Participating Faculty: Castration-Resistant Prostate Cancer: Addressing Treatment Challenges, Managed Care Aspects, and Integration of Existing and New Therapies Into Practice

This supplement to The American Journal of Managed Care is intended to provide an understanding of the pathophysiologic basis of castration-resistant prostate cancer (CRPC) and metastatic disease and the growing research surrounding potential therapeutic and prognostic markers in CRPC. The discussion will include classification of CRPC, the evolving standards of care, and the emergence of novel targeted therapies. Also included is an analysis of the healthcare resource utilization and the short- and longterm costs associated with CRPC and its consequences.Release date: December 12, 2013 | Expiration date: December 12, 2014

Estimated time to complete activity: 2.5 hours

Type of Activity: Knowledge | Activity fee: Free of charge

Medium: Print with Internet-based posttest, evaluation, and request for credit.

This activity is supported by educational grants from AbbVie Inc and Bayer HealthCare Pharmaceuticals.

Intended Audience

Physicians, pharmacists, and other healthcare professionals who oversee the treatment of patients with castration-resistant prostate cancer.

Statement of Educational Need

Advances in early detection of prostate cancer (PrCa) have led to a significant reduction in the number of patients who are initially diagnosed with advanced stages of the disease, as evidenced by a drop from 30% to 40% of men between 1984 and 1991 to only 5% of men today. However, despite improvements in early detection, PrCa continues to be the second-highest cause of cancer-related death among men in the United States, most likely due to hormone-refractory or androgen-independent disease, which is also referred to as castration-resistant prostate cancer (CRPC). The management of CRPC continues to be a substantial clinical challenge. With up to 20% to 40% of patients with PrCa experiencing disease recurrence following primary therapy and the constant threat of further metastatic disease, advances in the understanding and manipulation of cellular signaling have led to an increased focus on the benefits of targeted therapies.

The therapeutic pipeline for advanced PrCa and CRPC is an ever expanding one, with current treatment options including secondary hormone therapy, conventional chemotherapy, and targeted immunotherapy. While there is currently no standard therapy for post docetaxel CRPC, many of the new and emerging agents, such as abiraterone acetate, cabazitaxel, and sipuleucel- T, have demonstrated significant efficacy against the disease in various clinical trials. Coupled with an increased understanding of biomarkers and improved management strategies for associated comorbidities, such as skeletal- related events and bone metastases, there is a growing optimism among clinicians and other healthcare providers as expectations and the therapeutic paradigm continue to evolve.

Educational Objectives

Upon completion of the educational activity, the participant should be able to:

• Assess the incidence and clinical markers for classifying advanced prostate cancer (castration-resistant prostate cancer [CRPC])
• Evaluate the importance of the prostate tumor microenvironment, including the role of the immune system, epidermal growth factor receptors, and androgen receptor signaling
• Discuss current treatment approaches for CRPC, including challenges and limitations
• Examine managed care aspects of managing prostate cancer, including associated direct and indirect costs, resource utilization, and cost considerations in choosing treatment
• Assess strategies to integrate existing and new therapies into cancer clinical practice for treatment of advanced prostate cancer

Disclosure Policy

According to the disclosure policies of the Physicians’ Education Resource®, LLC (PER), and Pharmacy Times Office of Continuing Professional Education, all persons who are in a position to control content are required to disclose any relevant financial relationships with commercial interests. If a conflict is identified, it is the responsibility of the PER® and Pharmacy Times Office of Continuing Professional Education to initiate a mechanism to resolve the conflict(s). The existence of these relationships is not viewed as implying bias or decreasing the value of the activity. All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

Physician Credit

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Physicians’ Education Resource^®, LLC, and the Pharmacy Times Office of Continuing Professional Education. Physicians’ Education Resource^®, LLC, is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Physicians’ Education Resource^®, LLC, designates this journal-based CME activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacist Credit

Accreditation and Credit Designation

Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 2.5 contact hours (.25 CEUs) under the ACPE universal activity number 0290-9999-13-168-H01-P. The activity is available for CE credit through December 12, 2014.

Obtaining Credit: Each participant evaluating the activity and achieving a passing grade of 70% or higher on the posttest will receive a CME certificate or CPE statement of credit.

Faculty

Indu Lew, PharmD

Vice President, Corporate Pharmacy

Barnabas Health

South Plainfield, New Jersey

Daniel P. Petrylak, MD

Director, Prostate and GU Medical Oncology

Director, Prostate Cancer Translational Research Group

Professor of Medicine, Medical Oncology

Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven

New Haven, Connecticut

Contributing Editorial Support

Elizabeth Paczolt, MD, FACNM

Medical Consultant

Churchville, Pennsylvania

Faculty Disclosures

These faculty have disclosed the following relevant commercial financial relationships or affiliations in the past 12 months.

Daniel Petrylak, MD

Consultant or paid advisory board:

Bayer, Bellicum Pharmaceuticals, Dendreon, Exelixis, Ferring Pharmaceuticals, Johnson & Johnson, Medivation, Millennium, and sanofi-aventis

Grant support: Celgene, Dendreon, Johnson & Johnson, Millennium, OncoGenex Pharmaceuticals, and Progenics Pharmaceuticals

Indu Lew, PharmD; and Elizabeth Paczolt, MD, FACNM, have no relevant financial relationships with commercial interests to disclose.

The American Journal of Managed Care

Publishing Staff—Jeff D. Prescott, PharmD, RPh; Ida Delmendo; and Tara Petersen have disclosed no relevant financial relationships with commercial interests to disclose.

Pharmacy Times Office of Continuing Professional Education Physicians’ Education Resource®, LLC

Planning staff—Judy V. Lum, MPA; Steve Lin, PharmD, RPh; and Mary Jo Dixon, RPh, have no relevant financial relationships with commercial interests to disclose.

Off-label Disclosure and Disclaimer

The contents of this CME/CE supplement may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these products in the United States. Physicians and pharmacists should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information

for these products.

For additional information about approved uses, including approved indications, contraindications, and warnings, participants are advised to consult prescribing information for all products discussed. The information provided in this CME/CE activity is for continuing medical and pharmacy education purposes only and is not meant to substitute for the independent medical or pharmacy judgment of a physician or pharmacist relative to diagnostic, treatment, or management options for a specific patient’s medical condition.

The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of The American Journal of Managed Care, Physicians’ Education Resource® , LLC, the Pharmacy Times Office of Continuing Professional Education, or any of the companies that provided commercial support for this CME/CE activity.

Signed disclosures are on file at the office of The American Journal of Managed Care, Plainsboro, New Jersey.

Opinions expressed by authors, contributors, and advertisers are their own and not necessarily those of Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, the editorial staff, or any member of the editorial advisory board. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, is not responsible for accuracy of dosages given in articles printed herein. The appearance of advertisements in this publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality, or safety. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the articles or advertisements.

Publisher’s Note: The opinions expressed in this supplement are those of the authors, presenters, and/or panelists and are not attributable to the sponsor or the publisher, editor, or editorial board of The American Journal of Managed Care. Clinical judgment must guide each professional in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this supplement are not necessarily the same as indicated in the package insert for the product and may reflect the clinical experience of the authors, presenters, and/or panelists or may be derived from the professional literature or other clinical sources. Consult complete prescribing information before administering.

System Requirements

PC-based participants

Windows 7, Vista, XP, 2003 Server, or 2000

Macintosh®-based participants

Required: Mac OS X 10.4.11 (Tiger) or newer

© 2013 Managed Care & Healthcare Communications, LLC

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