Proceedings

Progress in the Management of Small Cell Carcinoma of the Lung:
Standards of Care and Clinical Guidelines
Jeffrey Crawford, MD
Professor of Medicine
Duke University Medical Center
Director of Clinical Research
Duke Comprehensive Cancer Center
Durham, North Carolina

Extending Survival in SCLC with Irinotecan:
Building on the Japanese Experience
Alan B. Sandler, MD
Associate Professor of Medicine
Vanderbilt University School of Medicine
Hematology/Oncology
Nashville, Tennessee

Combined Modality Therapy for Limited Stage Small Cell Lung Cancer
Hak Choy, MD
Professor, Vice Chairman
Clinical Director
Department of Radiation Oncology
Vanderbilt University School of Medicine
Nashville, Tennessee

Irinotecan Combination Chemotherapy Regimens for SCLC:
Beyond Platinum-Based Therapy
John R. Murren, MD
Associate Professor of Medicine
Yale University School of Medicine
New Haven, Connecticut

Molecularly Targeted Therapies and the Future of Managing SCLC
Paul A. Bunn, Jr., MD
Grohne/Stapp Director and Professor
University of Colorado Cancer Center
Denver, Colorado

Program Description

Small cell lung cancer (SCLC) is characterized both by its aggressive disease course in the absence of treatment and by its high level of sensitivity to chemotherapy and radiotherapy. Yet, intensive clinical research over the past decade has resulted in minimal improvements in median and overall survival. The therapeutic potential of molecularly targeted therapy remains to be evaluated. Recent results, however, have identified newer, active chemotherapy regimens, which appear to offer improved outcomes in SCLC.

The Japanese Clinical Oncology Group reported results of a phase III trial of irinotecan/cisplatin, demonstrating a survival benefit in extensive disease. Ongoing confirmatory trials in the US and evaluations of novel combination regimens continue to explore the role of irinotecan in this malignancy. This program will review current treatment standards in SCLC and consider the controversies surrounding standard care and emerging treatment options. The program will be particularly useful to oncology professionals and clinicians treating patients with SCLC. There is no prerequisite for participation.

Program Objectives

Upon completion of this program, participants should be able to:

• Review the current standard of care and clinical guidelines for the treatment of SCLC.

• Evaluate results of irinotecan-based chemotherapy in SCLC, including the survival benefit demonstrated in the Japanese experience, and discuss ongoing confirmatory trials in the US.

• Explore the potential role of irinotecan in limited-disease SCLC, and discuss ongoing trials in this setting.

• Review recent results and discuss ongoing trials with newer combination chemotherapy regimens in SCLC.

• Describe the biology of SCLC.

• Examine the role of molecular therapies in the management of this malignancy.

Faculty Disclosure

Disclosure of Significant Relationships With Relevant Commercial Companies/Organizations

Having financial interest or affiliation with a corporate organization does not prevent an author from participating in a CME activity, but the relationship must be made known in accordance with the Standards of the Accreditation Council for Continuing Medical Education. Each author completed disclosure information forms for this program. Disclosures are described below.

Paul A. Bunn, Jr., MD

Research Support: Pharmacia Corporation

Consultant: Bristol-Myers Squibb Company, Aventis Pharmaceuticals, Eli Lilly and Company, Amgen, Inc., Pharmacia Corporation, AstraZeneca Pharmaceuticals, Genentech Inc., Immunex Corporation, Allos Therapeutics, Inc.

Speaker/Speaker’s Bureau: Bristol-Myers Squibb Company, Aventis Pharmaceuticals, Eli Lilly and Company, Amgen, Inc., Pharmacia Corporation, AstraZeneca Pharmaceuticals, Genentech Inc., Immunex Corporation, Allos Therapeutics, Inc.

Off-label uses will be discussed for SU 6668, SU 5416, Anti VEGF, ISIS 3521, R 5777, Sch 66366, CU 201.

Hak Choy, MD

Research Support: Pharmacia Corporation, Bristol-Myers Squibb Company, Allos Therapeutics, Inc., Supergen, Inc.

Speaker/Speaker’s Bureau: Bristol-Myers Squibb Company, Aventis Pharmaceuticals, Eli Lilly and Company, Pharmacia Corporation

Off-label uses will be discussed for paclitaxel and irinotecan with radiation therapy.

Jeffrey Crawford, MD

Research/Grant Support: Abgenix Inc., Amgen, Inc., AstraZeneca Pharmaceuticals, Aventis Pharmaceuticals, Bristol-Myers Squibb Company, GlaxoSmithKline, ImClone, Inc., Immunex Corporation, Eli Lilly and Company, Ortho Biotech, Inc.

Consultant: Amgen, Inc.

Speaker/Speaker’s Bureau/Advisory Board: Amgen, Inc., Aventis Pharmaceuticals, Bristol-Myers Squibb Company, GlaxoSmithKline, Eli Lilly and Company, Ortho Biotech, Inc.

Off-label uses will be discussed for cisplatin and carboplatin for small cell lung cancer.

John R. Murren, MD

Research/Grant Support: Battelle, Bristol-Myers Squibb Company, ImClone, Inc., Novartis Pharmaceuticals Corporation, Ortho Biotech, Inc., Pharmacia Corporation, GlaxoSmithKline, Vion Pharmaceuticals, Inc.

Consultant: Battelle, Pharmacia Corporation, Novartis Pharmaceuticals Corporation, Supergen, Inc.

Speaker/Speaker’s Bureau/Advisory Board: Pharmacia Corporation, Rhône-Poulenc Rorer Pharmaceuticals, Inc., GlaxoSmithKline

Off-label uses will be discussed for irinotecan.

Alan B. Sandler, MD

Research Support: AstraZeneca Pharmaceuticals, Genentech Inc., Eli Lilly and Company, Bristol-Myers Squibb Oncology, Aventis Pharmaceuticals, Gilead Sciences, Inc., Tularik Inc., Pharmacia Corporation

Consultant: AstraZeneca Pharmaceuticals, Genentech Inc., Aventis Pharmaceuticals, Gilead Sciences, Inc., Tularik Inc., Pharmacia Corporation

Speaker/Speaker’s Bureau: AstraZeneca Pharmaceuticals, Pharmacia Corporation, Eli Lilly and Company, Aventis Pharmaceuticals

Off-label uses will be discussed for CPT-11 for small cell lung cancer.

Accreditation

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for CME (ACCME) through the joint sponsorship of Seton Hall University School of Graduate Medical Education, the American Academy of CME^SM (AACME), and Clinical Insights, Inc. Seton Hall University School of Graduate Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

Credit

Seton Hall University School of Graduate Medical Education designates this CME activity for a maximum of 2 hours in Category 1 credit toward the American Medical Association Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

CME Certificate