Supplement
Issue:
Non-Small Cell Lung Cancer: Clinical and Economic Considerations in Targeting Therapy Based on Molecular Profiling [CME/CPE]
Volume:
19
Number:
19 Suppl
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 an educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.

Intended Audience
Physicians, pharmacists, and other healthcare professionals who oversee the treatment of patients with non-small cell lung cancer.

Statement of Educational Need
Accounting for nearly one-third of all cancer-related deaths, lung cancer affected over 200,000 individuals in 2010, and continues to be the leading cause of cancer-related mortality worldwide. Approximately 85% of these malignancies are classified as non-small cell lung cancer (NSCLC), which is associated with a dismal 5-year survival rate of only 16% across all stages of disease. While localized disease has a slightly more optimistic prognosis, with a 5-year survival rate of approximately 50%, only 15% of patients with lung cancer are diagnosed at this early stage. Unfortunately, the majority of patients will present with advanced disease, which is not only associated with high mortality, but also comes with substantial morbidity and economic burden.

Although platinum-based doublet chemotherapy continues to be the firstline treatment for advanced NSCLC, therapeutic options have now expanded beyond traditional cytotoxic chemotherapy to include molecularly targeted treatments that specifically act against key components of cellular pathways that are involved in tumor growth and progression, including epidermal growth factor receptor (EGFR) and vascular endothelial growth factor receptor pathways. Beyond expanding the treatment armamentarium for NSCLC, these newer agents and novel mechanisms have also driven the evolution of current diagnostic and therapeutic practices, further affirming the value of histological testing and molecular profiling in advanced NSCLC. However, while therapeutically advantageous, the advent of newer treatments, updated diagnostic procedures, and improved clinical practices for NSCLC has also been associated with increased costs and healthcare expenditures. To achieve improved outcomes in today’s cost-constrained healthcare and managed care environment, it is imperative to further educate all members of the disease management team, and to offer informed guidance regarding optimal disease management, appropriate drug and diagnostic utilization, and best clinical practices.

Educational Objectives
Upon completion of the educational activity, the participant should be able to:
  • Examine the epidemiology and pathophysiology of NSCLC, and gene mutations in NSCLC
  • Explore the current treatment strategies for NSCLC, including the utility of biomarker analysis in targeted therapies
  • Discuss the managed care aspects of EFGR testing in NSCLC, including implementation into clinical practice and the evaluation of cost-effectiveness
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 0290-9999-13-167-H01-P. The activity is available for CE credit through December 12, 2014.
Obtaining Credit: Testing and Grading Directions
Participants must read each article in this supplement, complete the online posttest achieving a passing score of 70% or higher, and complete an online evaluation and request for credit.


Faculty

Robert T. Adamson, PharmD, FASHP
Corporate Vice President of Clinical Pharmacy Services
Barnabas Health
West Orange, NJ

Jonathan Riess, MD, MS
Assistant Professor
University of California, Davis Medical School
UC Davis Comprehensive Cancer Center
Department of Internal Medicine
Division of Hematology/Oncology
Sacramento, California

Contributing Editorial Support

A. Scott Mathis, PharmD
Director of Pharmacy
Monmouth Medical Center
Long Branch, New Jersey

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

Jonathan Riess, MD, MS; Robert T. Adamson, PharmD, FASHP; and A. Scott Mathis, PharmD, 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; David Heckard; and Steve Lin, PharmD, 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
ARTICLES
Jonathan Riess, MD, MS
Robert T. Adamson, PharmD, FASHP
AUTHOR INDEX
CE/CME QUIZ