To receive CME credit for this program:
- Read the CME information and mark the checkbox confirming you have read the disclosures to download the PDF file below
- Review the article and illustration
- Login or register at the CME post test website (http://www.bucmetest.com)
- Locate the course code I.ANG11MCRCHCC and take the test
Jointly sponsored by Boston University School of Medicine and the Angiogenesis Foundation
ACCREDITATION STATEMENT
This CME activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through Joint Sponsorship of Boston University School of Medicine and the Angiogenesis Foundation. Boston University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
CREDIT DESIGNATION
Boston University School of Medicine designates this Internet activity for a maximum of 1.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit will be awarded provided this activity is used and completed according to instructions and a score of 70% or better is achieved. A certificate of credit will be issued to those who successfully complete the examination.
RELEASE AND EXPIRATION
Date of original release: November 15, 2011
Date of expiration: November 14, 2012
Estimated Time To Complete: 1.75 Hours
CME Course Code: I.ANG11MCRCHCC
TARGET AUDIENCE
Practicing oncologists in the U.S., researchers and medical students
HEALTHCARE GAP
More than 142,570 new cases of colorectal cancer were diagnosed in the U.S. in 2010, and an estimated 51,370 people died from this disease. While better early detection and improved chemotherapy regimens to treat advanced CRC have prolonged life expectancy, these improvements, however, have come at the cost of increasingly complex and toxic chemotherapy regimens, which often compromises patient quality of life. The FDA approval of bevacizumab (Avastin®) for the treatment of mCRC has increased the complexity of treating this disease. In addition, oncologists are faced with an increasing number of targeted agents being evaluated in clinical trials for mCRC.
More than 26,190 new cases of hepatocellular carcinoma will be diagnosed in 2011, and an estimated 19,590 people will die from this disease. An average man's lifetime risk of getting liver or bile duct cancer is about 1 in 100, while an average woman's risk is about 1 in 217. The majority of patients with HCC die within 1 year after the diagnosis of their disease. Unfortunately, the disease is often diagnosed at a late stage when potentially curative therapies are least effective. The 5-year relative survival rate for patients with metastatic HCC is only 7%. The prognosis for HCC patients who have surgically resectable tumors is better, but the 5-year survival rate is still only 15% to 39%. The FDA approval of sorafenib (Nexavar®) as the first systemic therapy for advanced HCC was a major milestone in the treatment of this tumor. New antiangiogenic agents in clinical trials will likely provide further gains.
A critical need exists to develop strategies that may increase the degree of the anti-tumor effects with the hope of inducing more complete responses impeding the onset of or elimination of refractory disease. Combinations of these and other targeted agents may overcome the resistance that develops with single-agent therapy and could be incorporated either as part of initial therapy or later when disease resistance develops. Even with approved agents on the market, the relatively new approaches to CRC and HCC management lead to a critical need to rapidly and effectively educate physicians about the pathways and mechanisms; strategies by which new treatments are being integrated into traditional therapeutic protocols; efficacy and safety data emerging from well-designed and rigorous clinical studies; and how this data can directly be used to improve clinical decision-making and outcomes for cancer patients. The management of the common side effects of antiangiogenic therapies is also an emerging concern. These side effects, while varied, can usually be managed through established methods, but physicians must be able to quickly identify side effects as they develop.
PROGRAM LEARNING OBJECTIVES
The overarching objective is to educate medical oncologists who have a high number of patients in their practice that could benefit from new treatments targeting tumor angiogenesis in cancer.
At the completion of this activity, participants should be able to:
- Describe the role of tumor angiogenesis as both a disease mechanism and therapeutic target in mCRC and advanced HCC.
- Explain how antiangiogenic therapies may be integrated into current mCRC and HCC treatment regimens, including front-line, second-line, maintenance, and adjuvant therapy settings.
- Discuss clinical efficacy and safety data from recent studies on antiangiogenic therapies for mCRC and HCC.
