Participating Faculty: Non-Small Cell Lung Cancer: Clinical and Economic Considerations in Targeting Therapy Based on Molecular Profiling [CME/CPE]

Published Online: December 30, 2013
This supplement to The American Journal of Managed Care provides an overview of the epidemiology and pathophysiology of non-small cell lung cancer (NSCLC) and examines the gene mutations involved in the pathogenesis of NSCLC. Also discussed are the current and emerging treatment strategies for NSCLC, including the utility of biomarker analysis in targeted therapies, as well as the managed care aspects of epidermal growth factor receptor testing in NSCLC, such as its implementation into clinical practice and the evaluation of outcomes for cost-effectiveness.
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 (0.25 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.


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.