TARGET AUDIENCE
This activity is intended for medical oncologists, hematology-oncology fellows, surgeons and other healthcare providers involved in the treatment of gastrointestinal (GI) cancers.

OVERVIEW OF ACTIVITY
Given the prevalent nature of the disease, extensive resources are allocated to colorectal cancer research and education. Interestingly, however, although individually less frequently encountered, the collection of other noncolorectal GI cancers accounts for more per annum cancer-related deaths than those attributed to tumors of the colon and rectum combined. Among this collection of distinct tumor types, a few areas in particular — namely gastric/gastroesophageal and hepatocellular cancer — have witnessed several recent advances that have altered or have the potential to drastically alter current treatment considerations and approaches.

These audio proceedings from a CME symposium held during the 2019 Gastrointestinal Cancers Symposium feature discussions with leading researchers with an expertise in GI cancers regarding actual cases from their practices and the published data that drive clinical decision-making for patients in those and diverse other situations. By providing information on the latest research developments and their potential application to routine practice, this activity is designed to assist medical oncologists, hematology-oncology fellows and other healthcare providers with the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

• Develop a long-term care plan for patients diagnosed with metastatic colorectal cancer, considering biomarker profile, tumor location, prior systemic therapy, symptomatology, performance status and personal goals of treatment.
• Use HER2 status, PD-L1 combined positive score, clinical factors and patient preferences to optimize the selection and sequence of systemic therapy for locally advanced or metastatic gastric/gastroesophageal cancer.
• Review recent therapeutic advances and related FDA authorizations for patients with newly diagnosed and relapsed/refractory advanced hepatocellular carcinoma, and integrate this information, as appropriate, into routine clinical practice.
• Recall the biologic rationale for, published clinical trial data with and ongoing research evaluating the use of immune checkpoint inhibitors alone or in combination with chemotherapy, targeted agents or other immunotherapies for colorectal, esophageal, gastric/gastroesophageal and hepatocellular cancer, and identify patients who may be eligible for these strategies in or outside of a protocol setting.
• Appreciate available Phase III data with and consider the potential clinical roles of novel agents (eg, cabozantinib, ramucirumab, TAS-102) that may soon provide additional treatment options to patients with diseases beyond those for which those agents were initially indicated.
• Design and implement a plan of care to recognize and manage side effects and toxicities associated with novel and recently approved systemic therapies for locally advanced or metastatic colorectal, gastric and hepatocellular cancer to support quality of life and continuation of therapy.
• Recall available and emerging data with other investigational agents currently in clinical testing for colorectal, gastric/gastroesophageal and hepatocellular cancer, and, where applicable, refer eligible patients for trial participation or other expanded access programs.

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
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 an audio 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:

Ghassan Abou-Alfa, MD
Attending
Memorial Sloan Kettering Cancer Center
Professor
Weill Cornell Medicine at Cornell University
New York, New York

Consulting Agreements: 3DMedcare, Agios Pharmaceuticals Inc, Alignmed, Amgen Inc, Antengene, Aptus Clinical, Arbutus Biopharma, ASLAN Pharmaceuticals, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, BeiGene, BioLineRx, Boston Scientific Corporation, BridgeBio, Bristol-Myers Squibb Company, CARsgen Therapeutics, CASI Pharmaceuticals, Celgene Corporation, Cipla Limited, CytomX Therapeutics, Daiichi Sankyo Inc, Debiopharm Group, Delcath Systems Inc, Eisai Inc, Exelixis Inc, Genoscience Pharma, Gilead Sciences Inc, Halozyme Inc, Hengrui Therapeutics Inc, Incyte Corporation, Inovio Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Kyowa Hakko Kirin Co Ltd, LAM, Lilly, Loxo Oncology, Merck, MINAPHARM Pharmaceuticals, NewLink Genetics Corporation, Novella Clinical, Onxeo, PCI Biotech, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, PharmaCyte Biotech, Pieris Pharmaceuticals, QED Therapeutics, RedHill, Sanofi Genzyme, Servier, Silenseed Ltd, SillaJen, Sobi, Targovax, twoXAR, Vicus Therapeutics, Yakult Pharmaceutical Industry CO LTD, Yiviva; Contracted Research: Acta Biologica, Agios Pharmaceuticals Inc, Array BioPharma Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, BeiGene, Bristol-Myers Squibb Company, CASI Pharmaceuticals, Celgene Corporation, Exelixis Inc, Genentech, Halozyme Inc, Incyte Corporation, Lilly, MabVax, Novartis, OncoQuest Inc, Polaris Group, Puma Biotechnology, QED Therapeutics, Roche Laboratories Inc.

Peter C Enzinger, MD
Director, Center for Esophageal and Gastric Cancer
Associate Professor of Medicine
Harvard Medical School
Dana-Farber Cancer Institute
Boston, Massachusetts

Consulting Agreements: Astellas Pharma Global Development Inc, Celgene Corporation, Lilly, Loxo Oncology, Merck, Taiho Oncology Inc.

Tim Greten, MD
Bethesda, Maryland

No relevant conflicts of interest to disclose.

David H Ilson, MD, PhD
Professor of Medicine
Weill Cornell Medical College
Attending Physician, Memorial Hospital
Memorial Sloan Kettering Cancer Center
New York, New York

Advisory Committee: Amgen Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Lilly, Merck, Pieris Pharmaceuticals, Roche Laboratories Inc, Taiho Oncology Inc; Consulting Agreements: Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Lilly, Merck, Pieris Pharmaceuticals, Roche Laboratories Inc, Taiho Oncology Inc; Contracted Research: Taiho Oncology Inc.

Wells A Messersmith, MD
Professor and Director, GI Medical Oncology Program
Co-Leader, Developmental Therapeutics Program
University of Colorado Cancer Center
Aurora, Colorado

Contracted Research with Institution: Aduro Biotech, ALX Oncology, AstraZeneca Pharmaceuticals LP, Exelixis Inc, Genentech, Incyte Corporation, Pfizer Inc; Data and Safety Monitoring Board/Committee: Five Prime Therapeutics Inc, Gilead Sciences Inc; Unpaid Consulting Agreements: AstraZeneca Pharmaceuticals LP, Pfizer Inc.

Eric Van Cutsem, MD, PhD
Professor of Medicine
Digestive Oncology
University Hospital Gasthuisberg/Leuven
Leuven, Belgium

Advisory Committee: Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Celgene Corporation, Lilly, Merck KGaA, Darmstadt, Germany, Merck Sharp & Dohme Corp, Novartis, Roche Laboratories Inc, Servier; Paid Research: Amgen Inc, Bayer HealthCare Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Ipsen Biopharmaceuticals Inc, Lilly, Merck, Merck KGaA, Darmstadt, Germany, Novartis, Roche Laboratories Inc, Servier.

MODERATOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma — A member of the AstraZeneca Group, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech, Genmab, Genomic Health Inc, Gilead Sciences Inc, Guardant Health, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Loxo Oncology, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, a Novartis Division, Sanofi Genzyme, Seattle Genetics, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro, Teva Oncology, Tokai Pharmaceuticals Inc and Tolero Pharmaceuticals.

RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent 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 AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Eisai Inc, Genentech, Lilly, Merck and Taiho Oncology Inc.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
Adobe Flash Player 27 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Release date: April 2019
Expiration date: April 2020