TARGET AUDIENCE
This activity is intended for medical oncologists and other healthcare providers involved in the treatment of pancreatic cancer.

OVERVIEW OF ACTIVITY
An estimated 53,070 people will be diagnosed with pancreatic cancer in the United States in 2016, and approximately 41,780 will die of the disease. For the better part of the past 2 decades, gemcitabine chemotherapy had been the main systemic therapy used to treat locally advanced and metastatic pancreatic adenocarcinoma. However, its actual clinical benefit was a modest 1-month extension in overall survival when compared to 5-FU alone. Despite the recent breakthroughs with FOLFIRINOX and nab paclitaxel, systemic options for patients with advanced pancreatic adenocarcinoma remain limited. However, ongoing research into other therapeutic strategies continues. One chemotherapeutic agent in particular, nanoliposomal irinotecan (nal-IRI), has recently garnered the attention of gastrointestinal oncologists and patients alike. As more and better treatment options become available and patients are living longer, a variety of supportive care issues, including pain management and palliative care, become more relevant considerations. In fact, the institution of early palliative care, including adequate pain control, can now be considered a life-extending intervention in and of itself.

Although pessimism has reigned for some time in the management of pancreatic adenocarcinoma, the past few years have witnessed the emergence of a variety of therapeutic and investigational strategies such as FOLFIRINOX, nab paclitaxel and nal-IRI that have already changed clinical practice. The use of PARP inhibitors and immune-directed therapies also holds promise to do so in the future. To offer optimal patient care, clinicians need educational interventions designed to increase their knowledge of recent advancements and appropriately counsel them regarding how those new strategies can be safely and effectively integrated into current protocol and off-protocol treatment algorithms for patients with pancreatic cancer.

LEARNING OBJECTIVES

• Apply the results of emerging clinical research to the best-practice management of pancreatic adenocarcinoma.
• Develop an evidence-based strategy for the initial diagnosis and treatment of resectable pancreatic cancer, exploring the role of neoadjuvant and adjuvant chemotherapy and/or radiation therapy.
• Consider age, performance status and other clinical and logistical factors in the selection of systemic therapy for patients with locally advanced or metastatic pancreatic cancer.
• Appreciate the recent FDA approval of nal-IRI in the management of treatment-refractory metastatic pancreatic cancer, and optimally incorporate this agent into patient care algorithms.
• Recall new data with other investigational agents demonstrating promising activity in pancreatic cancer.
• Review the potential impact of early palliative care, pain management and end-of-life planning on clinical outcomes for patients with advanced pancreatic cancer, and integrate this information, where applicable, into routine practice.

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

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)

CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
This CME activity consists of a video component.

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 conflicts of interest with faculty, planners and managers of CME activities. 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 relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

Tanios Bekaii-Saab, MD
Co-Leader, GI Cancer Program
Mayo Clinic Cancer Center
Senior Associate Consultant
Mayo Clinic Arizona
Scottsdale, Arizona

Consulting Agreements: Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Genentech BioOncology, Merck, Taiho Oncology Inc; Data and Safety Monitoring Board: Exelixis Inc, Silagen.

Margaret A Tempero, MD
Director, UCSF Pancreas Center
The Rombauer Family Distinguished Professorship in
Pancreas Cancer Clinical and Translational Science
Leader, Pancreas Cancer Program
Professor of Medicine, Division of Hematology and Oncology
San Francisco, California

Advisory Committee: EMD Serono Inc, Gilead Sciences Inc, Threshold Pharmaceuticals; Consulting Agreements: Champions Oncology, Cornerstone Pharmaceuticals Inc, Lilly, Novocure, Opsona Therapeutics; Contracted Research: Celgene Corporation, Halozyme Therapeutics.

COMMUNITY ONCOLOGISTS — The following community oncologists (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

Philip L Brooks, MD
Hematologist-Medical Oncologist
CancerCare of Maine/Eastern Maine Medical Center
Brewer, Maine

No relevant conflicts of interest to disclose.

Philip T Glynn, MD
Director, Medical Oncology, Mercy Medical Center
Director of Oncology, Noble Hospital
Director of Noble VNA and Hospice Services
Springfield, Massachusetts

No relevant conflicts of interest to disclose.

Michael Schwartz, MD
Attending, Division of Hematology and Oncology
Mount Sinai Medical Center
Miami Beach, Florida

No relevant conflicts of interest to disclose.

MODERATOR — 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, Acerta Pharma, Agendia Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, 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 Corp, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Therapeutics, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, 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 relevant 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 Celgene Corporation and Merrimack Pharmaceuticals Inc.

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: March 2017
Expiration date: March 2018