Statement of Need
An estimated 50,000 new cases of squamous cell carcinoma of the head and neck (SCCHN) will be diagnosed in 2009. The aggressiveness of head and neck cancers and their anatomical location pose unique treatment challenges, requiring a highly-trained, multidisciplinary team of specialists to ensure the best patient outcome. Although complete surgical resection of the gross primary tumor may be possible in some instances, surgery often creates significant cosmetic and functional deficits while frequently leaving behind a genetically abnormal field that increases the risk of subsequent primary tumors. More than 60% of patients with SCCHN initially present with advanced locoregional disease. Despite multiple treatment modalities, 50%-60% of patients with advanced locoregional disease experience recurrence within 2 years of treatment and 20%-30% of patients develop distant metastases. Consequently, complex multimodality treatment protocols have evolved to minimize local recurrence and spread of the disease, while attempting to minimize the considerable toxicity and functional deficits associated with treatment. Current research is focused on improvements in the delivery and sequencing of cytotoxic chemotherapy, novel targeted agents, and radiotherapy Targeted agents inhibiting the epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) are also being investigated, and results from clinical trials suggest a role for these agents in combined modality treatment regimens for patients with locally advanced SCCHN. At the end of this activity, participants will be able to discuss recent advances in neoadjuvant chemotherapy and targeted therapy (including EGFR and VEGF inhibition), explain the potential role of biomarkers in predicting response or resistance to targeted therapy, and describe the role of surgery in the multidisciplinary management of patients with SCCHN.

Target Audience
This activity is intended for medical oncologists, surgical oncologists, physician assistants, and other healthcare professionals interested in the treatment of patients with head and neck cancer.

Educational Objectives
Upon completion of this activity, participants will be able to

1. Evaluate results from recent clinical trials investigating neoadjuvant chemotherapy for the treatment of patients with SCCHN.
2. Assess results from recent clinical trials investigating the efficacy of targeted agents, including EGFR inhibitors, for the treatment of patients with SCCHN.
3. Discuss recent data evaluating the potential role of predictors of response or resistance to targeted therapy, including EGFR inhibitors, in patients with SCCHN.
4. Summarize the role of the surgeon in the multidisciplinary management team for patients with SCCHN.

Agenda
Welcome and Introduction, Case Study Presentation and Audience Response System
Defining the Role of Neoadjuvant Chemotherapy in the Combined Modality Treatment of Locally Advanced Head and Neck Cancer
Robert Haddad

Medical Oncologist Perspective
Ezra Cohen

Surgical Oncologist Perspective
Marion E. Couch

Case Study Presentation and Audience Response System
Integrating EGFR Inhibitors Into the Treatment of Locally Advanced Head and Neck Cancers
Robert Haddad

Medical Oncologist Perspective
Robert Haddad

Surgical Oncologist Perspective
Robert L. Ferris

Panel Discussion

Method of Participation
This activity requires that your computer be configured to access the Internet. A high-speed Internet connection may be required to view large files. The webcast will be available on www.thecbce.com.




Method of Participation for iPhone™ or iPod Touch^®
This activity can be accessed using an iPhone™ or iPod Touch^® and will be a featured program on the CBCE CME app, which may be downloaded from the Apple^® App Store.

Accreditation
Physicians: The CBCE™ (The Center for Biomedical Continuing Education) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The CBCE designates this educational activity for a maximum of 1.50 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in this activity.

Physician Assistants: AAPA accepts certificates of participation for educational activities certified for Category 1 credit from AOACCME, Prescribed credit from AAFP, and AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 1.50 hours of Category 1 credit for completing this program.

Webcast Credit Instructions
Successful completion of this activity includes the following:

• Score 70% or above on the posttest.
• Complete the Evaluation and Request for Credit Form.
• Fax the completed posttest and form to the CBCE, (214) 260-0509.

Participants will receive their certificate 4-6 weeks after the CBCE receives their posttest and form.

CBCE CME App Credit Instructions
Successful completion of this activity includes the following:

• Complete the online posttest and score 70% or above.
• Complete the online Evaluation and Request for Credit Form.

Participants will receive their certificates via e-mail 4-6 weeks after submission of the online Evaluation and Request for Credit Form.

Participants of the live activity are not eligible to receive credit for this activity.

Acknowledgement of Commercial Support
The CBCE gratefully acknowledges the educational grant provided by Bristol-Myers Squibb Company/ImClone Systems Incorporated.

Educational Inquiries
For further information, please contact the CBCE, 1707 Market Place Blvd., Suite 370, Irving, TX 75063; Phone: (214) 260-9024; Fax: (214) 260-0509; E-mail: info@thecbce.com.

Disclaimer
The content and views presented in this educational activity are those of the faculty and do not necessarily reflect the opinions or recommendations of the CBCE or Bristol-Myers Squibb Company/ImClone Systems Incorporated. This material has been prepared based on a review of multiple sources of information but is not comprehensive. Participants are advised to critically appraise the information presented, and they are encouraged to consult the available literature on any product or device mentioned in this program.

Disclosure of Unlabeled Uses
This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the US Food and Drug Administration. For additional information about approved uses, including approved indications, contraindications, and warnings, please refer to the prescribing information for each product or consult the latest edition of the Physicians’ Desk Reference.

Disclosure of Financial Relationships With Any Commercial Interest
As a provider accredited by the ACCME, it is the policy of the CBCE to require that everyone who is in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest, and identify and resolve all conflicts of interest prior to the educational activity. The CBCE defines “relevant financial relationships” as any amount occurring within the past 12 months.

Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honorarium, ownership interest (eg, stocks, stock options, or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. The CBCE considers relationships of the person involved in the educational activity to include financial relationships of a spouse or partner.

Faculty who refuse to disclose relevant financial relationships will be disqualified from being a planning committee member, a teacher, or an author, and cannot have control of or responsibility for the development, management, presentation, or evaluation of the educational activity. For an individual with no relevant financial relationship, participants must be informed that no relevant financial relationship exists.

Disclosure of Potential Conflicts of Interest
The CBCE assesses conflicts of interest with its faculty, planners, and managers of CBCE activities. Identified conflicts of interest are thoroughly evaluated for fair balance, scientific objectivity relative to studies utilized in this activity, and patient-care recommendations. The CBCE is committed to providing participants with high-quality, unbiased, and state-of-the-art education.

The following faculty reported real or apparent conflicts of interest, and these conflicts have been resolved through a peer-review process:

Ezra Cohen, MD
Honoraria
Bristol-Myers Squibb Company
sanofi-aventis

Robert L. Ferris, MD, PhD, FACS
Consultant
Merck & Co., Inc.
Grant/Research Support
Amgen Inc.

Robert Haddad, MD
Consultant
Bristol-Myers Squibb Company
Honoraria
sanofi-aventis

The following faculty declared they have no financial relationships that require disclosure:

Marion E. Couch, MD, PhD, FACS


Institutional Disclosure
The CBCE receives educational grants from the pharmaceutical industry and other commercial sources. Companies providing grants to the CBCE include the commercial supporter of this activity as well as the manufacturers of certain drugs and/or devices discussed in this activity.

Staff Disclosure
The CBCE staff have declared they have no financial relationships that require disclosure.