- Describe common safety concerns of antiangiogenic cancer therapy and their management.
- Explain strategies for addressing progressive disease, including the use of combination antiangiogenic treatment or new therapy targets under investigation.
METHOD OF PARTICIPATION
There are no fees for participating in and receiving credit for this online educational activity. The participant should, in order, read the objectives and faculty disclosures, review the educational content, answer the multiple-choice post-test and complete the evaluation. This program is available in PDF format accessible from the Angiogenesis Foundation's website (http://www.angio.org) in the CME section. A print version is also available; for more information contact outreach@angio.org. After reviewing the material, CME credits are available through the Boston University School of Medicine's website (http://www.bucmetest.com) by selecting the name of the program (registration required). Course code: I.ANG11MCRCHCC.
ACKNOWLEDGEMENT OF SUPPORT
This activity is supported by an educational grant from Abbott and Genentech.
COURSE FACULTY
Al B. Benson III, M.D., FACP (mCRC)
Professor in Medicine—Hematology/Oncology
Robert H. Lurie Comprehensive Cancer Center
Northwestern University Feinberg School of Medicine
Scott Kopetz, M.D., Ph.D., FACP (mCRC)
Assistant Professor
Department of Gastrointestinal Medical Oncology
University of Texas MD Anderson Cancer Center
William R. Jarnagin, M.D., FACS (HCC)
Vice Chair, Surgical Services, Department of Surgery; Chief, Hepatopancreatobiliary Service
Enid A. Haupt Chair in Surgery
Memorial Sloan-Kettering Cancer Center
Eileen O’Reilly, M.D. (HCC)
Associate Attending
Gastrointestinal Medical Oncology
Memorial Sloan-Kettering Cancer Center
Associate Professor of Medicine
Weill Medical College of Cornell
DISCLOSURE
Boston University School of Medicine asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve apparent conflicts of interest. In addition, faculty members are asked to disclose when any unapproved use of pharmaceuticals and devices is being discussed.
Al B. Benson III, M.D., FACP
Northwestern University Feinberg School of Medicine
Faculty
Dr. Benson receives grant/research support from Amgen, Bayer, Genentech and Gilead, and is a consultant for Abbott Laboratories, Amgen and Gilead.
Scott Kopetz, M.D., Ph.D., FACP
University of Texas MD Anderson Cancer Center
Faculty
Dr. Kopetz receives grant/research supports from AstraZeneca and Roche, and is a consultant for Bayer, MedImmune and Roche.
Eileen O’Reilly, M.D.
Memorial Sloan-Kettering Cancer Center
Faculty
Dr. O’Reilly receives grant/research support from Agensys, Amgen, Astella, AstraZeneca, Bayer, Chugai, ImClone, Medigene, Polaris, and Sanofi-Aventis, and is a consultant for Abbott, Amgen, BMS, Bayer, Celsion, Chugai, Clovis, Genentech, GenVec, Halozyme, ImClone, Jennerex, Medigene, Merck, Novartis, OSI, Piramal, Polaris, Proacta, Roche, Sanofi- Aventis, Vicus, and Ziopharm.
William R. Jarnigan, M.D., FACS
Memorial Sloan-Kettering Cancer Center
Faculty
Dr. Jarnigan receives grant/research support from Pathfinder Therapeutics.
William W. Li, M.D.,
President, the Angiogenesis Foundation, Editor-in-Chief
Dr. Li has nothing to disclose with regard to commercial interests.
Vickie R. Driver, DPM, M.S., FACFAS, Associate Professor of Surgery, Boston University School of Medicine
Course Director
Dr. Driver receives grant/research support from Baxter, Celleration, and 3M.
Jody Walker, M.S.
BUSM CME Program Manager
BUSM CME Program Manager has nothing to disclose with regard to commercial interests.
Roderick A. Smith, M.S.
Medical Writer, Program Manager, the Angiogenesis Foundation
Medical Writer, Program Manager has nothing to disclose with regard to commercial interests.
