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Patterns of Care: A CME Series Activity |
STATEMENT OF NEED/TARGET
AUDIENCE
It is important for practicing oncologists to be
aware of similarities and differences between
his or her practice patterns, those of others in
community practice and those of breast cancer
clinical research leaders. 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. Also included is research leader
commentary and references addressing these
issues. 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 community oncologists and cancer
research leaders 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.
PURPOSE OF THIS ISSUE
The purpose of this issue of Patterns of Care is
to support these objectives by comparing the
perspectives of 100 randomly selected community
medical oncologists interviewed in depth
in August and September of 2005 with those
of 45 breast cancer researchers surveyed,
and to offer in-depth commentary from faculty
regarding their practice patterns in the management
of breast 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 2.25 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.
COMMERCIAL SUPPORT
This program is supported by education grants
from Abraxis Oncology, AstraZeneca Pharmaceuticals
LP and Genentech BioOncology.
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 grantors.
FACULTY AFFILIATIONS/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: Terry Ann
Glauser, MD, MPH, 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 — shareholder of Amgen
Inc. 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, who
have no influence on the content development
of our educational activities.
In addition, the following faculty (and their
spouses/partners) have reported real or
apparent conflicts of interest that have been
resolved through a peer review process:
Michael Baum, MD, ChM: Emeritus Professor
of Surgery and Visiting Professor of Medical
Humanities, University College London,
London, United Kingdom. Grants/Research
Support and Consulting Fees: AstraZeneca
Pharmaceuticals LP; Honorarium: AstraZeneca
Pharmaceuticals LP, Novartis Pharmaceuticals,
Pfizer Inc. Joanne L Blum, MD, PhD: Director,
Hereditary Cancer Risk Program and Research
Site Leader, Baylor-Charles A Sammons
Cancer Center, Dallas, Texas. Speakers
Bureau: American BioScience Inc,
AstraZeneca Pharmaceuticals LP, Myriad
Genetics Inc, Roche Laboratories Inc, Sanofi-
Aventis. Adam M Brufsky, MD, PhD: Assistant
Professor of Medicine, University of Pittsburgh,
Member, University of Pittsburgh Cancer
Institute, Director, Comprehensive Breast
Cancer Center, Associate Division Chief,
University of Pittsburgh, Department of
Medicine, Division of Hematology/Oncology,
Pittsburgh, Pennsylvania. Grants/Research
Support, Honorarium and Speakers Bureau:
Bristol-Myers Squibb Company, Genentech
BioOncology, Sanofi-Aventis. Harold J
Burstein, MD, PhD: Assistant Professor of
Medicine, Harvard Medical School, Breast
Oncology Center, Dana-Farber Cancer Institute,
Boston, Massachusetts. Grants/Research
Support: Genentech BioOncology. Robert W
Carlson, MD: Professor of Medicine, Division of
Oncology and Stanford Medical Informatics,
Stanford University Medical Center, Stanford,
California. Consulting Fees: AstraZeneca
Pharmaceuticals LP. Rowan T Chlebowski, MD,
PhD: Professor of Medicine, David Geffen
School of Medicine at UCLA, Chief, Medical
Oncology, Harbor-UCLA Medical Center,
Torrance, California. Grants/Research Support:
Amgen Inc, Pfizer Inc; Consulting Fees and
Other Financial/Material Support:
AstraZeneca, Pharmaceuticals LP, Eli Lilly and
Company, Novartis Pharmaceuticals, Organon,
Pfizer Inc, Sanofi-Aventis. Jack Cuzick, PhD:
John Snow Professor of Epidemiology, Cancer
Research UK Centre for Epidemiology,
Mathematics and Statistics, Wolfson Institute
of Preventive Medicine, Barts and the London,
Queen Mary’s School of Medicine and
Dentistry, London, United Kingdom. Consulting
Fees: AstraZeneca Pharmaceuticals LP, Eli Lilly
and Company, Pfizer Inc. Nancy E Davidson,
MD: Professor of Oncology, Breast Cancer
Research Chair in Oncology, Director of the
Breast Cancer Research Program, The Sidney
Kimmel Comprehensive Cancer Center at
Johns Hopkins, Baltimore, Maryland;
Consulting Fees and Honorarium: AstraZeneca Pharmaceuticals LP; Speakers
Bureau: Eli Lilly and Company. Maura N
Dickler, MD: Assistant Attending Physician,
Breast Cancer Medicine Service, Memorial
Sloan-Kettering Cancer Center, New York, New
York. Grants/Research Support: Genentech
BioOncology; Consulting Fees: AstraZeneca
Pharmaceuticals LP, Novartis Pharmaceuticals,
Pfizer Inc. J Michael Dixon, MD: Consultant
Surgeon and Senior Lecturer, Academic Office,
Edinburgh Breast Unit, Western General
Hospital, Edinburgh, United Kingdom. Grants/
Research Support: AstraZeneca
Pharmaceuticals LP, Novartis Pharmaceuticals,
Pfizer Inc. Mitchell Dowsett, PhD: Professor of
Biochemical Endocrinology, Head of Academic
Department of Biochemistry, Royal Marsden
Hospital, London, England. Grants/Research
Support and Honorarium: AstraZeneca
Pharmaceuticals LP, Novartis Pharmaceuticals,
Roche Laboratories Inc; Consulting Fees:
AstraZeneca Pharmaceuticals LP, Eli Lilly and
Company, Novartis Pharmaceuticals, Roche
Laboratories Inc. Charles E Geyer Jr, MD:
Director of Medical Affairs, National Surgical
Adjuvant Breast and Bowel Project, Director of
Breast Medical Oncology, Allegheny General
Hospital, Pittsburgh, Pennsylvania. Advisory
Board: EMD Pharmaceuticals Inc, Genentech
BioOncology, GlaxoSmithKline, Pfizer Inc,
Roche Laboratories Inc, Sanofi-Aventis.
