Oncology Knowledge into Practice Podcast

In today's episode, we welcome Dr. Sandip Patel, who is a Professor of Medical Oncology at the University of California, San Diego, to discuss the evolution of molecular profiling technology, focusing on how next-generation sequencing can help support patients with advanced thyroid cancer, but also how to integrate molecular profiling into clinical practice.

Learning Objective(s):

After completing this educational activity, learners will be able to discuss precision medicine and new technologies, including liquid biopsy

Funding Information:

This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in collaboration with an independent steering committee; Eli Lilly had no influence on the content of this educational activity.

Accreditation:

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the ACHL and Liberum IME. ACHL is accredited by the ACCME to provide continuing medical education for physicians.

The Academy for Continued Healthcare Learning (ACHL) designates this enduring material for up to 0.25 AMA PRA Category 1 Credits™. Physicians should claim credit commensurate with the extent of their participation in the activity.

The American Medical Association (AMA) has an agreement of mutual recognition of Continuing Medical Education (CME) credits with the European Union of Medical Specialists (UEMS), the accreditation body for European countries. Physicians interested in converting AMA PRA Category 1 Credit™ to UEMS-European Accreditation Council for Continuing Medical Education CME credits (ECMEC®s) should contact the UEMS at mutualrecognition@uems.eu

The content for this activity was developed independently of the ineligible companies. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantors.

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

Faculty disclosures

Dr. Sandip Patel:

Scientific advising (Ongoing): Amgen, AstraZeneca, BeiGene, Bristol-Myers Squibb, Certis, Eli Lilly, Jazz, Genentech, Illumina, Merck, Pfizer, Rakuten, and Tempus

Institutional research funding (Ongoing): Amgen, AstraZeneca/MedImmune, Bristol-Myers Squibb, Eli Lilly, Fate Therapeutics, Gilead, Iovance, Merck, Pfizer, Roche/Genentech, SQZ Biotechnologies"

Other disclosures

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

In today's episode, we welcome Dr. Conor Steuer, which is Associate Professor at the Department of Hematology and Medical Oncology at Emory University School of Medicine in Atlanta, USA, to discuss adaptation of thyroid cancer guidelines to local care settings. We touch on strategies for guideline implementation and how to overcome potential barriers.

Target Audience:

Oncologists, pathologists and other HCPs involved in the diagnosis of RET and TRK cancers, with a focus on community practitioners.

Learning Objective(s):

After completing this educational activity, learners will be able to:

• Recall thyroid RET and TRK fusion-positive cancer diagnosis and relevant genomic testing guidelines, and identify ways to adapt the guidelines to local settings

• Review the organization of care and strategies for more efficient care delivery

Funding Information:

This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in collaboration with an independent steering committee; Eli Lilly had no influence on the content of this educational activity.

Accreditation:

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the ACHL and Liberum IME. ACHL is accredited by the ACCME to provide continuing medical education for physicians.

The Academy for Continued Healthcare Learning (ACHL) designates this enduring material for up to 0.25 AMA PRA Category 1 Credits™. Physicians should claim credit commensurate with the extent of their participation in the activity.

The American Medical Association (AMA) has an agreement of mutual recognition of Continuing Medical Education (CME) credits with the European Union of Medical Specialists (UEMS), the accreditation body for European countries. Physicians interested in converting AMA PRA Category 1 Credit™ to UEMS-European Accreditation Council for Continuing Medical Education CME credits (ECMEC®s) should contact the UEMS at mutualrecognition@uems.eu

The content for this activity was developed independently of the ineligible companies. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantors.

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

Faculty disclosures:

Conor Steuer

Advisory Board/Steering Committee (Ongoing): Daiichi

Advisory Board (Former): Caris, Merck, Mirati, Novocure, Sanofi/Regeneron

Other disclosures

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

Developments in precision medicine have led to a paradigm shift in the management of advanced thyroid cancer. The ESMO Guidelines Committee recently developed a new clinical practice guideline on the use of systemic therapy in this setting.

This episode offers guideline insights into the applications recently approved therapies that have been approved by the FDA and/or the EMA, including cabozantinib, selpercatinib, pralsetinib, and entrectinib. It also provides data updates of previously approved therapies and how guidelines have been adapted accordingly. To answer questions on the 2022 ESMO Clinical Practice Guideline update, we have invited Dr. Ahmad Awada to join us. He is Head of the Oncology Medicine Department at Jules Bordet Cancer Institute Brussels, Belgium.

