STATEMENT OF NEED / TARGET AUDIENCE

It is important for practicing oncologists to be aware of similarities and differences between his or her practice patterns, those of others in community practice and those of breast cancer clinical investigators. It is also important for oncologists to recognize that heterogeneity exists in the oncology community, especially in clinical situations for which there is suboptimal research evidence.

This program focuses on the self-described practice patterns of randomly selected medical oncologists on a variety of key clinical issues in cancer. Also included are clinical investigator commentary and references addressing these issues. This CME program will provide medical oncologists with information on national cancer patterns of care to assist with the development of clinical management strategies.

LEARNING OBJECTIVES FOR THE PATTERNS OF CARE SERIES

• Compare management strategies of community oncologists and cancer clinical investigators in the adjuvant and metastatic settings, and apply relevant information to the treatment of patients with breast cancer.
• Evaluate management issues for patients with cancer for which relative agreement and heterogeneity exist in patterns of care, and make treatment decisions considering this information.
• Counsel patients with cancer about multiple acceptable treatment options when they exist.

PURPOSE OF THIS ISSUE

The purpose of this issue of Patterns of Care is to support these objectives by comparing the perspectives of 100 community medical oncologists to those of 43 breast cancer specialists and to offer in-depth commentary from faculty regarding their practice patterns in the management of breast cancer.

ACCREDITATION STATEMENT

Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT

Research To Practice designates this educational activity for a maximum of 3 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity

HOW TO USE THIS CME ACTIVITY

This monograph is one issue of a CME series activity. To receive credit for this activity, the participant should read the monograph and complete the Educational Assessment and Credit Form located in the back of this book or on our website www.PatternsOfCare.com. PowerPoint files of the graphics contained in this document can be downloaded at www.PatternsOfCare.com.

COMMERCIAL SUPPORT

This program is supported by educational grants from Abraxis BioScience, AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Genomic Health Inc and Sanofi-Aventis.

PHARMACEUTICAL AGENTS DISCUSSED IN THIS PROGRAM

This educational activity includes discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

CONTENT VALIDATION AND DISCLOSURES

Research To Practice is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the Research To Practice scientific staff and an external, independent reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — The following faculty (and their spouses/partners) reported real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process: Dr Miller — Consulting Agreements: Eli Lilly and Company, Genentech BioOncology, Roche Laboratories Inc; Paid Research: Pfizer Inc, Roche Laboratories Inc; Speakers Bureau: Genentech BioOncology, Roche Laboratories Inc. Dr Muss — Consulting Agreements: Amgen Inc, Bristol-Myers Squibb Company, Pfizer Inc, Roche Laboratories Inc.

RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no real or apparent conflicts of interest to disclose.