Michael Gnant, MD: Professor of Experimental
Surgical Oncology, Medical University of
Vienna, Vienna, Austria; Grants/Research
Support and Honorarium: AstraZeneca
Pharmaceuticals LP, Novartis Pharmaceuticals,
Sanofi-Aventis. William J Gradishar, MD:
Director, Breast Medical Oncology, Associate
Professor of Medicine, Robert H Lurie
Comprehensive Cancer Center, Northwestern
University Feinberg School of Medicine,
Chicago, Illinois. Grants/Research Support:
Abraxis Oncology, AstraZeneca
Pharmaceuticals LP, Novartis Pharmaceuticals,
Sanofi-Aventis; Consulting Fees and
Honorarium: Amgen Inc, GlaxoSmithKline,
Roche Laboratories Inc. Daniel F Hayes, MD:
Professor of Internal Medicine, Clinical
Director, Breast Oncology Program, Division of
Hematology/Oncology, Department of Internal
Medicine, University of Michigan
Comprehensive Cancer Center, Ann Arbor,
Michigan. Grants/Research Support: Amgen
Inc, Bristol-Myers Squibb Company,
Genentech BioOncology, Immunicon
Corporation, Novartis Pharmaceuticals, Sanofi-
Aventis; Consulting Fees and Honorarium:
AstraZeneca Pharmaceuticals LP, Bristol-Myers
Squibb Company, Dako Diagnostics AG,
Genomic Health Inc, Immunicon Corporation,
Novartis Pharmaceuticals, Roche Laboratories
Inc, Sanofi-Aventis, Wyeth. I Craig Henderson,
MD: Adjunct Professor of Medicine, University
of California, San Francisco, San Francisco,
California; Consulting Fees: AstraZeneca
Pharmaceuticals LP, Eli Lilly and Company,
Novartis Pharmaceuticals, Pfizer Inc; Stock
Shareholder: Keryx Biopharmaceuticals Inc. Gabriel N Hortobagyi, MD: Professor of
Medicine, Nellie B Connally Chair in Breast
Cancer, Chairman, Department of Breast
Medical Oncology, The University of Texas MD
Anderson Cancer Center, Houston, Texas.
Consulting Fees: Pfizer Inc, Honorarium:
AstraZeneca Pharmaceuticals LP, Pfizer Inc,
Sanofi-Aventis. Anthony Howell, MD: Professor
of Medical Oncology, University of Manchester,
Manchester, England. Consulting Fees and
Honorarium: AstraZeneca Pharmaceuticals LP.
Speakers Bureau: AstraZeneca
Pharmaceuticals LP, Novartis Pharmaceuticals.
Clifford Hudis, MD: Chief, Breast Cancer
Medicine Service, Solid Tumor Division,
Memorial Sloan-Kettering Cancer Center, New
York, New York. Grants/Research Support and
Honorarium: Amgen Inc, AstraZeneca
Pharmaceuticals LP, Bristol-Myers Squibb
Company, Eli Lilly and Company, Genentech
BioOncology, Pfizer Inc, Roche Laboratories
Inc, Sanofi-Aventis. Consulting Fees: Amgen
Inc, AstraZeneca Pharmaceuticals LP, Bristol-
Myers Squibb Company, Eli Lilly and Company,
Genentech BioOncology, Genomic Health Inc,
Pfizer Inc, Roche Laboratories Inc, Sanofi-
Aventis. Stock Shareholder: Genomic Health
Inc. Raimund V Jakesz, MD: Department of
Surgery, Vienna Medical School, President,
Austrian Breast and Colorectal Cancer Study
Group, Vienna, Austria. Grants/Research
Support: AstraZeneca Pharmaceuticals LP,
Novartis Pharmaceuticals; Honorarium: Amgen
Inc, AstraZeneca Pharmaceuticals LP, Novartis
Pharmaceuticals, Pfizer Inc. Stephen E Jones,
MD: Director, Breast Cancer Research, Charles
A Sammons Cancer Center, Baylor University
Medical Center, Dallas, Texas, Chair, US
Oncology Breast Cancer Research, Medical
Director, US Oncology Research, Houston,
Texas; Consulting Fees: AstraZeneca
Pharmaceuticals LP; Honorarium: AstraZeneca
Pharmaceuticals LP, Roche Laboratories Inc.
