Using the Morbidity and Mortality Conference Model to Explore and Improve Community-Based Oncology Care


LUNG CANCER — Discussion with Maria Picton, MD, Estelamari Rodriguez, MD, MPH and Heather Wakelee, MD

Track 1: Case discussion: A 52-year-old woman and never smoker with metastatic pan-wild-type adenocarcinoma of the lung achieves a partial response with carboplatin/pemetrexed/bevacizumab as first-line treatment
Track 2: Optimal molecular testing algorithm for patients with metastatic lung adenocarcinoma
Track 3: Results of the KEYNOTE-024 trial evaluating pembrolizumab versus platinum-based chemotherapy as first-line therapy for advanced non-small cell lung cancer (NSCLC) with a PD-L1 tumor proportion score of 50% or greater
Track 4: Responses and side effects associated with immune checkpoint inhibitors
Track 5: Treatment options after disease progression on immunotherapy
Track 6: Approach to front-line therapy for patients with pan-wild-type metastatic adenocarcinoma
Track 7: Activity and tolerability of ramucirumab/docetaxel as second-line therapy for advanced NSCLC
Track 8: Targeting HER2 alterations in NSCLC
Track 9: KEYNOTE-021 trial: Significant improvement in outcomes with the addition of pembrolizumab to chemotherapy for advanced NSCLC
Track 10: Potential risks and benefits of combining immunotherapy and chemotherapy
Track 11: Challenges in enrolling patients with advanced lung cancer on clinical trials
Track 12: Viewpoint on hospice in end-of-life care
Track 13: Benefits of early palliative care for patients with lung cancer
Track 14: Perspective on the Death with Dignity Act for terminally ill patients with cancer
Track 15: Access to palliative care services for oncologists in community-based practice
Track 16: Case discussion: A 77-year-old man and heavy smoker with metastatic lung adenocarcinoma and multiple comorbidities receives nivolumab after disease progression on chemotherapy
Track 17: Management of pneumonitis in patients receiving immune checkpoint inhibitors
Track 18: Case discussion: A 78-year-old woman and never smoker with Stage IV lung adenocarcinoma develops severe pneumonitis after radiation therapy followed by immunotherapy
Track 19: Design of the ALCHEMIST trial for patients with early-stage NSCLC in the adjuvant setting
Track 20: Ongoing investigation of checkpoint inhibitors in the adjuvant setting
Track 21: Finding meaning and satisfaction as an oncologist
Track 22: Role of the oncologist in helping patients live life to the fullest
Track 23: Providing emotional support to patients and their caregivers
Track 24: Insight into the quality of clinical care from a patient’s perspective
Track 25: Involving patients with cancer in the treatment decision-making process
Track 26: Importance of giving hope to patients with cancer

COLORECTAL CANCER — Discussion with Gigi Qiqi Chen, MD, Margaret Deutsch, MD and J Randolph Hecht, MD

Track 1: Use of anti-EGFR antibodies for RAS wild-type metastatic colorectal cancer (mCRC)
Track 2: Effect of primary tumor location on the efficacy of anti-EGFR therapy
Track 3: Clinical implications of BRAF mutation testing
Track 4: Molecular profiling for patients with mCRC
Track 5: HER2 amplification and the role of HER2-targeted therapy in mCRC
Track 6: Incidence of BRAF mutations and association with microsatellite instability (MSI)
Track 7: Efficacy of BRAF inhibitors in BRAF mutation-positive mCRC
Track 8: Approach to BRAF mutation-positive mCRC in the first-line setting
Track 9: Role of next-generation sequencing in the up-front setting for patients with mCRC
Track 10: Identification of potentially actionable alterations in CRC
Track 11: PD-1 blockade in patients with mismatch repair-deficient advanced CRC
Track 12: Efficacy and tolerability of anti-PD-1/PD-L1 antibodies in patients with MSI-high mCRC
Track 13: Perspective on the potential use of checkpoint inhibitors as up-front therapy for patients with MSI-high advanced CRC
Track 14: Synergistic immunotherapeutic strategies under investigation for CRC
Track 15: Use of checkpoint inhibitors for patients with preexisting autoimmune disease
Track 16: Local treatment approaches for hepatic metastases from CRC
Track 17: Rationale for the ongoing investigation of talimogene laherparepvec for liver metastases
Track 18: Case discussion: A 60-year-old woman who presents with abdominal pain and a large pelvic mass is diagnosed with right-sided, KRAS mutation-positive mCRC
Track 19: Viewpoint on resection of the primary tumor in patients presenting with mCRC
Track 20: Selection of second-line therapy for patients with KRAS mutation-positive mCRC
Track 21: Side effects and dose adjustments with regorafenib and TAS-102
Track 22: End-of-life planning for patients with mCRC
Track 23: Case discussion: A 31-year-old man with Stage IV CRC receives radioembolization with Y-90 microspheres for liver-only metastases after disease progression on
FOLFOX/bevacizumab
Track 24: Case discussion: A 62-year-old alcoholic man with left-sided mCRC experiences disease progression through multiple lines of therapy

