OVERVIEW OF ACTIVITY

It is important for practicing oncologists to be aware of similarities and differences between their treatment patterns and those of other oncologists. It is also important for cancer care specialists to recognize that heterogeneity exists in the oncology community, especially in clinical situations for which there is suboptimal research evidence to definitively support a single strategy.

This program focuses on the self-described practice patterns of randomly selected medical oncologists related to key clinical issues in supportive cancer care. Also included are clinical investigator commentary and excerpts from select publications addressing these topics. This CME program will provide medical oncologists with information on national cancer patterns of care to assist with the development of clinical management strategies.

LEARNING OBJECTIVES

• Compare and contrast self-reported supportive care management strategies utilized by community oncologists when addressing toxicities related to the endocrine treatment of breast cancer.
• Maintain effective anticancer regimens by employing prophylactic and acute supportive care strategies that minimize the incidence and severity of aromatase inhibitor-associated joint discomfort and bone loss.
• Identify premedication regimens to reduce the risk of hypersensitivity and emetogenic reactions among patients receiving systemic chemotherapy.
• Recall the chemical entities that are associated with chemotherapy-induced peripheral neuropathy, and utilize practical interventions to abrogate this toxicity without compromising the efficacy of primary anticancer treatments.
• Describe the incidence and clinical presentation of cutaneous side effects accompanying specific cytotoxic agents and EGFR and multitargeted tyrosine kinase inhibitors, and incorporate evidence-based management strategies into routine patient care.
• Develop a cardiovascular risk-reduction strategy and monitoring plan to reduce the incidence of short- and long-term toxicity associated with anti-angiogenic and anti-HER2 therapies.
• Recognize the signs of cancer-related depression and recommend medical and behavioral alternatives for affected patients.
• Delineate the complementary and alternative practices employed by cancer specialists to support oncology patients undergoing conventional antineoplastic treatments.

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 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

HOW TO USE THIS CME ACTIVITY

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 Educational Assessment and Credit Form located on our website at www.ResearchToPractice.com/POC/SupportiveCare. PowerPoint files of the graphics contained in this document can be downloaded at www.ResearchToPractice.com/POC/SupportiveCare.

COMMERCIAL SUPPORT

This program is supported by educational grants from AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Eisai Inc, Genentech BioOncology, ImClone Systems Incorporated, Merck and Company Inc, Pfizer Inc and Sanofi-Aventis.

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.

CONTENT VALIDATION AND DISCLOSURES

Research To Practice (RTP) 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 through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

