Combatting Treatment-Naïve, Extensive-Stage SCLC With Novel Immunotherapeutic Strategies
Leora Horn, MD, MSc
Ingram Associate Professor of Cancer Research
Vice Chairman for Faculty Development
Director, Thoracic Oncology Program
Vanderbilt University Medical Center
Stephen V. Liu, MD
Associate Professor of Medicine
Lombardi Comprehensive Cancer Center
Georgetown University Medical Center
Erin Grothey, MS
Clinical Content Manager
Laura Rafferty, ELS
Kathryn Schaefer, MSN, RN, CPHRM
Senior Manager, Accreditation and Compliance
East Lansing, MI
Katherine Stevens-Favorite, PhD
Upon completion, participants should be able to:
- Assess clinical data on immunotherapies for patients with treatment-naïve, extensive-stage SCLC
- Apply clinical evidence about novel immunotherapeutic strategies to the treatment decision-making process for patients with treatment-naïve, extensive-stage SCLC
- Develop strategies to adequately assess treatment response and appropriately manage immune-related toxicities in patients with extensive-stage SCLC receiving treatment with immune checkpoint inhibitors
This activity is intended for medical oncologists, radiation oncologists, and oncology-focused nurse practitioners and physician assistants.
Statement of Need
Rapidly evolving clinical evidence on the use of immune checkpoint inhibitors (ICIs) in various malignancies has demonstrated their ability to improve clinical outcomes. A report from a randomized clinical trial comparing the addition of atezolizumab, which blocks the programmed cell death-ligand 1 (PD-L1), and placebo to carboplatin/etoposide in patients with treatment-naïve, extensive-stage small cell lung cancer (ES-SCLC) found that it prolonged progression-free and overall survival. Based on these data, the United States Food and Drug Administration (FDA) granted priority review for the atezolizumab-chemotherapy regimen in this setting, with an expected decision date of March 18, 2019, and the National Comprehensive Cancer Network updated its guidelines (v1.2019) to include this regimen as preferred therapy for ES-SCLC. Additionally, reports from several large randomized trials evaluating ICIs that block the action of PD-L1, programmed cell death 1 (PD-1), and/or cytotoxic T-lymphocyte antigen (CTLA-4) as first-line therapy for ES-SCLC are eagerly awaited; results are expected in 2019 and 2020. Due to this rapid release of clinical evidence, oncologists, nurse practitioners, and physician assistants must be aware of the effectiveness and safety of this regimen and the impact of incorporating ICIs into first-line ES-SCLC therapy on existing treatment paradigms. Furthermore, providers must be familiar with appropriate strategies for assessing treatment response as well as identifying and effectively managing immune-related adverse events associated with ICIs.
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Medium/Method of Participation
This CME activity consists of a 0.5-credit online publication. To receive credit, read the introductory CME material, read the publication, and complete the post-survey, evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.
Initial Release Date: April 12, 2019
Expiration Date: April 11, 2020
Estimated Time to Complete This Activity: 30 minutes
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The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.
Leora Horn, MD, MSc
Consulting fees/advisory boards: AbbVie Inc., AstraZeneca, Bristol-Myers Squibb, EMD Serono, Inc., Genentech, Incyte Corporation, Merck & Co., Inc., Xcovery
Stephen V. Liu, MD
Consulting fees/advisory boards: AstraZeneca, Bristol-Myers Squibb, Celgene Corporation, Genentech, Heron Therapeutics, Inc., Lilly USA, LLC, Merck & Co., Inc., Pfizer, Inc., Regeneron Pharmaceuticals, Inc., Taiho Pharmaceutical Co., Ltd., Takeda Pharmaceuticals North America, Inc.
Contracted research: AstraZeneca, Bayer HealthCare Pharmaceuticals, Blueprint Medicines, Clovis Oncology, Corvus Pharmaceuticals, Esanex, Genentech, Lilly USA, LLC, Lycera Corp., Merck & Co., Inc., Molecular Partners, OncoMed Pharmaceuticals, Inc., Pfizer, Inc., Rain Therapeutics, Threshold Pharmaceuticals, Inc.
Katherine Stevens-Favorite, PhD
Other: Atara Biotherapeutics, Halozyme Therapeutics, Incyte Corporation, Portola Pharmaceuticals, Inc., Takeda Pharmaceuticals North America, Inc.
The peer reviewers and other activity planners have no financial relationships to disclose.
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This activity is supported by an educational grant from Genentech.
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