office, Stanford University Cancer Center, Palo Alto, California. Grants/Research Support: AstraZeneca Pharmaceuticals LP; Consulting Fees: Bristol-Myers Squibb Company, Sanofi- Aventis; Honorarium: Bristol-Myers Squibb Company, Roche Laboratories Inc, Sanofi-Aventis. Aimery de Gramont, MD: Professor of Oncology (Professeur des Universités-Praticien Hospitalier), Department Head of Internal Medicine - Oncology, Hôpital Saint- Antoine, Paris, France, Paris, France. Grants/Research Support: Baxter International Inc, Roche Laboratories Inc, Sanofi-Aventis. Axel Grothey, MD: Mayo Clinic College of Medicine, Rochester, Minnesota. Consulting Fees: Genentech BioOncology, Roche Laboratories Inc, Sanofi-Aventis. Daniel G Haller, MD: Professor of Medicine, Abramson Cancer Center at the University of Pennsylvania, Philadelphia, Pennsylvania. Grants/Research Support, Consulting Fees and Honorarium: Bristol-Myers Squibb Company, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis; Speakers Bureau: Sanofi-Aventis. Howard S Hochster, MD: Professor of Medicine and Clinical Pharmacology, NYU Cancer Institute, New York, NY. Consulting Fees: Genentech BioOncology, Novartis Pharmaceuticals, Sanofi-Aventis. Paulo M Hoff, MD: Associate Professor of Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas. Grants/ Research Support: Daiichi Pharmaceutical Co Ltd, Genentech BioOncology, Novartis Pharmaceuticals, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis. John L Marshall, MD: Associate Professor, Director of Developmental Therapeutics and GI Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC. Grants/Research Support, Consulting Fees, Honorarium and Speakers Bureau: Boehringer Ingelheim GmbH, Genentech BioOncology, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis. Michael J O’Connell, MD: Professor of Human Oncology, Drexel University School of Medicine, Director, Allegheny Cancer Center, Director, Division of Medical Oncology, Allegheny General Hospital, Associate Chairman, National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh, Pennsylvania. No financial interests or affiliations to disclose. Philip A Philip, MD, PhD: Professor, Hematology and Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan. Grants/Research Support and Speakers Bureau: Genentech BioOncology, Pfizer Inc, Roche Laboratories Inc; Consulting Fees: Bristol-Myers Squibb Company. Leonard B Saltz, MD: Professor of Medicine, Weill Medical College of Cornell University, Attending Physician, Colorectal Disease Management Team Leader, Memorial Sloan-Kettering Cancer Center, New York, New York. Grants/Research Support: Bristol-Myers Squibb Company, ImClone Systems, Pfizer Inc, Roche Laboratories Inc; Consulting Fees: Genentech BioOncology, Pfizer Inc, Sanofi-Aventis. Chris Twelves, MD: NTRAC Professor of Clinical Cancer Pharmacology and Oncology, University of Leeds and Bradford NHS Hospitals Trust, Bradford, UK. Grants/Research Support: AstraZeneca Pharmaceuticals LP, KuDOS Pharmaceuticals, Pfizer Inc, Roche Laboratories Inc, SuperGen Inc; Consulting Fees and Speakers Bureau: Roche Laboratories Inc. Alan Venook, MD: Professor of Clinical Medicine, Associate Chief, Division of Medical Oncology, Director, Clinical Research Office, UCSF Cancer Center, San Francisco, California. Grants/ Research Support: Amgen Inc, Roche Laboratories Inc, Sanofi-Aventis; Consulting Fees: Genentech BioOncology, Tularik Inc. Robert A Wolff, MD: Associate Professor of Medicine, Deputy Chairman for Clinical Affairs, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, Consulting Fees: Eli Lilly and Company, Pfizer Inc. Norman Wolmark, MD: Professor and Chairman, Department of Human Oncology, Allegheny General Hospital, Professor, Drexel University College of Medicine, Chairman, National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, Pennsylvania. No financial interests or affiliations to disclose.