CME DISCLOSURES FOR QUOTED FACULTY

Drs Burstein, Geyer, Giordano, Lin, Morrow, Peto and Winer had no real or apparent conflicts of interest to disclose. The following faculty (and their spouses/partners) reported real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process: Dr Albain — Consulting Fees: Bristol-Myers Squibb Company, Eli Lilly and Company, Genentech BioOncology, Genomic Health Inc, Novartis Pharmaceuticals Corporation, Pfizer Inc; Contracted Research: Abraxis BioScience, Genentech BioOncology, Genomic Health Inc. Dr Budd — Consulting Fees: AstraZeneca Pharmaceuticals LP, Pfizer Inc. Dr Burris — Consulting Fees: Celgene Corporation, Keryx Biopharmaceuticals Inc, Novartis Pharmaceuticals Corporation; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: Sanofi-Aventis. Dr Carlson — Advisory Committee: Genomic Health Inc; Consulting Agreements: AstraZeneca Pharmaceuticals LP, Pfizer Inc; Paid Research: AstraZeneca Pharmaceuticals LP, Genentech BioOncology. Prof Forbes — Consulting Fees: Novartis Pharmaceuticals Corporation; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: AstraZeneca Pharmaceuticals LP, Novartis Pharmaceuticals Corporation. Dr Goss — Consulting Fees and Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: AstraZeneca Pharmaceuticals LP, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Pfizer Inc. Dr Gradishar — Consulting Fees and Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: Abraxis BioScience, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Genomic Health Inc, Novartis Pharmaceuticals Corporation, Pfizer Inc, Sanofi-Aventis. Dr Gralow — Consulting Agreements: Amgen Inc, Genentech BioOncology, Genomic Health Inc, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi-Aventis. Dr Hayes — Contracted Research: AstraZeneca Pharmaceuticals LP. Dr Hudis — Advisory Committee: Amgen Inc, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Pfizer Inc, Sanofi-Aventis; Consulting Agreements: Bristol-Myers Squibb Company, Genentech BioOncology, Wyeth; Paid Research: AstraZeneca Pharmaceuticals LP, Onyx Pharmaceuticals Inc, Roche Laboratories Inc; Stock Ownership: Genomic Health Inc. Dr Jones — Consulting Fees: Pfizer Inc, Sanofi-Aventis; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, GlaxoSmithKline, Pfizer Inc, Sanofi-Aventis. Dr Mackey — Honoraria: Amgen Inc, AstraZeneca Pharmaceuticals LP, Roche Laboratories Inc, Sanofi-Aventis.Dr O’Shaughnessy — Consulting Fees: Biogen Idec, Bristol-Myers Squibb Company, Eisai Inc, Eli Lilly and Company, Genentech BioOncology, Genzyme Corporation, Novartis Pharmaceuticals Corporation, Ortho Biotech Products LP, Pfizer Inc; Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: Abraxis BioScience, Eli Lilly and Company, Sanofi-Aventis. Dr Pegram — Advisory Committee: Amgen Inc, Bristol-Myers Squibb Company, Genentech BioOncology, Genomic Health Inc, GlaxoSmithKline, Pfizer Inc; Speakers Bureau: Genentech BioOncology, GlaxoSmithKline, Sanofi-Aventis. Dr Perez — Paid Research: Bristol-Myers Squibb Company, Genentech BioOncology, GlaxoSmithKline, Novartis Pharmaceuticals Corporation. Dr Ravdin — Consulting Agreement: Genomic Health Inc; Speakers Bureau: AstraZeneca Pharmaceuticals LP; Stock Ownership: Adjuvant! Inc, Bristol-Myers Squibb Company, Pfizer Inc, Wyeth. Dr Robert — Advisory Committee: Novartis Pharmaceuticals Corporation, Pfizer Inc, Sanofi-Aventis; Consulting Agreements: Bristol-Myers Squibb Company, Novartis Pharmaceuticals Corporation; Speakers Bureau: Novartis Pharmaceuticals Corporation. Dr Slamon — Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: Genentech BioOncology, GlaxoSmithKline, Sanofi-Aventis; Ownership Interest: Amgen Inc, Pfizer Inc. Dr Sledge — Consulting Fees: Genentech BioOncology; Contracted Research: Sanofi-Aventis. Prof Smith — Advisory Committee: AstraZeneca Pharmaceuticals LP, Eli Lilly and Company, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, Sanofi-Aventis; Lecturing: AstraZeneca Pharmaceuticals LP, Eli Lilly and Company, GlaxoSmithKline; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Eli Lilly and Company, Novartis Pharmaceuticals Corporation, Pfizer Inc, Roche Laboratories Inc, Sanofi-Aventis. Dr Sparano — Consulting Fees: Bristol-Myers Squibb Company, Eisai Inc, Genentech BioOncology, GlaxoSmithKline, Johnson & Johnson Pharmaceuticals, Merck and Company Inc, Sanofi-Aventis. Dr Swain — Consulting Fees: Johnson & Johnson Pharmaceuticals, Roche Laboratories Inc; Travel for Clinical Investigator Meeting: Genentech BioOncology, Sanofi-Aventis. Dr Whitworth — Consulting Fees and Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: AstraZeneca Pharmaceuticals LP, Ethicon Endo-Surgery Inc, General Electric Company, Genomic Health Inc, Myriad Genetics Inc, Novartis Pharmaceuticals Corporation, Sanarus Medical Inc, Sanofi-Aventis, SenoRx Inc, SonoSite Inc, Veridex LLC; Ownership Interest: SenoRx Inc. Dr Wolff — Paid Research: Roche Laboratories Inc.

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Click on the image to enlarge