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Biomarkers and Beyond: Redefining Systemic Therapy for NSCLC Release Date: December-19-11 Credit Expiration Date: December-19-12 This educational activity is designed to meet the needs of oncologist, pathologists, radiologist, and other healthcare professionals involved or interested in the treatment of patients with lung cancer. There are no prerequisites to participate in this program. Estimated amount of time to complete: 60 minutes Online Presentation THIS ONLINE PROGRAM WAS PREVIOUSLY PRESENTED AS LIVE GRAND ROUNDS. IF YOU RECEIVED CREDIT AT THE LIVE PROGRAM YOU ARE INELIGIBLE TO RECEIVE CREDIT FOR PARTICIPATING IN THIS ONLINE PROGRAM. Lung cancer is the leading cause of worldwide cancer mortality and is responsible for more deaths annually in the U.S. than the combination of breast, colorectal, and prostate cancer. About 87% of lung cancer cases in the U.S. are classified as non-small cell lung cancer (NSCLC), and most cases are diagnosed at an advanced stage resulting in poor overall survival for most patients. Advanced NSCLC is incurable, and thus the goal of therapy is not only to improve survival times, but also to assure the best quality of life possible. Recently, treatment for advanced NSCLC has expanded beyond using chemotherapy as the cornerstone of treatment to include a new generation of targeted therapies that disrupt the cellular pathways involved in tumor growth, progression, and cell death. The use of molecularly targeted therapies represents a significant advancement in the NSCLC treatment. Oncologists can improve the prognosis of patients with advanced NSCLC by learning how to incorporate the latest evidence-based recommendations regarding molecularly targeted therapies and emerging clinical evidence into individualized treatment plans that target the underlying heterogeneous molecular pathways of tumor progression. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity. Upon completion of this educational activity, the participant should be able to: 1. Integrate biomarker and histology testing to identify appropriate initial therapy for patients with NSCLC. 2. Assess the rationale and limitations of molecularly targeted therapies in first-line treatment of NSCLC. 3. Assess the rationale and limitations of maintenance treatment of NSCLC. 4. Tailor treatment regimens for patients presenting with NSCLC based on assessment of the molecular pathways that underlie each individual patient’s tumor. Presenter: Jyoti D. Patel, MD Assistant Professor of Medicine Division of Hematology/Oncology Feinberg School of Medicine Northwestern University Chicago, IL Program Chair: David S. Ettinger, MD, FACP, FCCP (Course Chair) Alex Grass Professor of Oncology The Johns Hopkins University School of Medicine The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore, Maryland FACULTY DISCLOSURES As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) to require signed disclosure of the existence of financial relationships with industry from any individual in a position to control the content of a CME activity sponsored by OCME. Members of the Planning Committee are required to disclose all relationships regardless of their relevance to the content of the activity. Faculty are required to disclose only those relationships that are relevant to their specific presentation. The following relationships have been reported for this activity: Faculty Presenter: Jyoti Patel has no relevant financial relationships to disclose. Planner Disclosure: David Ettinger: Consultant: Biodesix, Inc., Boehringer Ingelheim, Celgene, Eli Lilly & Co., Genentech/Roche, Merck & Co., Inc. No other planners have indicated that they have any financial interests or relationships with a commercial entity. Note: Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution which receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s). OFF-LABEL PRODUCT DISCUSSION This activity references unlabelled/ unapproved uses of: Erlotinib, combination therapies: cetuximab + cisplatin/vinorelbine; erlotinib + bevacizumab. The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients. Accreditation Statement: The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Credit Designation Statement: The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To receive your CME credit certificate,complete the post-test and evaluation, and document the amount of time you spent in the activity. Participants receiving a grade of 70% or higher will receive a CME certificate. There is no fee to participate in this program. This continuing medical education activity is made possible by an educational grant from Genentech BioOncology. Minimum System Requirements: Pentium III, 600 MHz or Equivalent Processor • 512 MB of RAM • Windows XP, Vista, or 7. Or, Mac OS X • 800x600 Monitor Resolution • 16-bit Color • 16 bit Sound Card with Speakers 1. Please turn off all pop-up blockers to ensure access to the educational activity. 2. Click on the "Start program" icon at the bottom of this page. If you are not already registered as a user of this website, this will bring you to the login/registration page where you will be able to register as a new CMEcorner.com member or check existing registration information. When ready, click on the "Continue to Program" icon at the bottom of the screen. 3. The activity will take approximately 60 minutes to complete. 4. After the activity has finished, click on the "Post-test" button. 5. Instructions for completing and submitting the post-test and evaluation are provided on the post-test screen. A credit statement/certificate will be awarded for a score of 70% or better and may be printed immediately after passing the post-test. $0.00 © 2011: All Rights Reserved – The Johns Hopkins University School of Medicine HIPAA STATEMENT CONFIDENTIALITY DISCLAIMER FOR CME CONFERENCE ATTENDEES I certify that I am attending a Johns Hopkins University School of Medicine CME activity for accredited training and/or educational purposes. I understand that while I am attending in this capacity, I may be exposed to "protected health information," as that term is defined and used in Hopkins policies and in the federal HIPAA privacy regulations (the "Privacy Regulations"). Protected health information is information about a person’s health or treatment that identifies the person. I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential. I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality. The contact information is: Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu. “The Office of Continuing Medical Education at the Johns Hopkins University School of Medicine, as provider of this activity, has relayed information with the CME attendees/participants and certifies that the visitor is attending for training, education and/or observation purposes only.” For CME Questions, please contact the CME Office at (410) 955-2959 or e-mail cmenet@jhmi.edu. For CME Certificates, please call (410) 502-9634. Johns Hopkins University School of Medicine Office of Continuing Medical Education Turner 20/720 Rutland Avenue Baltimore, Maryland 21205-2195 Reviewed & Approved by: General Counsel, Johns Hopkins Medicine (4/1/03) Updated 4/09

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