Target Audience: Oncologists, pathologists and other HCPs involved in the management of advanced thyroid cancer, with a focus on community practitioners. Learning objectives: After completing this educational activity, learners will be able to:

• Recall thyroid RET and TRK fusion-positive cancer diagnosis and relevant genomic testing guidelines, and identify ways to adapt the guidelines to local settings
• Discuss precision medicine and new technologies, including liquid biopsy
• Review the organization of care and strategies for more efficient care delivery

Funding information: This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in collaboration with an independent steering committee; Eli Lilly had no influence on the content of this educational activity.

Disclosures Dr. Ahmad Awada declares the following financial relationships from the past 24 months: Speaker fees: Amgen, AstraZeneca, Bayer, Daiichi Sankyo, Eisai, Genomic Health, Ipsen, Leo Pharma, Eli Lilly, Merck, MSD, Novartis, Pfizer, and Seattle Genetics. Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.
ACHL requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any ineligible companies. All relevant financial relationships have been mitigated prior to this activity.
This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion.
Discussion of Off-Label, Investigational, or Experimental Drug Use: N/A

In today’s episode, we welcome expert Oncologist Dr. Claire Arthur and expert Endocrinologist Dr. Sarimar Agosto Salgado to discuss the challenges they have encountered and strategies that they have implemented to improve multidisciplinary collaboration in the management of patients with thyroid cancer and continued integration of precision medicine approaches.

References

1. Fenton ME et al. Variability in thyroid cancer multidisciplinary team meeting recommendations is not explained by standard variables: Outcomes of a single centre review. J Clin Med 2021;10:4150

2. Horgan D et al. Tackling thyroid cancer in Europe—The challenges and opportunities. Healthcare 2022;10:1621

3. Mehra S et al. Improving the quality of thyroid cancer care: How does the Thyroid Cancer Care Collaborative cross the Institute of Medicine’s Quality Chasm? Thyroid 2014;24:615–624

Target Audience:

Oncologists, pathologists and other HCPs involved in the diagnosis of RET and TRK cancers, with a focus on community practitioners.

Learning Objective:

1. Recall thyroid RET andTRK fusion-positive cancer diagnosis and relevant genomic testing guidelines and identify ways to adapt the guidelines to local settings

2. Discuss “precision medicine” and new technologies, including “liquid biopsy”

3. Review the organisation of care and strategies for more efficient care delivery

Funding Information:

This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty.

Disclosures:

Dr Sarimar Agosto Salgado: 

- Speaker: Lilly

- Advisor: Exelisis, Lilly, Blueprint medicines, Eisai

Dr Claire Arthur

Dr Claire Arthur has no relevant disclosures against this module

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

In today’s episode, we welcome Dr. Antonio Matrone, an endocrinologist at the University of Pisa, to discuss the many factors involved in treatment decision-making and strategies for the management of patients with advanced thyroid cancer where an oncogenic driver has been identified.

References

1. Matrone A et al. Differentiated thyroid cancer, from active surveillance to advanced therapy: Toward a personalized medicine. Front Endocrinol (Lausanne) 2019;10:884
2. Sherman SI. Evolution of targeted therapies for thyroid carcinoma. Trans Am Clin Climatol Assoc 2019;130:255–265
3. Filetti S et al. ESMO Clinical Practice Guideline update on the use of systemic therapy in advanced thyroid cancer. Ann Oncol 2022;33(7):P674–P684
4. Capdevila J et al. Molecular diagnosis and targeted treatment of advanced follicular cell-derived thyroid cancer in the precision medicine era. Cancer Treat Rev 2022;106:102380
5. Dabrafenib highlights of prescribing information. 2022
6. Wirth LJ et al. Efficacy of selpercatinib in RET-altered thyroid cancers. N Engl J Med 2020;383:825–835
7. Josfeld L et al. Cancer patient’s perspective on shared decision-making and decision aids in oncology. J Cancer Res Clin Oncol 2021;147:1725–1732

Target Audience:

Oncologists, pathologists and other HCPs involved in the diagnosis of RET and TRK cancers, with a focus on community practitioners.

Learning Objective:

1. Recall thyroid RET and TRK fusion-positive cancer diagnosis and relevant genomic testing guidelines and identify ways to adapt the guidelines to local settings
2. Discuss “precision medicine” and new technologies, including “liquid biopsy”
3. Review the organisation of care and strategies for more efficient care delivery

These learning objectives are for the podcast series. This episode focuses on the first and third objective.

Funding Information:

This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty.

Staff Disclosure:

Dr. Matrone declares the following:

Consultant - Eli Lilly

In today’s episode, we welcome Principal Researcher Dr. David Tamborero who was integral to the development of the Molecular Tumor Board Portal to discuss the benefits associated with molecular tumor boards and the way in which the portal can support the discussions that take place at tumor board meetings, as well as how these initiatives can support the management of patients with thyroid cancer.

