This educational activity is intended for medical, surgical, and radiation oncologists, as well as allied oncology healthcare professionals who treat patients with breast cancer.

Significant improvements have occurred in the management of breast cancer over the past decade. One of the most widely studied approaches in the field of cancer, particularly breast cancer, is personalized treatment strategies incorporating gene array profiles, new agents, and novel combinations. Despite these advances, uncertainties remain. With novel pharmacologic agents, diagnostic and treatment strategies, the decision-making process is challenging, thereby requiring in-depth knowledge of current clinical and experimental data for the appropriate integration of new treatment strategies into clinical practice. Because of this, healthcare professionals caring for patients with breast cancer need to understand the basis for treatment approaches likely to change clinical practice in the next few years, as well as the preclinical and clinical data supporting the development and integration of these therapies into practice.

Interview  #1 The Evolution of Breast Cancer Therapy From Empiric to Individualized
Martine Piccart-Gebhart, MD, PhD Institute Jules Bordet, Brussels, Belgium	Norman Wolmark, MD Allegheny General Hospital, Pittsburgh, Pennsylvania, USA
Learning Objectives: After successful completion of this activity, participants should be able to: Describe the evolution of breast cancer therapy from empiric to individualized and personalized approaches to management Explain the importance of partnership between the oncology community, patients and patient advocates, industry, and regulatory agencies in improving cancer care   Estimated time to complete activity: 0.5 hours
Interview #2 Treatment Guidelines and Economic Realities: How Can We Live With Both?
Nadia Harbeck, MD, PhD Technical University of Munich, Munich, Germany	Thomas Szucs, MD University of Zurich, Zurich, Switzerland
Learning Objectives: After successful completion of this activity, participants should be able to: Identify the potential effects of economic limitations on current treatment guidelines for breast cancer Explain the role of breast cancer clinical practice guidelines on the national and international levels Identify the correlation between disease burden and spending related to cancer care   Estimated time to complete activity: 0.5 hours
Interview  #3 Breast Cancer as a Model for Targeted Therapy
Mark Pegram, MD University of Miami, Miami, Florida, USA	Sunil Verma, MD             Toronto Sunnybrook Regional Cancer Center, Toronto, Ontario, Canada
Learning Objectives: After successful completion of this activity, participants should be able to: Explain the relationship of targeted therapies and breast cancer biology Identify potential future treatment strategies utilizing the combination of chemotherapy and other novel agents   Estimated time to complete activity: 0.5 hours
Interview #4 Node-Negative Early Stage Breast Cancer
Carlos Barrios, MD São Lucas Hospital, Porto Allegre, RS, Brazil	Arlene Chan, MD             Mount Hospital, Perth, Western Australia, Australia
Learning Objectives: After successful completion of this activity, participants should be able to: Define optimal therapeutic strategies for patients with node-negative early breast cancer Predict the risk of disease recurrence in patients with node-negative early breast cancer   Estimated time to complete activity: 0.5 hours
Interview #5 Non-anthracycline Regimens: Current and Future Role
Joseph Gligorov, MD Tenon Hospital, Paris, France	Michael Ewer, MD The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
Learning Objectives: After successful completion of this activity, participants should be able to: Contrast anthracycline-based and non-anthracycline–based treatment regimens with regard to risks, benefits, and patient selection Describe the importance of cardiac monitoring in patients receiving cardiotoxic therapy   Estimated time to complete activity: 0.5 hours
Interview #6 Designing and Conducting Efficient Clinical Trials
Cliff Hudis, MD Memorial Sloan-Kettering Cancer Center, New York, New York, USA	John Crown, MD St Vincent’s Hospital, Dublin, Ireland
Learning Objective: After successful completion of this activity, participants should be able to: Describe approaches for the incorporation of novel therapies into appropriate and efficient clinical trials List ongoing clinical trials that incorporate gene expression profiling for treatment selection   Estimated time to complete activity: 0.5 hours

Postgraduate Institute for Medicine 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 PIM for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

Dr Barrios has disclosed that he has no real or apparent conflicts of interest to report. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Chan has disclosed that she has received consulting fees from Amgen, Inc, GlaxoSmithKline, Roche Laboratories Inc, and sanofi-aventis. She has also disclosed fees for non-CME services received directly from Amgen, Inc, GlaxoSmithKline, Roche Laboratories Inc, and sanofi-aventis. None of these relationships will impact her ability to present an unbiased presentation. She has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Crown has disclosed that he has received consulting fees from GlaxoSmithKline, Roche Laboratories Inc, and sanofi-aventis. He has also disclosed fees for non-CME services received directly from GlaxoSmithKline, Roche Laboratories Inc, and sanofi-aventis. None of these relationships will impact his ability to present an unbiased presentation. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Ewer has disclosed that he has received consulting fees from Roche Laboratories Inc and Genentech BioOncology. He has also disclosed fees for non-CME services received directly from Roche Laboratories Inc and sanofi-aventis. None of these relationships will impact his ability to present an unbiased presentation. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Gligorov has disclosed that he has no real or apparent conflicts of interest to report. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Harbeck has disclosed that she has no real or apparent conflicts of interest to report. She has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in her presentation.

Dr Hudis has disclosed that he has received consulting fees from Amgen, Bristol-Myers Squibb Company, Genentech BioOncology, and sanofi-aventis. He performs contracted research (ie investigator-initiated protocols) for AstraZeneca Pharmaceuticals LP and Kosan Biosciences. He has also disclosed ownership interest (stocks, stock options or other ownership interest excluding diversified mutual funds) in Genomic Health. None of these relationships will impact his ability to present an unbiased presentation. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Lokey has disclosed that he has no real or apparent conflicts of interest to report. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Pegram has disclosed that he has received consulting fees from AstraZeneca Pharmaceuticals LP, Genentech BioOncology, GlaxoSmithKline, and sanofi-aventis. He also performs contracted research (ie investigator-initiated protocols) for sanofi-aventis. None of these relationships will impact his ability to present an unbiased presentation. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Szucs has disclosed that he has no real or apparent conflicts of interest to report. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Verma has disclosed that he has received consulting fees from GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Roche Laboratories Inc, and sanofi-aventis. None of these relationships will impact his ability to present an unbiased presentation. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.

Dr Wolmark has disclosed that he has no real or apparent conflicts of interest to report. He has agreed to disclose any unlabeled/unapproved uses of drugs or products referenced in his presentation.


 
The employees of Postgraduate Institute for Medicine have disclosed:
Linda Graham, RN - No real or apparent conflicts of interest
Jan Hixon, RN - No real or apparent conflicts of interest
Trace Hutchison, PharmD - No real or apparent conflicts of interest


 
The employees of PRIME Oncology have disclosed:
Amy White, RN, OCN (clinical) - No real or apparent conflicts of interest
Trudy Stoddert, ELS (editorial) - No real or apparent conflicts of interest

This educational activity may contain discussion of published or and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Postgraduate Institute for Medicine, PRIME Oncology, and sanofi-aventis 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 PIM, PRIME Oncology, or sanofi-aventis. 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 patients’ conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.