Developmental Therapeutics in Advanced Breast Cancer:
Novel Mechanisms and Future Directions

Program Description:

A substantial number of patients who are diagnosed with curable, early-stage breast cancer eventually experience a recurrence, either locally or at a distant site. Currently available treatment modalities—including surgery, radiation, chemotherapy, and targeted therapy such as hormone therapy—are unlikely to cure metastatic breast cancer, but they do prolong survival. The search continues for therapies that halt tumor growth while preserving healthy, noncancerous cells, thereby prolonging survival while minimizing the toxicity seen with conventional therapeutic agents. New medications that show promise are emerging for patients with advanced breast cancer, including small-molecule enzyme inhibitors, monoclonal antibodies, and microtubule inhibitors. Physicians need to be up to date on novel mechanisms and developmental therapeutics being used in the treatment of metastatic breast cancer, including efficacy, safety, and tolerability of new and experimental drugs and the potential impact of novel agents on survival and quality of life.

Activity Objectives:

After taking part in this educational activity, participants should be able to:

• Describe at least three possible molecular mechanisms by which breast cancer tumors grow and metastasize
• Discuss at least three new and novel mechanisms of action of investigational agents for advanced breast cancer
• Summarize clinical trial data on efficacy, safety, and tolerability for at least three investigational agents for advanced breast cancer
• Compare and contrast the biologic actions and potential role of small-molecule inhibitors, monoclonal antibodies, and chemotherapeutic agents in the treatment of advanced breast cancer
• Stratify risk and determine which therapeutic agents, alone or in combination, are most appropriate for a given clinical circumstance and how to integrate them into a comprehensive treatment plan

Faculty:

Carol L. Rosenberg, MD
Course Director
Associate Professor of Medicine and Pathology
Boston University School of Medicine
Boston, MA

William J. Gradishar, MD, FACP
Program Chair
Professor of Medicine
Director, Breast Medical Oncology
Robert H. Lurie Comprehensive Cancer Center
Northwestern University Feinberg School of Medicine
Chicago, IL

Lori J. Goldstein, MD
Director, Breast Evaluation Center
Leader, Breast Cancer Research Program
Fox Chase Cancer Center
Philadelphia, PA

Hope S. Rugo, MD
Clinical Professor of Medicine
Director, Breast Medical Oncology Clinical Trials Program
University of California, San Francisco
Helen Diller Family Comprehensive Cancer Center
San Francisco, CA

Disclosures:

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 any apparent conflicts of interest. In addition, faculty members are asked to disclose when any unapproved use of pharmaceuticals and/or devices is being discussed.

This activity was reviewed and approved by Carol L. Rosenberg, MD, Associate Professor of Medicine and Pathology, Boston University School of Medicine, Boston, Massachusetts. Carol L. Rosenberg, MD, has no conflict of interest to report.

William J. Gradishar, MD, FACP, has no conflict of interest to report.

Lori J. Goldstein, MD, is a consultant to AKA, Amgen, AstraZeneca, Bayer HealthCare, Bristol-Myers Squibb, Eisai, Eli Lilly, Genentech, Genomic Health, GlaxoSmithKline, Novartis, Pfizer, Pharmion, Roche, and sanofi-aventis. She has received grant/research support from AstraZeneca, Bristol-Myers Squibb, Genomic Health, GlaxoSmithKline, Johnson & Johnson, Merck, sanofi-aventis, and Wyeth.

Hope S. Rugo, MD, is a consultant to Merck, is on the speakers’ bureau of Genomic Health, and has received grant/research support from Bristol-Myers Squibb, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Roche.

Elizabeth Gifford, Boston University School of Medicine, CME, and Jillian Lokere and Suzanne Wolfe, Haymarket Medical Education LP, have no conflicts of interest to report.

Unlabeled/investigational uses of commercial products are discussed in this monograph.

DISCLAIMER THESE MATERIALS AND ALL OTHER MATERIALS PROVIDED IN CONJUNCTION WITH CONTINUING MEDICAL EDUCATION ACTIVITIES ARE INTENDED SOLELY FOR PURPOSES OF SUPPLEMENTING CONTINUING MEDICAL EDUCATION PROGRAMS FOR QUALIFIED HEALTH-CARE PROFESSIONALS. ANYONE USING THE MATERIALS ASSUMES FULL RESPONSIBILITY AND ALL RISK FOR THEIR APPROPRIATE USE. TRUSTEES OF BOSTON UNIVERSITY MAKES 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.

This program is sponsored by the Boston University School of Medicine.

This program is supported by an unrestricted educational grant from Eisai Inc.

If you wish to contact the Boston University School of Medicine, please email cme@bu.edu, or visit the website, http://www.bu.edu/cme. To view the privacy policy of Boston University School of Medicine, please visit http://www.bu.edu/cme/policies/privacy_policy.html

Instructions:

To obtain credit, a score of 70% or greater is required. This CME is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the posttest survey, and have received your digital copy of your credit certificate. Your online certificate will be saved on myCME.com within your Profile/Exam History, which you can then access at any time.

SYSTEM REQUIREMENTS:

WINDOWS PC SYSTEM REQUIREMENTS:
266-MHz Pentium II; Windows 98 or higher; 64 MB RAM; 800 x 600 screen resolution set for “High Color (16-Bit)”; Macromedia Flash Player 6 or higher.

MACINTOSH^® SYSTEM REQUIREMENTS:
Power Mac g3 at 300 MHz; System 8.5 or higher (excluding Mac OSX); 96 MB RAM; 20 MB minimum hard disk space available; 800 x 600 screen resolution set to “Thousands of Colors”; Macromedia Flash Player 6 or higher.