OVARIAN CANCER — Interview with Michael Birrer, MD, PhD

Track 1: Selection of systemic therapy for patients with metastatic ovarian cancer (OC)
Track 2: Importance of BRCA testing for all patients with OC
Track 3: Role of next-generation sequencing for patients with OC
Track 4: Benefits of early palliative care and psychological counseling
Track 5: Effects of early palliative care on symptom management and quality of life
Track 6: Overall survival benefit with early palliative care
Track 7: Effect of short-term goals on a patient’s will to live
Track 8: Perspective on finding satisfaction in the practice of oncology
Track 9: Viewpoint on end-of-life care, including hospice
Track 10: Support for family members of patients with end-stage cancer
Track 11: Case discussion: A 67-year-old woman with Stage IIIC epithelial OC receives multiple lines of therapy, including chemotherapy/bevacizumab, mirvetuximab soravtansine (IMGN853) and a PARP inhibitor on clinical trials
Track 12: Neoadjuvant chemotherapy versus primary surgery for advanced OC
Track 13: Improvement in progression-free survival with the addition of bevacizumab to chemotherapy as first-line treatment for advanced OC
Track 14: Side-effect profile of bevazicumab
Track 15: Management of bevacizumab-associated hypertension
Track 16: Therapeutic options for patients with platinum-sensitive recurrent OC
Track 17: Mechanism of action, efficacy and tolerability of mirvetuximab soravtansine
Track 18: Activity and ongoing investigation of PARP inhibitors for advanced OC
Track 19: Results of the Phase III ENGOT-OV16/NOVA trial of niraparib maintenance therapy in platinum-sensitive, recurrent OC
Track 20: Clinical implications of the ENGOT-OV16/NOVA trial results
Track 21: Future role of PARP inhibitors in the management of OC
Track 22: Comparison of the toxicity profiles of PARP inhibitors
Track 23: Importance of offering patients the option of clinical trial enrollment

Bonus audio excerpts - Listen to interviews with Drs Willmott and Hussein

OVARIAN CANCER — Interview with Lyndsay J Willmott, MD

Track 1: Case discussion: A 52-year-old woman with Stage IIIC OC receives adjuvant carboplatin/paclitaxel followed by bevacizumab maintenance
Track 2: Side effects associated with platinum-based chemotherapy regimens
Track 3: Risk of bowel perforation associated with the use of bevacizumab in patients with heavily treated OC
Track 4: Approach to using bevacizumab as maintenance for first-line treatment of OC
Track 5: Bevacizumab-related hypertension and associated renal toxicity
Track 6: Potential role of niraparib as maintenance for recurrent OC
Track 7: Management of niraparib-associated myelosuppression and gastrointestinal toxicities
Track 8: BRCA mutation testing for patients with OC
Track 9: Role of family support and patient involvement in treatment decision-making
Track 10: Use of checkpoint inhibitors as late-line therapy
Track 11: Approach to end-of-life care for patients with OC
Track 12: Case discussion: A 59-year-old woman with Stage IIIC high-grade, serous OC that progresses rapidly through multiple lines of treatment
Track 13: Viewpoint on neoadjuvant therapy for advanced OC
Track 14: Importance of setting realistic goals and expectations for patients
Track 15: Finding meaning and satisfaction as an oncologist

OVARIAN CANCER — Interview with Atif M Hussein, MD

Track 1: Case discussion: A 51-year-old woman with Stage III adenocarcinoma of the ovary develops acute renal failure after treatment with bevacizumab
Track 2: Hypertension as a surrogate marker of response to bevacizumab
Track 3: Perspective on the rewarding experience of being an oncologist
Track 4: Case discussion: A 49-year-old woman with a history of triple-negative breast cancer is diagnosed with BRCA2 mutation-positive Stage IIIB OC
Track 5: Activity and tolerability of olaparib
Track 6: Case discussion: A 68-year-old woman who presents with ascites is diagnosed with Stage IIIC OC
Track 7: Selection of intraperitoneal versus intravenous chemotherapy for advanced OC
Track 8: Case discussion: A 55-year-old woman with Stage III endometrioid OC receives adjuvant carboplatin/paclitaxel
Track 9: Effects of mindfulness and early palliative care on response to treatment
Track 10: Challenges associated with enrolling patients with OC on clinical trials
Track 11: Case discussion: A 52-year-old woman with Stage IIIC OC develops recurrence 2 years after achieving a good response to adjuvant intraperitoneal chemotherapy
 
FACULTY:
 
LUNG CANCER
 
Clinical Investigator
Heather Wakelee, MD
Associate Professor of Medicine
Division of Oncology
Stanford University School of Medicine
Stanford Cancer Institute
Stanford, California
 
General Oncologists
Maria Picton, MD
Physicians East
Greenville, North Carolina
 
Estelamari Rodriguez, MD, MPH
Medical Director, Thoracic Oncology
Chair, Women’s Centered Care Network
Mount Sinai Medical Center
Comprehensive Cancer Center
Miami Beach, Florida
 
COLORECTAL CANCER
 
Clinical Investigator
J Randolph Hecht, MD
Professor of Clinical Medicine
Director, UCLA GI Oncology Program
Carol and Saul Rosenzweig Chair in
Cancer Therapies Development
Santa Monica, California
 
General Oncologists
Gigi Qiqi Chen, MD
Diablo Valley Oncology and
Hematology Medical Group
Pleasant Hill, California
 
Margaret Deutsch, MD
Clinical Associate — Medical Oncology
Duke Cancer Institute
Duke Cancer Center Raleigh
Raleigh, North Carolina
 
OVARIAN CANCER
 
Clinical Investigator
Michael Birrer, MD, PhD
Director, UAB Comprehensive Cancer Center
University of Alabama at Birmingham
Birmingham, Alabama
 
General Oncologists
Atif M Hussein, MD
Memorial Health System
Hollywood, Florida
 
Lyndsay J Willmott, MD
Assistant Professor
Division of Gynecologic Oncology
Creighton University School of Medicine
at Dignity Health St Joseph’s Hospital
and Medical Center
Arizona Oncology
The US Oncology Network
Phoenix, Arizona
 
EDITOR:
Neil Love, MD
Research To Practice
Miami, Florida