CME DISCLOSURES FOR QUOTED FACULTY

FACULTY — Drs Alberts, Giordano, Gnant, Howell and Lin had no financial interests or affiliations to disclose. The following faculty (and their spouses/partners) reported real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process: Dr Berlin — Consulting Fees: Amgen Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Genentech BioOncology, ImClone Systems Incorporated, Novartis Pharmaceuticals Corporation, Pfizer Inc, Sanofi-Aventis. Dr Brahmer — Consulting Agreements: Cephalon Inc, Eli Lilly and Company, Genentech BioOncology; Paid Research: AstraZeneca Pharmaceuticals LP, Medarex Inc, Merck and Company Inc, Pfizer Inc, Wyeth. Dr Burstein — Speakers Bureau: Amgen Inc, Genentech BioOncology. Dr Chlebowski — Consulting Fees: AstraZeneca Pharmaceuticals LP, Novartis Pharmaceuticals Corporation, Pfizer Inc; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: AstraZeneca Pharmaceuticals LP, Novartis Pharmaceuticals Corporation. Dr Cuzick — Consulting Fees: AstraZeneca Pharmaceuticals LP, Eli Lilly and Company, Pfizer Inc. Dr Davidson — Paid Research: Eisai Inc. Dr de Gramont — Consulting Fees: Genentech BioOncology, Roche Laboratories Inc, Sanofi-Aventis. Dr Durand — Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Sanofi-Aventis. Dr Enzinger — Consulting Fees: Daiichi Pharmaceutical Co Ltd, Genentech BioOncology, Pfizer Inc, Sanofi-Aventis. Dr Figlin — Consulting Agreements: Biogen Idec, Idera Pharmaceuticals Inc, Keryx Biopharmaceuticals Inc, Novartis Pharmaceuticals Corporation, Pfizer Inc, Wyeth; Paid Research: Amgen Inc, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Pfizer Inc, Wyeth. Ms Fish-Steagall — Advisory Committee: Bristol-Myers Squibb Company, Genentech BioOncology; Consulting Agreement: Bristol-Myers Squibb Company; Speakers Bureau: Bristol-Myers Squibb Company, Eli Lilly and Company, Genentech BioOncology. Prof Forbes — Consulting Fees: Novartis Pharmaceuticals Corporation; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: AstraZeneca Pharmaceuticals LP, Novartis Pharmaceuticals Corporation. Dr Gralow — Consulting Agreements: Amgen Inc, Genentech BioOncology, Genomic Health Inc, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi-Aventis. Dr Greco — Advisory Committee: Bristol-Myers Squibb Company, Eli Lilly and Company; Paid Research: Eli Lilly and Company; Speakers Bureau: Eli Lilly and Company, GlaxoSmithKline. Dr Grothey — Advisory Committee: Genentech BioOncology, Genomic Health Inc, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis; Consulting Agreements: Amgen Inc, Bayer Pharmaceuticals Corporation, Bristol-Myers Squibb Company, Genentech BioOncology, Roche Laboratories Inc. Dr Haller — Consulting Fees: Amgen Inc, Bristol-Myers Squibb Company, Genentech BioOncology, Roche Laboratories Inc, Sanofi-Aventis, Taiho Pharmaceutical Co Ltd; Other Financial Support: Genentech BioOncology, Roche Laboratories Inc, Sanofi-Aventis. Dr Hayes — Paid Research: AstraZeneca Pharmaceuticals LP, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Pfizer Inc. Dr Holmes — Consulting Fees: Elan Corporation, GlaxoSmithKline, Roche Laboratories Inc. Dr Hurwitz — Consulting Fees: Bristol-Myers Squibb Company, Genentech BioOncology, Roche Laboratories Inc; Contracted Research: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Genentech BioOncology, GlaxoSmithKline, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis, Sunesis Pharmaceuticals Inc; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: Genentech BioOncology. Dr Jones — Consulting Fees: Pfizer Inc, Sanofi-Aventis; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, GlaxoSmithKline, Pfizer Inc, Sanofi-Aventis. Dr Lacouture — Consulting Agreement: Onyx Pharmaceuticals Inc; Paid Research: GlaxoSmithKline, Hana Biosciences Inc; Paid Speaker: Bristol-Myers Squibb Company; Speakers Bureau: ImClone Systems Incorporated. Dr Lynch — Consulting Agreements: AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Eli Lilly and Company, Genentech BioOncology, ImClone Systems Incorporated, OSI Oncology, Roche Laboratories Inc, Sanofi-Aventis; Patent for EGFR Testing: Genzyme Corporation. Dr O’Connell — Consulting Fees: ImClone Systems Incorporated. Dr O’Shaughnessy — Consulting Fees: Biogen Idec, Bristol-Myers Squibb Company, Eisai Inc, Eli Lilly and Company, Genentech BioOncology, Genzyme Corporation, Novartis Pharmaceuticals Corporation, Ortho Biotech Products LP, Pfizer Inc; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: Abraxis BioScience, Eli Lilly and Company, Sanofi-Aventis. Dr Perez-Soler — Consulting Fees, Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents and Ownership Interest: Eli Lilly and Company, Genentech BioOncology; Receipt of Intellectual Property Rights/Patent Holder: Hana Biosciences Inc. Dr Slamon — Speakers Bureau: Genentech BioOncology, Sanofi-Aventis. Dr Stadler — Advisory Committee: Bayer Pharmaceuticals Corporation, Wyeth; Consulting Agreements: Amgen Inc, AstraZeneca Pharmaceuticals LP, Bayer Pharmaceuticals Corporation, Genentech BioOncology, Millennium Pharmaceuticals Inc, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals Inc, Pfizer Inc; Stock Ownership: Abbott Laboratories. Dr Venook — Advisory Committee: Amgen Inc, ImClone Systems Incorporated; Grant Funding: Genentech BioOncology; Paid Research: Novartis Pharmaceuticals Corporation, Pfizer Inc. Dr Vogel — Consulting Fees: Amgen Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Genentech BioOncology, GlaxoSmithKline, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis; Contracted Research: Amgen Inc, AstraZeneca Pharmaceuticals LP, Bionovo, Genentech BioOncology, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis, Sopherion Therapeutics Inc, Taiho Pharmaceutical Co Ltd; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: Amgen Inc, AstraZeneca Pharmaceuticals LP, Genentech BioOncology, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis.

EDITOR — Dr Love does not receive any direct remuneration from industry. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: Abraxis BioScience, AstraZeneca Pharmaceuticals LP, Aureon Laboratories Inc, Bayer Pharmaceuticals Corporation/Onyx Pharmaceuticals Inc, Biogen Idec, Bristol-Myers Squibb Company, Celgene Corporation, Eisai Inc, Eli Lilly and Company, Genentech BioOncology, Genomic Health Inc, GlaxoSmithKline, ImClone Systems Incorporated, Merck and Company Inc, Millennium Pharmaceuticals Inc, Novartis Pharmaceuticals Corporation, Ortho Biotech Products LP, OSI Oncology, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis, Synta Pharmaceuticals Corp and Wyeth.

RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no real or apparent conflicts of interest to disclose.