Consensus or Controversy? The Integration of Novel Therapies into the Interdisciplinary Management of Non-Small Cell Lung Cancer with CNS Metastases: Our most recent one-on-one interview with Dr Riely.

Proceedings from a CME symposium held during the 24th Annual Meeting and Education Day of the Society for Neuro-Oncology. Featuring perspectives from moderator Dr Matthew Gubens and faculty members Drs Manmeet S Ahluwalia, Daniel Gomez and Gregory J Riely:

• Prevalence and Clinical Significance of Central Nervous System (CNS) Involvement in Non-Small Cell Lung Cancer (NSCLC); Indications for Various Local Treatment Modalities — Dr Gomez (00:00)
• Optimal Management of Brain Metastases in Oncogene-Driven NSCLC — Dr Riely (9:23)
• Management of Leptomeningeal Metastases in NSCLC with a Targetable Tumor Mutation; Role of Immune Checkpoint Inhibition in the Treatment of CNS Disease Stemming from NSCLC — Dr Ahluwalia (19:59)

CME information and select publications

Featuring perspectives from moderator Dr Matthew Gubens and faculty members Drs Manmeet S Ahluwalia, Daniel Gomez and Gregory J Riely.

Genomic Assays in the “Real” Oncology World — Part 1: Genomic Assays and Colorectal Cancer — Featuring a roundtable discussion with Drs Emmanuel S Antonarakis, Johanna Bendell, Ian E Krop and Andrew McKenzie.

• Multiplex Genomic Assays and Their Role in Therapeutic Decision-Making
• Case: A man in his mid-80s with metastatic castration-resistant prostate cancer (mCRPC) whose disease progressed through multiple therapies is found to have CD274 (PD-L1) amplification, microsatellite instability (MSI)-high status and mutations in ATM and EGFR
• Effect of CD274 amplification on response to immune checkpoint inhibitors; activity of PARP inhibitors in patients with ATM mutations
• Advantages and limitations of multiplex genomic testing
• Role of serial testing to identify variations in genomic mutations or aberrations over time; potential benefit of liquid next-generation sequencing (NGS) panels
• Use of multiplex genomic assays by community oncologists and implications for clinical practice
• Optimal timing of genetic testing for patients diagnosed with metastatic disease
• Presentation (Dr McKenzie): Overview of multiplex genomic assay methodology
• Rationale for the use of serial testing and liquid assays to identify variations in genomic mutations or aberrations over time
• Differentiating between germline and somatic mutations in cancer tissue
• Perspective on the use of tissue versus liquid biopsy for genetic testing
• Sensitivity of liquid biopsies in detecting tumor mutations
• Available data exploring the impact of NGS use on patient outcomes
• Selection of a multiplex genomic assay for detecting genetic alterations
• Implications of multiplex genomic assay results for therapeutic decision-making
• Comprehensive Genetic Profiling and Precision Medicine for Metastatic Colorectal Cancer (mCRC)
• Specific biomarkers and genetic alterations routinely evaluated in clinical practice
• Effects of up-front multiplex genomic assay testing on outcomes for patients with mCRC
• Response to immune checkpoint inhibitors in patients with MSI-high mCRC (1:09:3s
• Presentation (Dr Bendell): Biomarker assessment in mCRC; role of multiplex testing
• Actionable genetic alterations in mCRC; detection of BRAF and HER2 mutations and implications for practice
• Rationale and indications for the assessment of MSI and DNA mismatch repair (MMR) status; emerging role of tumor mutational burden
• Role of liquid versus tumor biopsies for detecting genetic alterations
• MSI/MMR and tumor mutational burden as predictors of benefit from immune checkpoint inhibitors
• Emerging role for the assessment of neoantigen load
• Case (Dr Bendell): A man in his mid-50s with mCRC, Lynch syndrome and MSI-high status achieves a partial response to pembrolizumab as second-line therapy
• Case (Dr Bendell): A woman in her early 60s with microsatellite stable mCRC and a BRAF V600E mutation receives the combination of cetuximab, encorafenib and binimetinib after disease progression on FOLFOXIRI/bevacizumab
• Case (Dr Bendell): A man in his early 40s with HER2-positive mCRC receives trastuzumab and pertuzumab on a clinical trial after disease progression on FOLFIRI/bevacizumab and attains a partial response
• Novel HER2-targeted therapies under evaluation for patients with mCRC and HER2 alterations
• Analysis of the gut microbiome and strategies to enhance the immune response to cancer

 

CME information and select publications

Genomic Assays in the “Real” Oncology World — Part 1: Genomic Assays and Colorectal Cancer — Featuring a roundtable discussion with Drs Emmanuel S Antonarakis, Johanna Bendell, Ian E Krop and Andrew McKenzie.

