Miami Cancer Institute Breast Cancer Genetics Update

Miami Cancer Institute’s Breast Cancer Genetics Update provides a comprehensive overview of breast cancer treatment and genomic testing in patients with BRCA1/2 +/- PALB2, HR+/HER2- breast cancer, HER2+ disease, triple-negative breast cancer and populations with ESR1 mutations. 

Deaths per year from breast cancer are declining because of advances in HER2+ disease. The incorporation of genomic assays has allowed us to better tailor our treatment recommendations for patients with HR+/HER2- breast cancer.  A better understanding of molecular mechanisms underlying pathogenesis of HER2+ disease has generated targeted therapy options to combat this poor prognosis. This course provides learners with an overview of the recent advances in available treatment for HR+/HER2- early breast cancer patients and in advanced disease populations with ESR1 mutation. 

This course also addresses current and emerging therapeutic options for triple-negative breast cancer. The role of adjuvant immunotherapy in early-stage disease is discussed, as well as the role of additional therapy in those patients with residual disease. The course assesses the chemotherapy backbone of treatment planning in triple-negative patients. 

This course concludes by delving further into genetic testing. The role of a cancer genetic counselor becomes essential when considering universal testing for the most actionable genes (BRCA1/2 +/- PALB2) and guiding treatment plans when multi-gene panels identify genes of uncertain significance. 

Topics include:

  • Breast Cancer Genomic Testing – Clinical Applications
  • Challenges in HER2+ Breast Cancer
  • Current and Emerging Therapeutic Options for Triple-Negative Breast Cancer: Immunotherapy and Beyond
  • Universal Testing for Breast Cancer Predisposition

Target Audience

Breast Surgeons, General Surgeons, Reconstructive Surgeons, Obstetricians and Gynecologists, Oncologists, Medical Oncologists, Physiatrists, Radiation Oncologists, Psychiatrists, Pathologists, Geneticists, Radiologists, General Practitioners,  Nurses, Advanced Practice Registered Nurses, Physician Assistants/Physician Associates, Patient Navigators, Psychiatrists and all other interested healthcare professionals.

Learning Objectives

  • Incorporate genomic assays to better tailor treatment recommendations for patients with HR+/HER2- breast cancer.
  • Examine the benefits of chemotherapy over ovarian function suppression in premenopausal women.
  • Utilize adjuvant therapies for high-risk patients with HR+/HER2- early breast cancer.
  • Discuss how ESR1 mutation testing is now actionable in advanced disease populations.
  • Define advanced triple-negative breast cancer (TNBC) standard of care treatment vs. early TNBC standard of care and explain investigational agents/regimens. 
  • Recognize molecular mechanisms underlying pathogenesis of HER2+ disease and develop targeted therapy to combat poor prognosis.
  • Explain genetic testing criteria and examine the performance characteristics of testing criteria (sensitivity, specificity, PPV, NPV).
  • Recognize the implications of including moderate penetrance genes in broad genetic testing.

Commercial Supporter

Baptist Health gratefully acknowledges the commercial support provided by AstraZeneca.

Additional information
Bibliography: 
  • Andre, F., Ismaila, N., Allison, K. H., Barlow, W. E., Collyar, D. E., Damodaran, S., ... & Stearns, V. (2022). Biomarkers for adjuvant endocrine and chemotherapy in early-stage breast cancer: ASCO guideline update. Journal of Clinical Oncology, 40(16), 1816-1837.
  • Kalinsky, K. M., Barlow, W. E., & Gralow, J. R. (2021, December). Updated results from a phase 3 randomized clinical trial in participants (pts) with 1-3 positive lymph nodes (LN), hormone receptor-positive (HR+) and HER2-negative (HER2–) breast cancer (BC) with recurrence score (RS)< 25 randomized to endocrine therapy (ET)+/–chemotherapy (CT): SWOG S1007 (RxPONDER). In San Antonio Breast Cancer Symposium (SABCS).
  • Regan, M. M., Walley, B. A., Fleming, G. F., Francis, P. A., Colleoni, M. A., Láng, I., Gómez, H. L., Tondini, C. A., Burstein, H. J., Goetz, M. P., Ciruelos, E. M., Stearns, V., Bonnefoi, H. R., Martino, S., Geyer, C. E., Chini, C., Minisini, A. M., Spazzapan, S., Ruhstaller, T., … Pagani, O. (2022, February 15). Abstract GS2-05: Randomized comparison of adjuvant aromatase inhibitor exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor-positive (HR+) early breast cancer (BC): update of the combined TEXT and SOFT trials . American Association for Cancer Research. 
  • Hu, C., Hart, S. N., Gnanaolivu, R., Huang, H., Lee, K. Y., Na, J., ... & Couch, F. J. (2021). A population-based study of genes previously implicated in breast cancer. New England Journal of Medicine, 384(5), 440-451.
  • Stadler, Z. K., Maio, A., Chakravarty, D., Kemel, Y., Sheehan, M., Salo-Mullen, E., ... & Robson, M. E. (2021). Therapeutic implications of germline testing in patients with advanced cancers. Journal of Clinical Oncology, 39(24), 2698-2709.
  • Tung, N., & Desai, N. (2021). Germline genetic testing for women with breast cancer: shifting the paradigm from whom to test to whom not to test. Journal of Clinical Oncology, 39(31), 3415-3418.
  • Marra, A., Trapani, D., Viale, G., Criscitiello, C., & Curigliano, G. (2020). Practical classification of triple-negative breast cancer: intratumoral heterogeneity, mechanisms of drug resistance, and novel therapies. NPJ breast cancer, 6(1), 54.
  • Cortes, J., Cescon, D. W., Rugo, H. S., Nowecki, Z., Im, S. A., Yusof, M. M., ... & de las Heras Begona, B. (2020). Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (KEYNOTE-355): a randomised, placebo-controlled, double-blind, phase 3 clinical trial. The Lancet, 396(10265), 1817-1828.
  • Tolaney, S. M., Tayob, N., Dang, C., Yardley, D. A., Isakoff, S. J., Valero, V., ... & Krop, I. (2021). Adjuvant trastuzumab emtansine versus paclitaxel in combination with trastuzumab for stage I HER2-positive breast cancer (ATEMPT): a randomized clinical trial. Journal of Clinical Oncology, 39(21), 2375-2385.
Course Summary
Available credit: 
  • 2.25 AMA PRA Category 1 Credit™
  • 2.25 General certificate of attendance
  • 2.00 Nurse Practitioners
  • 2.00 Florida Board of Nursing
Course opens: 
11/01/2023
Course expires: 
10/31/2026
Cost:
$9.95

