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Optimizing Biomarker Testing to Guide Treatment Selection for Metastatic Colorectal Cancer

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  • Overview

    This 1.0-credit activity provides oncology clinicians with practical insights into the importance of biomarker testing in patients diagnosed with metastatic colorectal cancer (mCRC), optimizing biomarker testing procedures, and the role of biomarkers in guiding treatment selection. Case vignettes will provide the basis for expert faculty discussions that explore ways to address common barriers to biomarker testing, benefits of tissue versus liquid biopsy, when to test and why, and the use of biomarkers in prediction and prognosis. Finally, individualizing the treatment of mCRC based on molecular (eg, RAS, BRAF, MSI-high, HER2), patient (eg, comorbidities, age), and tumor (location, resectability) characteristics, as well as patient preferences (quality of life, treatment toxicities) will be discussed.

  • Activity Abstract

    Here are the key takeaways from this activity. Deeper insights and evidence are available below.

    • CRC is a heterogeneous disease that varies on the molecular and anatomic level
    • Biomarker testing is recommended for all patients diagnosed with CRC
    • Although core tumor biopsy is currently the gold standard biomarker testing method, tumor heterogeneity and cancer evolution are major limitations of this single-snapshot approach
    • Liquid biopsy can overcome many of the limitations of solid tissue biopsy and can identify minimum residual disease after surgery and treatment, as well as identify druggable molecular alterations to help tailor treatment
    • Barriers to biomarker testing include patient-specific factors (eg, socioeconomic factors); tissue/timing issues (eg, tissue acquisition, uncertainty about when to test); and system-based challenges (eg, access to testing, inconsistent results reporting, communication between pathologist and oncologist)
    • Current actionable biomarkers for mCRC include KRAS/NRAS (the MAPK pathway of RAS/RAF/MEK/ERK is downstream of EGFR), BRAF V600E, HER2 amplification, mismatch repair deficiency, NTRK fusions, and tumor mutational burden
    • Treatment of mCRC must be tailored according to individual patient needs, taking into account tumor characteristics, molecular profile, patient characteristics (eg, age, comorbidities, prior treatment, performance status), and patient preferences (eg, toxicity risk tolerance, quality of life considerations)
  • Activity Planners

    Susan Kuhn, MHSc
    Manager, Educational Strategy and Content
    Med-IQ
    Baltimore, MD

    Larissa Picard
    CME Coordinator
    Med-IQ
    Baltimore, MD

    Nikki Berry
    Director, Accreditation
    Med-IQ
    Baltimore, MD

  • Learning Objectives

    Upon completion, participants should be able to:

    • Describe the evidence surrounding the use of biomarker testing in guiding personalized treatment selection for patients with mCRC 
    • Identify strategies to address common barriers to optimal CRC biomarker testing, results interpretation, and application
    • Summarize the efficacy and safety of novel therapies that target key CRC variants and place them within the mCRC treatment paradigm  
    • Integrate biomarkers into treatment selection decisions for patients with mCRC
  • Target Audience

    This activity is intended for community oncologists.

  • Statement of Need

    Metastatic colorectal cancer (mCRC) is a heterogeneous disease characterized by multiple gene alterations that can significantly affect prognosis and treatment selection. Biomarker testing for specific genetic variants confers the promise of personalized medicine that can improve outcomes and reduce exposure to unnecessary and ineffective treatments. Based on landmark trials involving biomarkers to provide personalized care, multiple guidelines now recommend biomarker testing for KRAS/NRAS and BRAF mutations, HER2 amplifications, and MSI/MMR status as the standard of care for patients with mCRC.However, several studies have shown that biomarker testing rates and application of test results to treatment decisions in accordance with guideline recommendations are suboptimal in patients with mCRC. With the availability of new therapies targeting the aforementioned gene alterations, clinicians must be up to date on the latest actionable markers, optimal biomarker testing methods, how to interpret the results, recent testing/treatment guidelines, and the clinical data supporting the use of biomarkers to guide treatment selection.

  • Core Competencies

    Patient-centered Care

    Medical Knowledge/Application to Patient Care

    Systems-based Practice

  • Provider(s)/Educational Partner(s)


    Provided by Med-IQ.

  • Accreditation and Credit Designation Statements

    Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Med-IQ designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.

