STATEMENT OF NEED / TARGET AUDIENCE

Improvements in survival of patients with breast cancer require increased attention to the trade-offs between the benefits of commonly utilized, effective therapies and the iatrogenic effects of those treatments, including the increasingly recognized potential cardiotoxic side effects. Understanding of treatment-associated cardiotoxicity will allow physicians to more effectively counsel patients about treatment options and to more effectively manage treatment-related adverse events. To bridge the gap between research and patient care, this activity uses one-on-one discussions with leading oncology investigators and case discussions with community oncologists and investigators. By providing access to the latest research developments and expert perspectives, this CME program assists medical oncologists in the formulation of up-to-date clinical management strategies.

GLOBAL LEARNING OBJECTIVES

• Understand the pathophysiologic mechanisms, risks and the nature of cardiotoxicity associated with anthracyclines, trastuzumab and other biologic agents in order to assist patients with breast cancer in treatment decision-making.
• Develop a clinical algorithm for monitoring cardiac functioning in patients receiving anthracyclines, trastuzumab and other biologic agents, and develop an approach to managing treatment-induced cardiotoxicity while providing optimally effective cancer treatment.
• Identify the relative advantages and disadvantages of MUGA and echocardiography for monitoring left ventricular ejection fraction (LVEF).
• Develop awareness of the intraindividual and interobserver variability in the assessment of LVEF in order to evaluate the relevance of changes to individual patient care.
• Evaluate the relative advantages and disadvantages of anthracycline- and nonanthracycline-containing regimens in order to counsel patients with HER2-positive and HER2-negative disease about potential treatment options with less cardiac risk.
• Recognize the importance of cardiology-oncology collaboration in the care of patients with cardiac risk factors, particularly those receiving potentially cardiotoxic adjuvant therapy, in order to mitigate risk of congestive heart failure.

PURPOSE OF THIS CME ACTIVITY

The purpose of this program is to support these global objectives by offering the perspectives of Drs Steingart, Slamon and Burstein on the integration of emerging clinical research data into the management of breast cancer.

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

Research To Practice designates this educational activity for a maximum of 4.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

HOW TO USE THIS CME ACTIVITY

This CME activity contains both audio and print components. To receive credit, the participant should listen to the CDs, review the monograph and complete the Post-test and Evaluation Form located in the back of this monograph or on our website. This monograph contains edited comments, clinical trial schemas, graphics and references that supplement the audio program. BreastCancerUpdate.com/Cardiac includes an easy-to-use, interactive version of this monograph with links to relevant full-text articles, abstracts, trial information and other web resources indicated here in blue underlined text.

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Interviews
Richard M Steingart, MD
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Tumor Panel Case Discussions
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Dennis J Slamon, MD, PhD
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Harold J Burstein, MD, PhD
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