Clinical Consults In Sarcoma: A Case-based CME Activity

Program Overview

Sarcomas are an uncommon and complex family of cancers that are more prevalent in children than in adults. Soft tissue sarcomas are the most frequently occurring sarcomas, and the gastrointestinal stromal tumor (GIST) is the most common mesenchymal form of soft tissue sarcoma occurring in the gastrointestinal tract. The treatment guidelines for sarcomas have evolved significantly due to the introduction of novel treatment options and screening mechanisms. It is critical for medical oncologists, surgical oncologists, radiation oncologists, and other health care professionals treating patients with sarcomas to keep abreast of the latest advances in the management of this type of cancer.

The past year has seen an improved outlook for patients with sarcomas, with the first positive results from a systemic agent in 20 years, a new systemic agent submitted for approval by the FDA, and clinical trials of additional prospective agents. Clinicians who treat patients with sarcoma need to be made aware of these advances in the management of sarcoma and incorporate these insights into their clinical practices, in order to optimize patient care.

Faculty

	George D. Demetri, MD Senior Vice President for Experimental Therapeutics Dana-Farber Cancer Institute Director, Ludwig Center at Dana-Farber / Harvard Cancer Center Quick Family Senior Investigator in Medical Oncology Dana-Farber Cancer Institute and Harvard Medical School Boston, MA Read Biography George D. Demetri, MD received an undergraduate degree in biochemistry from Harvard University, followed by a Rotary Foundation Fellowship to do research at the Université de Besancon, France, after which he received his medical degree from Stanford University School of Medicine, Stanford, CA. After completing an internal medicine residency and chief residency at the University of Washington Hospitals in Seattle, WA, Dr. Demetri pursued a fellowship in medical oncology at the Dana-Farber Cancer Institute (DFCI) and Harvard Medical School, where he has served as an attending physician since 1989. Dr. Demetri and colleagues at Harvard have developed a large research-focused multidisciplinary center of excellence for sarcoma patients at the Dana-Farber/Harvard Cancer Center, supporting a number of translational and clinical research projects in sarcomas and focusing on new drug development. Dr. Demetri’s research and clinical interests have focused on mechanism-based drug development for solid tumors, with a particular emphasis on molecularly-defined subsets of sarcomas, such as gastrointestinal stromal tumors (GIST). Work from the multidisciplinary team at Dana-Farber/Harvard has contributed to the development of several new drugs for sarcomas and other malignancies, including imatinib, sunitinib, dasatinib, trabectedin, and other new targeted therapies in development. Dr. Demetri serves as Co-chair of the Medical Advisory Board for the Sarcoma Foundation of America, as well as on several scientific and editorial advisory boards. With an interest in internet-based medical social network technologies, he also serves as an Editor of CancerNet www.cancer.net from the American Society of Clinical Oncology.
	Raphael E. Pollock, MD, PhD, FACS Professor and Head, Division of Surgery Senator A.M. Aiken Jr. Distinguished Chair University of Texas M.D. Anderson Cancer Center Houston, TX Read Biography Raphael E. Pollock, MD, PhD, FACS was born in Chicago, IL and graduated from Oberlin College, Oberlin, OH in 1972. He then earned his medical doctorate from the St. Louis University School of Medicine, Chicago, IL, and completed residencies in general surgery at the University of Chicago and Rush Medical College, a fellowship in surgical oncology at the University of Texas M. D. Anderson Cancer Center, and a PhD in tumor immunology from the Graduate School of the Biological Sciences at the University of Texas-Houston Health Sciences Center. Dr. Pollock joined the Department of Surgical Oncology at The University of Texas M. D. Anderson Cancer Center as a faculty member in 1984 and has remained in this department ever since. Dr. Pollock has dedicated his professional life to the care of solid tumor patients, as well as laboratory research in this area. His clinical and research activities focus on a rare form of connective tissue cancer known as soft tissue sarcoma, and Dr. Pollock provides leadership for the Sarcoma Research Center of the University of Texas M. D. Anderson Cancer Center. Dr. Pollock is the incumbent in the Senator A.M. Aiken Jr. Distinguished Chair and holds joint appointments in the Department of Molecular and Cellular Oncology at the University of Texas M. D. Anderson Cancer and the Department of Surgery at the University of Texas Health Sciences Center/Houston. Dr. Pollock became Chairman of the Department of Surgical Oncology in 1993 and became Head of the Division of Surgery at the University of Texas M. D. Anderson Cancer Center in 1997.
	Alexander Lazar, MD, PhD Associate Professor Director, Sarcoma Molecular Diagnostics Director, Soft Tissue Pathology Fellowship Program Sarcoma Research Center Department of Pathology The University of Texas M.D. Anderson Cancer Center Houston, TX Read Biography Alexander Lazar, MD, PhD was born in Santa Ana, CA and attended Austin College, a small liberal arts school in Sherman, TX. He received his MD and PhD degrees from the University of Texas Southwestern Medical Center in Dallas, TX. He completed his anatomic pathology residency at Brigham and Women’s Hospital/Harvard Medical School in Boston, MA, where he also completed a fellowship in soft tissue pathology followed by a dermatopathology fellowship at the Massachusetts General Hospital. Currently, Dr. Lazar is an Associate Professor and practicing academic pathologist focused on sarcoma and molecular diagnostics at the University of Texas M.D. Anderson Cancer Center, where he regularly participates in the Sarcoma Multidisciplinary Care Center. He is faculty in both the Sarcoma Research Center at M.D. Anderson and at the UT-Houston Graduate School of Biomedical Science. He serves on the American Joint Cancer Committee (AJCC) for soft tissue sarcoma staging, the World Health Organization (WHO) group for classification of bone and soft tissue neoplasms, and the Cancer Committee of the College of American Pathologists (CAP), where he helped develop the pathology reporting checklists for sarcomas and is the liaison to the Molecular Oncology Committee. His research interests revolve around molecular diagnostics of sarcomas, early genetic changes in sarcomagenesis, and predictive biomarkers for sarcoma and melanoma. He has authored or co-authored more than 175 original articles, reviews, and book chapters primarily in the sarcoma field.