  • Medium/Method of Participation

    To receive credit, read the introductory CME material, watch the webcast, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly. 

    Initial Release Date: 12/14/2023

    Expiration Date: 12/13/2024

    Estimated Time to Complete This Activity: 60 minutes

  • Disclosure of Conflicts of Interest

    Disclosure Policy
    Med-IQ requires any person in a position to control the content of an educational activity to disclose all financial relationships with ineligible companies within the prior 24 months. The ACCME deems financial relationships as relevant if the educational content an individual can control is related to the business lines or products of the ineligible company. Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and mitigate COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration. 

    Drug/Product Usage by Faculty
    Off-label/unapproved drug uses or products are not mentioned within this activity. 

    Disclosure Statement:
    The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been successfully mitigated through an established COI mitigation process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation. 

    Elizabeth Montgomery, MD
    Other (activity review): Pentax

    John Marshall, MD
    Salary: Individumed

    Consulting fees/advisory boards: AstraZeneca, Merck & Co., Inc., Bayer HealthCare Pharmaceuticals, Taiho Pharmaceutical Co, Ltd., Seagen Inc., Pfizer Inc., Caris Life Sciences

    Fees received for promotional/non-CME/CE activities: AstraZeneca, Merck & Co., Inc., Bayer HealthCare Pharmaceuticals, Taiho Pharmaceutical Co, Ltd., Seagen Inc., Pfizer Inc., Caris Life Sciences

    Med-IQ Disclosure:
    The activity planners, peer reviewers, and staff have no financial relationships to disclose.

  • Commercial Support

    This activity is supported by an educational grant from Seagen Inc.

  • Statement of Evidence-Based Content

    Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

    Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.

  • System Requirements

    • Supported Browsers (2 most recent versions):
      • Google Chrome for Windows, Mac OS, iOS, and Android
      • Apple Safari for Mac OS and iOS
      • Mozilla Firefox for Windows, Mac OS, iOS, and Android
      • Microsoft Edge for Windows
    • Recommended Internet Speed: 5Mbps+

  • Publication Dates

    Release Date:

    Expiration Date:

Recommended
Details
Presenters
Related
Comments
  • Overview

    This 1.0-credit activity provides oncology clinicians with practical insights into the importance of biomarker testing in patients diagnosed with metastatic colorectal cancer (mCRC), optimizing biomarker testing procedures, and the role of biomarkers in guiding treatment selection. Case vignettes will provide the basis for expert faculty discussions that explore ways to address common barriers to biomarker testing, benefits of tissue versus liquid biopsy, when to test and why, and the use of biomarkers in prediction and prognosis. Finally, individualizing the treatment of mCRC based on molecular (eg, RAS, BRAF, MSI-high, HER2), patient (eg, comorbidities, age), and tumor (location, resectability) characteristics, as well as patient preferences (quality of life, treatment toxicities) will be discussed.

  • Activity Abstract

    Here are the key takeaways from this activity. Deeper insights and evidence are available below.

    • CRC is a heterogeneous disease that varies on the molecular and anatomic level
    • Biomarker testing is recommended for all patients diagnosed with CRC
    • Although core tumor biopsy is currently the gold standard biomarker testing method, tumor heterogeneity and cancer evolution are major limitations of this single-snapshot approach
    • Liquid biopsy can overcome many of the limitations of solid tissue biopsy and can identify minimum residual disease after surgery and treatment, as well as identify druggable molecular alterations to help tailor treatment
    • Barriers to biomarker testing include patient-specific factors (eg, socioeconomic factors); tissue/timing issues (eg, tissue acquisition, uncertainty about when to test); and system-based challenges (eg, access to testing, inconsistent results reporting, communication between pathologist and oncologist)
    • Current actionable biomarkers for mCRC include KRAS/NRAS (the MAPK pathway of RAS/RAF/MEK/ERK is downstream of EGFR), BRAF V600E, HER2 amplification, mismatch repair deficiency, NTRK fusions, and tumor mutational burden
    • Treatment of mCRC must be tailored according to individual patient needs, taking into account tumor characteristics, molecular profile, patient characteristics (eg, age, comorbidities, prior treatment, performance status), and patient preferences (eg, toxicity risk tolerance, quality of life considerations)
  • Activity Planners