Joyce Carpenter, M.D.
Medical writer
Medical writer has nothing to disclose with regard to commercial interests.
DISCUSSION OF UNLABELLED USE
This CME activity contains discussion of published and/or investigational use of: aflibercept (VEGF Trap), axitinib, bevacizumab (Avastin®), BIBF 1120, brivanib, cediranib (Recentin®), cetuximab (Erbitux®), everolimus (RAD001; Afinitor®), linifanib, pazopanib (Votrient®), PI-88, ramucirumab (IMC-1121B), regorafenib, sorafenib (Nexavar®) sunitinib (Sutent®), temsirolimus (Torisel®), and vandetanib.
PRIVACY POLICY
The Office of Continuing Medical Education adheres to Boston University’s Conditions of Use and Policy on Computing Ethics. <http://www.bu.edu/cme/policies/privacy_policy.html>
Data gathered from participants who participate in Boston University School of Medicine’s (BUSM) Continuing Medical Education Internet-Based CME program is confidential.
Individual identifiable information is not shared with outside parties. Cumulative data may be analyzed by CME personnel, and, upon occasion, by individuals external to BUSM CME in order to determine trends.
THESE MATERIALS AND ALL OTHER MATERIALS PROVIDED IN CONJUNCTION WITH CONTINUING MEDICAL EDUCATION ACTIVITIES ARE INTENDED SOLEY FOR PURPOSES OF SUPPLEMENTING CONTINUING MEDICAL EDUCATION PROGRAMS FOR QUALIFIED HEALTH CARE PROFESSIONALS. ANYONE USING THE MATERIALS ASSUMES FULL RESPONSIBILITY AND RISK FOR THEIR APPROPRIATE USE. TRUSTEES OF BOSTON UNIVERSITY MAKE NO WARRANTIES OR REPRESENTATIONS WHATSOEVER REGARDING THE ACCURACY, COMPLETENESS, CURRENTNESS, NONINFRINGEMENT, MERCHANTABILITY, OR FITNESS FOR A PARTICULAR PURPOSE OF THE MATERIALS. IN NO EVENT WILL TRUSTEES OF BOSTON UNIVERSITY BE LIABLE TO ANYONE FOR ANY DECISION MADE OR ACTION TAKEN IN RELIANCE ON THE MATERIALS. IN NO EVENT SHOULD THE INFORMATION IN THE MATERIALS BE USED AS A SUBSTITUTE FOR PROFESSIONAL CARE.
TOPICS AND EDUCATIONAL CONTENT
Topics to cover include the biological mechanisms underpinning angiogenesis in CRC and HCC, mechanisms of action of antiangiogenic therapies; the latest safety and efficacy data on the use of antiangiogenic therapies for CRC and HCC; management strategies for side effects of anti-VEGF therapy; and information about ongoing clinical trials. Oncologists are incorporating targeted therapies into standard approved treatment regimens for their patients, and many are enrolling patients into clinical trials using targeted therapies. Bevacizumab (Avastin®) is now part of standard front-line therapy for mCRC and is being combined with a number of induction chemotherapy agents. Further, a new agent, aflibercept (VEGF Trap) is in phase 3 clinical trials for mCRC. For advanced HCC, two antiangiogenic agents, sorafenib (Nexavar®) and everolimus (RAD001; Afinitor®), are FDA approved for therapy. Recent clinical data on these and other agents is discussed.
SYSTEM REQUIREMENTS
This educational program is available in PDF format. To view and print PDF files, you must have Adobe Reader installed on your computer. Most computers already have this software installed. If yours does not, you can download Adobe Reader free from the Adobe Web site: http://www.adobe.com.
If you have questions regarding certificates, please contact BUSM CME by email at cme@bu.edu or visit http://www.bu.edu/cme
For questions about this program, please contact the Angiogenesis Foundation at 617-401-2779 or outreach@angio.org.
Copyright 2011 by the Angiogenesis Foundation. All rights reserved.
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