Target Audience

Educational Objectives

This program is designed to address the following IOM competencies: provide patient-centered care and employ evidence-based practice.

At the conclusion of this activity, participants should be able to demonstrate the ability to:

• Explain the diagnosis and classification of sarcomas and understand the timing for referral to a specialty center
• Utilize the updated NCCN clinical guidelines for the diagnosis and treatment of sarcoma and plan a multidisciplinary treatment approach for sarcoma
• Discuss ongoing trials in sarcoma and emerging data from novel treatment regimens for sarcoma

Accreditation

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Potomac Center for Medical Education and Rockpointe. Potomac Center for Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

The Potomac Center for Medical Education designates this educational activity for a maximum of 1.0 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

     For information about the accreditation of this program, please email contact@potomacme.org

Disclosure Information

Potomac Center for Medical Education (PCME) adheres to the policies and guidelines, including the Standards for Commercial Support, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous.

All persons in a position to control the content of a continuing medical education program sponsored by the Potomac Center for Medical Education are required to disclose any relevant financial relationships with any commercial interest to PCME as well as to learners. All conflicts are identified and resolved by PCME in accordance with the Standards for Commercial Support in advance of delivery of the activity to learners.

The content of this activity was vetted by an external medical reviewer to assure objectivity and that the activity is free of commercial bias.

The faculty reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

George Demetri, MD: Consultant: Novartis, Pfizer, Sanofi-Aventis, GlaxoSmithKline, Ariad, Johnson & Johnson, Genentech/Roche, Infinity Pharmaceuticals, ZioPharm, Merck, Amgen, Daiichi-Sankyo, ArQule; Research: Novartis, Pfizer, Sanofi-Aventis, GlaxoSmithKline, Ariad, Johnson & Johnson, Bristol-Myers Squibb, Infinity Pharmaceuticals, Daiichi-Sankyo, SARC; Advisory Board: ZioPharm

Raphael Pollock, MD: Nothing to Disclose

Alexander Lazar, MD: Speaker: Novartis; Spouse Employed by General Electric

Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Latha Shivakumar, PhD; Bradley Pine; Blair St. Amand; Jay Katz; Dana Simpler, MD: Nothing to Disclose

FDA Disclosure

The contents of some CME/CE activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.

System Requirements

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Instructions for Participants and Obtaining CME Credit

There is no fee for this activity. To receive credit, participants must take the pre-test, view this CME activity in its entirety, and then complete the post-test and evaluation. To complete the evaluation online, choose the best answer to each question. The estimated time for completion of this activity is 1.0 hour. To receive and print their certificates, participants must demonstrate mastery of the presented material via the post-test.

Joint Sponsorship

This activity is jointly sponsored by

Supported By

Supported by an independent educational grant from