Anne P. O'Dea, M.D. 
Medical Director 
Breast Cancer Clinical Research Program Services
The University of Kansas Medical Center
Kansas City, Kansas

Reshma Mahtani, D.O.
Chief of Breast Medical Oncology
Miami Cancer Institute
Miami, Florida 

Rita Nanda, M.D.
Director of Breast Oncology Program
Department of Medicine, The University of Chicago 
Chicago, Illinois

Mark Robson, M.D.
Chief of Breast Medicine Service
Memorial Sloan Kettering Cancer Center
New York, New York

Anne O'Dea, M.D., faculty for this educational activity, is a speaker and consultant for Puma Biotechnology, Pfizer Pharmaceutical, AstraZeneca, Daiichi-Sankyo, Gilead Sciences, Seagen Biotechnology and Novartis Pharmaceuticals, and has indicated that the presentation or discussion will not include off-label or unapproved product usage. 

Reshma Mahtani, D.O., co-director and faculty for this educational activity, is a consultant/adviser for Agendia, Amgen, AstraZeneca, Daiichi-Sankyo, Eisai Pharmaceutical, Gilead Sciences, Hologic, Eli Lilly, Merck, Novartis, Pfizer, Sanofi, Seagen and Puma Biotechnology. She has indicated that the presentation or discussion will not include off-label or unapproved product usage. 

Rita Nanda, M.D., faculty for this educational activity, is a researcher for Arvinas Pharmaceutical, Celgene Pharmaceutical, Corcept Therapeutics Pharmaceutical, AstraZeneca, Gilead Sciences, Merck & Co. Pharmaceutical, Seagen Biotechnology, Genentech Biotechnology, ImmunoGen, Roche Holding AG Pharmaceutical, OBI Pharma, OncoSec Medical, Pfizer, Relay Therapeutics, Sun Pharmaceutical Industries, Taiho Pharmaceutical, BeyondSpring Biotech, Fujifilm Pharmaceuticals U.S.A., GE HealthCare, Sanofi Pharmaceutical, Infinity Pharmaceuticals and iTeos Therapeutics. She has indicated that the presentation or discussion will not include off-label or unapproved product usage. 

Mark Robson, M.D., faculty for this educational activity, is a researcher for AstraZeneca, Merck and Pfizer, and an adviser for Artios Pharma Limited, Daiichi-Sankyo, Epic Sciences, Tempus Labs and Zenith Pharma. He has indicated that the presentation or discussion will not include off-label or unapproved product usage. 

John Diaz, M.D., co-director of this educational activity, is a researcher for Merck & Co. and AstraZeneca.

All of the relevant financial relationships listed for these individuals have been mitigated.

Starr Mautner, M.D., co-director of this educational activity, has no relevant financial relationships with ineligible companies* to disclose.

Eric Schroeder, M.D., co-director of this educational activity, has no relevant financial relationships with ineligible companies* to disclose.

Non-faculty contributors and others involved in the planning, development and editing/review of the content have no relevant financial relationships with ineligible companies* to disclose.  

*Ineligible companies – Companies whose primary business is producing, marketing, selling, re-selling or distributing healthcare products used by or on patients.

Disclosure Policy and Disclaimer

Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.
              
Baptist Health South Florida designates this enduring material for a maximum of 2.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Available Credit

  • 2.25 AMA PRA Category 1 Credit™
  • 2.25 General certificate of attendance
  • 2.00 Nurse Practitioners
  • 2.00 Florida Board of Nursing

Price

Cost:
$9.95
Please login or register for a Baptist Health CME account to take this course.

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