Gershon Locker, MD: Kellogg Scanlon Chair of
Oncology, Evanston Northwestern Healthcare,
Professor of Medicine, Northwestern
University, Feinberg School of Medicine,
Evanston, Illinois. Grants/Research Support:
AstraZeneca Pharmaceuticals LP; Consulting
Fees and Honorarium: AstraZeneca
Pharmaceuticals LP, Sanofi-Aventis. John
Mackey, MD: Medical Oncologist, Cross
Cancer Institute, Associate Professor, Medical
and Experimental Oncology, University of
Alberta, Chair, Northern Alberta Breast Cancer
Program, Canadian Leader, Breast Cancer
International Research Group, Alberta, Canada.
Grants/Research Support and Honorarium:
Amgen Inc, AstraZeneca Pharmaceuticals LP,
Novartis Pharmaceuticals, Roche Laboratories
Inc, Sanofi-Aventis; Consulting Fees: Sanofi-
Aventis. Eleftherios P Mamounas, MD, MPH:
Associate Professor of Surgery, Northeastern
Ohio Universities College of Medicine, Medical
Director, Aultman Cancer Center, Canton, Ohio.
Consulting Fees: AstraZeneca
Pharmaceuticals LP, Eli Lilly and Company,
Novartis Pharmaceuticals, Pfizer Inc, Sanofi-
Aventis; Honoraria: AstraZeneca
Pharmaceuticals LP, Genomic Health Inc,
Novartis Pharmaceuticals, Pfizer Inc, Sanofi-
Aventis. Joyce O’Shaughnessy, MD: Co-
Director, Breast Cancer Research Program,
Baylor-Charles A Sammons Cancer Center, US
Oncology, Dallas, Texas. Speakers Bureau: Eli
Lilly and Company, Roche Laboratories Inc,
Sanofi-Aventis. Edith A Perez, MD: Professor
of Medicine, Mayo Medical School, Director,
Cancer Clinical Study Unit, Director, Breast
Cancer Program, Division of Hematology and
Oncology, Mayo Clinic, Jacksonville, Florida;
Grants/Research Support: Genentech
BioOncology, Novartis Pharmaceuticals,
Sanofi-Aventis. Peter M Ravdin, MD, PhD:
Clinical Professor of Medicine, The University
of Texas, Health Science Center at San
Antonio, San Antonio, Texas. Grants/Research
Support: AstraZeneca Pharmaceuticals LP ;
Consulting Fees: Pfizer Inc, Sanofi-Aventis;
Ownership: Adjuvant! Inc. Edward H Romond,
MD: Associate Professor of Medicine, Division
of Hematology/Oncology, University of
Kentucky, Lexington, Kentucky, No financial
interests or affiliations to disclose. Dennis J
Slamon, MD, PhD: Professor of Medicine,
Chief, Division of Hematology/Oncology,
Director of Clinical/Translational Research,
Jonsson Comprehensive Cancer Center, David
Geffen School of Medicine at UCLA, Los
Angeles, California. Ownership Interest:
Amgen Inc, Schering-Plough Corporation;
Honoraria: Genentech BioOncology,
NewBiotics Inc, Pfizer Inc, Roche Laboratories
Inc, Sanofi-Aventis; Consulting Fees:
NewBiotics Inc, Pfizer Inc. George W Sledge
Jr, MD: Professor of Medicine, Ballve-Lantero
of Oncology, Indiana University Medical Center,
Indianapolis, Indiana; Consulting Fees:
Genentech BioOncology. Debu Tripathy, MD:
Professor of Internal Medicine, Director, Komen
UT Southwestern Breast Cancer Research
Program, University of Texas Southwestern
Medical Center, Dallas, Texas. Grants/
Research Support: Genentech BioOncology,
GlaxoSmithKline, Roche Laboratories Inc;
Consulting Fees: EMD Pharmaceuticals Inc,
Genentech BioOncology, Roche Laboratories
Inc. Eric P Winer, MD: Director, Breast
Oncology Center, Dana-Farber Cancer Institute,
Associate Professor of Medicine, Harvard
Medical School, Boston, Massachusetts.
Speakers Bureau: Genentech BioOncology.
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. Consulting
Fees: Sanofi-Aventis
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