References

1. Larson KL et al. Clinical Outcomes of Molecular Tumor Boards: A Systematic Review.  
   JCO Precis Oncol 2021;5:PO.20.00495
2. Capdevila J et al. Molecular diagnosis and targeted treatment of advanced follicular  
   cell-derived thyroid cancer in the precision medicine era. Cancer Treat Rev 2022;106:102380
3. Mahmood U and Lorch JH. Precision Medicine in Aggressive Thyroid Cancer: Moving Beyond Multitargeted Tyrosine Kinase Inhibitors. Cancer Cytopathol 2022;130:8–11
4. VanderWalde A et al. Establishment of a Molecular Tumor Board (MTB) and Uptake of Recommendations in a Community Setting. J Pers Med 2020;10:252
5. Tamborero D et al. The Molecular Tumor Board Portal supports clinical decisions and automated reporting for precision oncology. Nat Cancer 2022;3:251–261

Target Audience:

Oncologists, pathologists and other HCPs involved in the diagnosis of RET and TRK cancers, with a focus on community practitioners.

Learning Objective:

1. Recall thyroid RET and TRK fusion-positive cancer diagnosis and relevant genomic testing guidelines and identify ways to adapt the guidelines to local settings
2. Discuss “precision medicine” and new technologies, including “liquid biopsy”
3. Review the organisation of care and strategies for more efficient care delivery

These learning objectives are for the podcast series. This episode focuses on the second and third objective.

Funding Information:

This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty.

Staff Disclosure:

Dr. David Tamborero has no relevant disclosures to announce

In today’s episode, we welcome expert Oncologist Dr. Lori Wirth and expert Pathologist Dr. Thomas Giordano to discuss the challenges they have encountered and strategies that they have implemented to improve multidisciplinary collaboration in the management of patients with thyroid cancer and continued integration of precision medicine approaches.

References

1. Kilagat K, Griffin MJ, Baik F, et al. Thyroid Care Collaborative: an electronic health record facilitating multidisciplinary management of thyroid cancer. Int J Endo Oncol 2018;5(1):IJE03

Target Audience:

Oncologists, pathologists and other HCPs involved in the diagnosis of RET and TRK cancers, with a focus on community practitioners.

Learning Objective:

1. Recall thyroid RET and TRK fusion-positive cancer diagnosis and relevant genomic testing guidelines and identify ways to adapt the guidelines to local settings
2. Discuss “precision medicine” and new technologies, including “liquid biopsy”
3. Review the organisation of care and strategies for more efficient care delivery

These learning objectives are for the podcast series. This episode focuses on the third objective.

By completing this module you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment.

Funding Information:

This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty.

Staff Disclosures:

Dr Lori Wirth

Advisory Board - Bayer Healthcare, Coherus, Eli Lilly, Eisai, Exelixis, PDS Biotechnology Corp

Consultant - Curie Therapeutics, Morphic Therapeutics

Dr. Thomas Giordano

No relevant disclosures to declare

Developments in RET-targeted therapies have led to a paradigm shift in the management of advanced thyroid cancer. However, resistance to these drugs has been observed to develop through a variety of mechanisms, so precise monitoring is required to detect and react to disease development.

This episode offers insight into relevant mechanisms of resistance to RET inhibitors in thyroid cancer. It also considers how strategies such as combinations of targeted therapies and liquid biopsy could potentially help tackle the development of resistance. To answer questions on this topic, we have invited Professor Bruce Robinson to join us. He is a Professor of Medicine and Endocrinologist at the University of Sydney, Australia.

Funding Information:

This episode is supported by an educational grant from Eli Lilly, who have had no influence on the content or choice of faculty.

References

1. Román-Gil MS, Pozas J, Rosero-Rodríguez D, et al. Resistance to RET targeted therapy in Thyroid Cancer: Molecular basis and overcoming strategies. Cancer Treat Rev. 2022;105:102372. doi: 10.1016/j.ctrv.2022.102372
2. Subbiah V, Cascone T, Hess KR et al. Multi-kinase RET inhibitor vandetanib combined with mTOR inhibitor everolimus in patients with RET rearranged non-small cell lung cancer. Journal of Clinical Oncology. 36 (15). Doi: 10.1200/JCO.2018.36.15_suppl.9035

Precision medicine is a promising field that’s opening doors to novel therapeutics for many patients. But how does it fit into thyroid cancer specifically? What treatments are available or in the pipeline, for which patient subgroup, and what are the potential benefits? We’ll start off our series by exploring these questions, and we’ve invited Dr Eric Sherman, medical oncologist and thyroid cancer expert at the Memorial Sloan Kettering Cancer Center in New York, to provide his insights.

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education.

