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Case 1: Assessment of the Importance of Histology and Current Guidelines for Advanced NSCLC: A Clinical Case Discussion


Case 1: Assessment of the Importance of Histology and Current Guidelines for Advanced NSCLC: A Clinical Case Discussion

Topic: Oncology/ Hematology
Relevant Terms: Advanced Non-small-Cell Lung Cancer
Primary Audience: This activity is designed for medical oncologists and other healthcare professionals who are interested in treating patients with non-small-cell lung cancer with pharmacological agents.
Launch Date: 26-Mar-13
Credits: 0.5 AMA PRA Category 1 Credit
Expiration Date: The accreditation for this activity has expired.
Curriculum Name: Focused Update on the Optimal Care for Non-small-Cell Lung Cancer: A Clinical Case Discussion

Learning Objectives

After completing this activity, the participant will demonstrate the ability to:

  1. Identify the subtype of NSCLC in patients based on molecular profiling to individualize treatment options
  2. Choose optimal first-line therapy for the treatment of patients with NSCLC consistent with evidence-based data and current treatment guidelines
  3. Personalize maintenance therapy in managing patients with NSCLC based on unique patient characteristics
  4. Manage older patients with NSCLC appropriately with the goal of improving survival and quality of life while minimizing toxicity


    Mark A. Socinski, MD
    Activity Cochair
    Visiting Professor of Medicine and Thoracic Surgery
    Director, Lung Cancer Section, Division of Hematology/Oncology
    Co-Director, University of Pittsburgh Medical Center (UPMC) Lung Cancer Center of Excellence
    Co-Director, Lung and Thoracic Malignancies Program
    University of Pittsburgh School of Medicine
    Pittsburgh, Pennsylvania
    Chandra P. Belani, MD
    Activity Cochair
    Miriam Beckner Distinguished Professor of Medicine
    Penn State Milton S. Hershey Medical Center
    Penn State College of Medicine
    Deputy Director, Penn State Hershey Cancer Institute
    Hershey, Pennsylvania
    Program overview
    Lung cancer is the leading cause of cancer-related mortality in the US, accounting for more deaths than breast, prostate, and colon cancers combined. Despite the existence and discovery of novel therapies to treat NSCLC, the survival rate is abysmal. About 65% of patients diagnosed with lung carcinomas are already at an advanced stage, and most relapse, resulting in poor prognosis. NSCLC management is becoming increasingly complex, and subtype analyses based on histology and molecular profiling has clearly enabled clinicians to identify patients who may respond well to certain treatments and not others. Certain drugs are ineffective or contraindicated in selected subgroups of patients. Additionally, the 5-year survival rate of elderly patients with NSCLC is very low, indicating the lack of adequate care, thus, there is need to discuss and prioritize the current understanding on how elderly patients are appropriately managed. An educational activity highlighting the emergence of clinical trial data, the current guidelines, and the roles of molecular profiling and histology subtyping on the choice of first-line and maintenance therapies will assist clinicians in their efforts to provide optimal care. Hence, this educational initiative will be presented as 2 cases. Using these cases, the expert faculty will highlight the importance of histology and molecular profiling and will also discuss the current guidelines and the optimal choice of first-line and maintenance therapies in improving the quality of life and progression-free and/or overall survival, while minimizing toxicity in patients with NSCLC.

    15 minutes
    Case of a 66-year old female patient managed with optimal first-line and maintenance therapy; importance of histology; evidence-based data; and guideline recommendations

    Disclosure of Conflicts of Interest
    Indiana University School of Medicine (IUSM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by IUSM for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

    In accordance with the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support, educational programs sponsored by Indiana University School of Medicine (IUSM) must demonstrate balance, independence, objectivity, and scientific rigor. All faculty, authors, editors, and planning committee members participating in an IUSM-sponsored activity are required to disclose any relevant financial interest or other relationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services that are discussed in an educational activity.
    Dr. Mark A. Socinski reported that he has received research support from Genentech, Lilly USA, LLC, Synta Pharmaceuticals Corp, Merrimack Pharmaceuticals Inc., GlaxoSmithKline, and Pfizer Inc., and honoraria for speakers' bureaus from Genentech and Lilly USA, LLC.
    Dr. Chandra P. Belani reported that he has received consulting fees and honoraria for consulting with Lilly USA, LLC, Genentech, and Pfizer Inc.
    The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
    The Staff and Planning Committee: Nasser H. Hanna, MD, Tina Darling, and Monica Armin have disclosed that they have no potential or actual conflicts of interest. Cara Bilinsky has no relevant financial relationships with commercial interests to disclose. Jason LeDune, MS has no relevant financial relationships with commercial interests to disclose.

    Physician Accreditation
    This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Indiana University School of Medicine and ACCELMED. Indiana University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
    Credit Designation
    The Indiana University School of Medicine designates this enduring educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

    Note: while it offers CME credits, this activity is not intended to provide extensive training or certification in the field.
    Fee Information
    There is no fee for this educational activity.
    A statement of credit will be issued immediately upon successful completion of the post-test with a score of 70% or better. 

    Method of Participation
    There are no fees for participating and receiving CME credit for this activity. During the period March 26, 2013 through March 26, 2014, participants must read the learning objectives and faculty disclosures and study the educational activity.
    Disclosure of Unlabeled Use
    This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The Indiana University School of Medicine (IUSM), ACCELMED, Genentech, and Lilly USA, LLC do not recommend the use of any agent outside of the labeled indications.
    The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of IUSM, ACCELMED, Genentech, and Lilly USA, LLC. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
    Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

    Hardware / Software Requirements
    To view the activity online you will need the following hardware/software: Personal computer or smartphone with internet access, a Web browser (Google Chrome, Internet Explorer (v7.0+), Firefox (v3.5+), Safari (v4.0+) or Mozilla (v1.4+)) with JavaScript enabled. 

    Commercial Support Acknowledgement
    Our grateful acknowledgement to Genentech and Lilly USA, LLC for educational grants in support of this program.