OVERVIEW OF ACTIVITY
Non-Hodgkin lymphoma (NHL) is the most common cancer of the lymphatic system, a part of the immune system. It is estimated that 71,850 new cases will be diagnosed and 19,790 deaths will occur in the United States in 2015. Histologic subtypes of NHL include indolent lymphomas such as follicular lymphoma (FL), small lymphocytic lymphoma and chronic lymphocytic leukemia and the aggressive diffuse large B-cell lymphomas. Other NHL morphologies such as mantle-cell lymphoma, peripheral/cutaneous T-cell lymphoma and marginal zone B-cell lymphoma also exist.

The introduction of monoclonal antibodies with substantial activity, such as the anti-CD20 antibody rituximab, in B-cell NHL has improved outcomes and allowed patients to experience longer periods of remission. Despite this, several questions about how to optimize the use of monoclonal antibodies as induction and maintenance therapy for patients with NHL remain unanswered. Although various induction and maintenance strategies have been incorporated into current treatment algorithms, much is unknown about the adoption of these therapeutic approaches in clinical practice. The current challenge facing the oncology community is identifying those patients who will obtain the greatest benefit from a specific regimen while incurring the least toxicity.

Importantly, NHL as a single entity is among the most phenotypically and clinically diverse tumor types facing oncology/hematology healthcare practitioners. This CME endeavor documents the self-reported practice patterns of 101 general medical oncologists who elected to participate. The activity also offers clinical investigator perspectives on these findings in addition to their preferred approaches to the same scenarios examined. This information is presented in an effort to allow practicing medical oncologists to compare and contrast their own practice patterns with those of their peers and hematologic oncology experts and modify them accordingly.

LEARNING OBJECTIVES

• Compare and contrast induction and maintenance treatment strategies used by general oncologists and cancer clinical investigators, and apply this knowledge to individualize therapy for patients with FL.
• Evaluate the impact of patient age and risk status on the selection of induction and maintenance therapy for patients with FL.
• Determine the optimal duration of maintenance rituximab therapy for patients with FL and hypogammaglobulinemia.
• Examine the role of frequent monitoring using imaging techniques and the risk of relapse on maintenance rituximab, and use this information to counsel patients with FL.

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

CME credit is no longer available for this issue

CREDIT DESIGNATION STATEMENT

CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
This CME activity contains text, slide and video components.

CME credit is no longer available for this issue

CONTENT VALIDATION AND DISCLOSURES
Research To Practice (RTP) 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 RTP scientific staff and an external independent physician 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:

Brad S Kahl, MD
Professor of Medicine
Washington University School of Medicine
St Louis, Missouri

Advisory Committee: Celgene Corporation, Cephalon Inc, Genentech BioOncology, Roche Laboratories Inc, Takeda Oncology; Contracted Research: Abbott Laboratories, Cephalon Inc, Genentech BioOncology.

Michael E Williams, MD, ScM
Byrd S Leavell Professor of Medicine
Chief, Hematology/Oncology Division
University of Virginia School of Medicine
Charlottesville, Virginia

Advisory Committee: Celgene Corporation, Genentech BioOncology, Janssen Biotech Inc, Onyx Pharmaceuticals, an Amgen subsidiary; Consulting Agreements: Celgene Corporation, Takeda Oncology; Contracted Research: Allos Therapeutics, AstraZeneca Pharmaceuticals LP, Celgene Corporation, Genentech BioOncology, Gilead Sciences Inc, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics Inc, Takeda Oncology.

EDITOR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Amgen Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, ImmunoGen Inc, Incyte Corporation, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Teva Oncology, Tokai Pharmaceuticals Inc and VisionGate 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.

This educational activity contains 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.

This activity is supported by educational grants from Genentech BioOncology and Takeda Oncology.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
Adobe Flash Player 10.2 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Last review date: December 2015
Expiration date: December 2016