References:

American Cancer Society. Key Statistics for Thyroid Cancer. Updated January 12, 2021. Accessed November 23, 2021. American Cancer Society website. https://www.cancer.org/cancer/thyroid-cancer/about/key-statistics.html.

Araque KA, Gubbi S, Klubo-Gwiezdzinska J. Updates on the Management of Thyroid Cancer. Horm Metab Res. 2020;52(8):562-577. doi: 10.1055/a-1089-7870.

Cancer Connect. Therapies Show Initial Effectiveness in Subset of Papillary Thyroid Cancer. Cancer Connect website. Published July 18, 2018. Accessed December 14, 2021. https://news.cancerconnect.com/thyroid-cancer/therapies-show-initial-effectiveness-in-subset-of-papillary-thyroid-cancer?redir=1.

ClinicalTrials.gov website search results: pembrolizumab / Thyroid Cancer / Phase 2. Accessed December 14, 2021. https://clinicaltrials.gov/ct2/results?term=pembrolizumab&cond=Thyroid+Cancer&age_v=&gndr=&type=&rslt=&phase=1&Search=Apply

Dabrafenib With or Without Trametinib in Treating Patients With Recurrent Thyroid Cancer. ClinicalTrials.gov identifier: NCT01723202. Updated February 25, 2021. Accessed December 14, 2021.

Drilon A, Laetsch TW, Kummar S, et al. Efficacy of Larotrectinib in TRK Fusion-Positive Cancers in Adults and Children. N Engl J Med. 2018;378(8):731-739. doi: 10.1056/NEJMoa1714448.

Pekova B, Sykorova V, Mastnikova K, et al. NTRK Fusion Genes in Thyroid Carcinomas: Clinicopathological Characteristics and Their Impacts on Prognosis. Cancers. 2021;13(8):1932. doi: 10.3390/cancers13081932.

U.S. Food & Drug Administration. FDA approves selpercatinib for lung and thyroid cancers with RET gene mutations or fusions. FDA website. Updated May 11, 2020. Accessed November 23, 2021. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-selpercatinib-lung-and-thyroid-cancers-ret-gene-mutations-or-fusions.

U.S. Food & Drug Administration. FDA approves pembrolizumab for adults and children with TMB-H solid tumors. Updated June 17, 2020. Accessed December 14, 2021. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-pembrolizumab-adults-and-children-tmb-h-solid-tumors#:~:text=The%20recommended%20pembrolizumab%20dosage%20regimen%20for%20TMB-H%20solid,pediatric%20patients.%20View%20full%20prescribing%20information%20for%20KEYTRUDA.

U.S. Food & Drug Administration. FDA approves larotrectinib for solid tumors with NTRK gene fusions. FDA website. Updated December 14, 2018. Accessed November 25, 2021. https://www.fda.gov/drugs/fda-approves-larotrectinib-solid-tumors-ntrk-gene-fusions.

Weaver CH. Precision Cancer Medicine Treatment of Thyroid Cancers. Cancer Connect website. Published October 24, 2020. Updated September 20, 2021. Accessed November 23, 2021. https://news.cancerconnect.com/thyroid-cancer/precision-cancer-medicine-treatment-of-thyroid-cancers.

In this episode we speak with Dr Navel Daver, Associate Professor, Department of Leukemia, The University of Texas MD Anderson Cancer Center, USA, to get his thoughts on the highlights of ASCO and EHA for patients with MDS and AML.

Funding Statement:

This series is supported by educational grants from Servier Pharmaceuticals LLC and Takeda, who have had no influence on the content or choice of faculty

At the ASCO and EHA conferences, there were many interesting posters and presentations in the field of haemato-oncology. To share their conference highlights, we’ve invited our ALL expert Dr Dieter Hoelzer, director of internal medicine at the University of Frankfurt in Germany, and our MDS and AML expert Dr Amer Zeidan, Associate Professor Of Internal Medicine at the Yale University School Of Medicine in the US.

Funding statement: 

This series is supported by educational grants from Servier Pharmaceuticals LLC and Takeda, who have had no influence on the content or choice of faculty

We’re taking a break over the Christmas period, but we’ll be back in January with an exciting panel of experts discussing acute myeloid leukaemia, or AML. Until then, happy holidays and we'll see you in the new year!

In this bi-weekly podcast, cancer experts discuss game-changing topics in clinical oncology.

Produced by Oncology Knowledge into Practice (www.onckip.com), this podcast series will support and inform your practice in cancer management.

This podcast is intended for healthcare professionals only. Funding information is available in each episode's notes.

Access more free education today! Visit the website, follow us on Twitter (@onckip ) or connect on LinkedIn.

https://www.oncologyknowledgeintopractice.com/