    Susan Kuhn, MHSc
    Manager, Educational Strategy and Content
    Med-IQ
    Baltimore, MD

    Larissa Picard
    CME Coordinator
    Med-IQ
    Baltimore, MD

    Nikki Berry
    Director, Accreditation
    Med-IQ
    Baltimore, MD

  • Learning Objectives

    Upon completion, participants should be able to:

    • Describe the evidence surrounding the use of biomarker testing in guiding personalized treatment selection for patients with mCRC 
    • Identify strategies to address common barriers to optimal CRC biomarker testing, results interpretation, and application
    • Summarize the efficacy and safety of novel therapies that target key CRC variants and place them within the mCRC treatment paradigm  
    • Integrate biomarkers into treatment selection decisions for patients with mCRC
  • Target Audience

    This activity is intended for community oncologists.

  • Statement of Need

    Metastatic colorectal cancer (mCRC) is a heterogeneous disease characterized by multiple gene alterations that can significantly affect prognosis and treatment selection. Biomarker testing for specific genetic variants confers the promise of personalized medicine that can improve outcomes and reduce exposure to unnecessary and ineffective treatments. Based on landmark trials involving biomarkers to provide personalized care, multiple guidelines now recommend biomarker testing for KRAS/NRAS and BRAF mutations, HER2 amplifications, and MSI/MMR status as the standard of care for patients with mCRC.However, several studies have shown that biomarker testing rates and application of test results to treatment decisions in accordance with guideline recommendations are suboptimal in patients with mCRC. With the availability of new therapies targeting the aforementioned gene alterations, clinicians must be up to date on the latest actionable markers, optimal biomarker testing methods, how to interpret the results, recent testing/treatment guidelines, and the clinical data supporting the use of biomarkers to guide treatment selection.

  • Core Competencies

    Patient-centered Care

    Medical Knowledge/Application to Patient Care

    Systems-based Practice

  • Provider(s)/Educational Partner(s)


    Provided by Med-IQ.

  • Accreditation and Credit Designation Statements

    Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Med-IQ designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.

  • Medium/Method of Participation

    To receive credit, read the introductory CME material, watch the webcast, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly. 

    Initial Release Date: 12/14/2023

    Expiration Date: 12/13/2024

    Estimated Time to Complete This Activity: 60 minutes

  • Disclosure of Conflicts of Interest

    Disclosure Policy
    Med-IQ requires any person in a position to control the content of an educational activity to disclose all financial relationships with ineligible companies within the prior 24 months. The ACCME deems financial relationships as relevant if the educational content an individual can control is related to the business lines or products of the ineligible company. Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and mitigate COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration. 

    Drug/Product Usage by Faculty
    Off-label/unapproved drug uses or products are not mentioned within this activity. 

    Disclosure Statement:
    The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been successfully mitigated through an established COI mitigation process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation. 

    Elizabeth Montgomery, MD
    Other (activity review): Pentax

    John Marshall, MD
    Salary: Individumed

    Consulting fees/advisory boards: AstraZeneca, Merck & Co., Inc., Bayer HealthCare Pharmaceuticals, Taiho Pharmaceutical Co, Ltd., Seagen Inc., Pfizer Inc., Caris Life Sciences

    Fees received for promotional/non-CME/CE activities: AstraZeneca, Merck & Co., Inc., Bayer HealthCare Pharmaceuticals, Taiho Pharmaceutical Co, Ltd., Seagen Inc., Pfizer Inc., Caris Life Sciences

    Med-IQ Disclosure:
    The activity planners, peer reviewers, and staff have no financial relationships to disclose.

  • Commercial Support

    This activity is supported by an educational grant from Seagen Inc.

  • Statement of Evidence-Based Content

    Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

    Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.

  • System Requirements

    • Supported Browsers (2 most recent versions):
      • Google Chrome for Windows, Mac OS, iOS, and Android
      • Apple Safari for Mac OS and iOS
      • Mozilla Firefox for Windows, Mac OS, iOS, and Android
      • Microsoft Edge for Windows
    • Recommended Internet Speed: 5Mbps+

  • Publication Dates

    Release Date:

    Expiration Date:

Schedule29 Oct 2024