Genomic Assays in the “Real” Oncology World — Part 2: Genomic Assays in Prostate and Breast Cancer — Featuring a roundtable discussion with Drs Emmanuel S Antonarakis, Johanna Bendell, Ian E Krop and Andrew McKenzie.

• NGS for Metastatic Prostate Cancer (mPC) and the Potential Clinical Significance of Genomic Alterations
• Genetic alterations assessed in routine practice, including MSI status, BRCA mutations and AR-V7 variants; role of multiplex testing
• Presentation (Dr Antonarakis): Biomarker assessment in mPC; detection of DNA damage repair abnormalities and prediction of benefit with PARP and PD-1 inhibitors
• Landscape of DNA damage repair mutations in newly diagnosed and metastatic prostate cancer
• Rationale for the use of PARP inhibitors for prostate cancer with BRCA or ATM mutations
• Genetic testing of primary and metastatic tumors for alterations in the DNA repair and androgen receptor (AR) signaling pathways
• Clinical significance and genetic detection of AR splice variants
• Results of the CARD trial: Cabazitaxel versus enzalutamide or abiraterone for patients with mCRPC previously treated with docetaxel who experience rapid disease progression on an AR-targeted agent
• Efficacy of olaparib for mCRPC
• Available data with rucaparib, niraparib and talazoparib for mCRPC
• Role of radium-223 dichloride for patients with mPC; novel combination approaches with radium-223 under investigation
• Sensitivity of BRCA1, BRCA2 and ATM mutations to PARP inhibitors
• Activity of PARP inhibitors in patients with breast, ovarian, prostate and pancreatic cancers with BRCA mutations
• Homologous recombination deficiency and response to PARP inhibitors
• Case (Dr Antonarakis): A man in his mid-40s with mCRPC and a BRCA2 mutation attains a complete response to olaparib
• Case (Dr Antonarakis): A man in his mid-60s diagnosed with de novo mPC and MSI-high status, high tumor mutation burden and an MSH2 mutation experiences an excellent response to pembrolizumab after multiple lines of therapy
• Association of ductal and intraductal prostate cancer with a high prevalence of DNA damage repair gene mutations
• Predictors of benefit with immune checkpoint inhibitors
• Multigene Testing and Detection of Genomic Alterations in Metastatic Breast Cancer (mBC)
• Role of MSI testing and multiplex genomic assays in mBC
• Assessment of PIK3CA and BRCA mutations and assays for ESR1
• Presentation (Dr Krop): Biomarker assessment in mBC — ER-positive and triple-negative disease
• PTEN loss and implications for therapeutic decision-making for mBC
• ESR1 mutations and resistance to hormone therapy
• Efficacy of PARP inhibitors in patients with BRCA mutations
• HER2 expression in HER2 nonamplified cancers; activity of trastuzumab deruxtecan in HER2-low breast cancer
• PD-L1 and other biomarkers predictive of benefit from immunotherapy in triple-negative breast cancer (TNBC)
• Case (Dr Krop): A woman in her late 50s with de novo TNBC receives atezolizumab/nab paclitaxel as first-line therapy
• Case (Dr Krop): A woman in her early 60s with ER-positive, HER2-negative mBC and a germline BRCA2 mutation whose disease progresses through multiple therapies attains a partial response to olaparib
• The Sarah Cannon Experience with Molecular Tumor Boards
• The use of molecular tumor boards to review molecular profiling data and facilitate therapeutic decision-making

CME information and select publications

Genomic Assays in the “Real” Oncology World — Part 2: Genomic Assays in Prostate and Breast Cancer — Featuring a roundtable discussion with Drs Emmanuel S Antonarakis, Johanna Bendell, Ian E Krop and Andrew McKenzie.

Proceedings from RTP’s First Annual Oncology Nursing Symposium — Part 9: Lung Cancer — Featuring moderated discussion of important clinical research, ongoing trials and actual patient cases by Ms Kelly EH Goodwin, Dr Matthew Gubens, Ms Wendi S Lee and Dr Anne S Tsao. Moderated by Dr Neil Love.

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Proceedings from RTP’s First Annual Oncology Nursing Symposium — Part 9: Lung Cancer — Featuring moderated discussion of important clinical research, ongoing trials and actual patient cases by Ms Kelly EH Goodwin, Dr Matthew Gubens, Ms Wendi S Lee and Dr Anne S Tsao. Moderated by Dr Neil Love.

Proceedings from RTP’s First Annual Oncology Nursing Symposium — Part 8: Gynecologic Cancers — Featuring moderated discussion of important clinical research, ongoing trials and actual patient cases by Paula J Anastasia and Dr Kathleen Moore. Moderated by Dr Neil Love.

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