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8-9 March 2013

Torino, Italy

Scientific Agenda

Friday, 8 March, 2013

08:15

Welcome and introduction

Giorgio V. Scagliotti, MD, PhD

Session I: Early detection

Moderators: Pieter E. Postmus, MD, PhD and Giorgio V. Scagliotti, MD, PhD

Early detection of lung cancer is vital to improve lung cancer survival rates. New techniques for identifying lung cancer earlier are showing substantial promise. Currently, low-dose CT is the only early detection modality that has shown to improve survival rates. However, identifying persons at risk for lung cancer by methods that use less radiation is preferable.

08:30

Early detection and radiologic screening

Johan F. Vansteenkiste, MD, PhD

08:50

Early detection and developing pre-clinical biomarkers

John K. Field, PhD, FRCPath

09:10

MicroRNA and lung cancer

Gabriella Sozzi, PhD

09:30

Gender issues in lung cancer

Silvia Novello, MD, PhD

Session II: Surgery

Moderators: Ugo Pastorino, MD, PhD and Pieter E. Postmus, MD, PhD

In NSCLC, the determination of stage is important in terms of therapeutic and prognostic implications. Careful initial diagnostic evaluation to define the location and to determine the extent of primary and metastatic tumor involvement is critical for the appropriate care of patients. The distinction between clinical stage and pathological stage should be considered when evaluating reports of survival outcome. Clinical situations for extended resection and a review of modalities and outcomes for extended resection will be discussed with the advancement in multimodality therapies. In addition, because there exists a substantial risk for recurrence and death even after complete surgical resection, systemic therapy in early stage NSCLC will be discussed.

09:50

Optimizing NSCLC staging: EBUS vs. Mediastinoscopy

Paul E. Van Schil, MD, PhD

10:10

Extended resections for lung cancer: Chest wall and pancoast tumors

Ugo Pastorino, MD, PhD

10:30

Systemic therapy in early stage NSCLC

Christian Manegold, MD

10:50

End morning sessions and Break

11:45

Satellite Symposium begins

Reflections on Progress in Advanced Non Small Cell Lung Cancer

Supported by Eli Lilly (Export) SA.

13:15

Satellite Symposium ends

Session III: Radiotherapy

Moderators: Umberto Ricardi, MD, PhD and Giorgio V. Scagliotti, MD, PhD

Radiation therapy plays a major role in the treatment of patients affected with lung cancer, both in early and locally advanced disease. Local control and survival rates are still poor, even with the best combination of chemotherapy and/or targeted agents. The recent technical advances in radiotherapy have changed the planning and delivery processes, enabling radiation oncologists to modify treatment schedules towards further dose intensification, while opening a new scenario for future clinical studies. Major technical strategies in the field of thoracic radiotherapy for primary lung tumors and their potential in improving clinical outcomes will be discussed.

13:30

Four-dimensional stereotactic radiotherapy for centrally located lung tumors

Joost J. Nuyttens, MD, PhD

13:50

Stereotactic ablative radiation therapy (SABR) in patients with potentially operable stage I NSCLC

Frank J. Lagerwaard, MD, PhD

14:10

How to combine chemotherapy, targeted agents and radiotherapy in locally advanced NSCLC?

Dirk de Ruysscher, MD, PhD

14:30

New concepts and insights regarding the role of radiation therapy in metastatic disease

Umberto Ricardi, MD, PhD

14:50

Interactive Tumor Board: case-based panel discussion

Faculty panel

15:30

Break

Session IV: Pathology

Moderators: Keith M. Kerr, FRCPath and Pieter E. Postmus, MD, PhD

Recent advances in NSCLC therapy mean the relatively simple discrimination between small-cell and ‘non-small-cell’ carcinoma is insufficient to determine the best treatment for individual patients. Safety, efficacy and prescribing requirements mandate more specific subtyping of NSCLC for several new drugs: practice made difficult by the tumor heterogeneity combined with the lack of tissue in most diagnostic samples. Immunohistochemical approaches have emerged as accurate predictors of probable tumor histotype. Molecular characteristics may predict response to both newer molecular targeted agents and traditional cytotoxic agents. Specific mutations in the EGFR gene as predictors of response to EGFR TKIs are the first example of markers which predict response to targeted agents. Actual drug targets or markers of the tumor’s ability to repair cytotoxic drug-induced damage may well also complement NSCLC diagnosis. This extended diagnostic requirement from increasingly limited material provided by minimally invasive biopsy techniques poses major challenges for pathology.

15:50

The challenges for the pathologist in the era of personalized medicine

Elisabeth Brambilla, MD, PhD

16:10

The multidisciplinary classification of adenocarcinoma

Keith M. Kerr, FRCPath

16:30

Neuroendocrine tumors of the lung

Giulio Rossi, MD, PhD

16:50

Case-based panel discussion

17:20

Adjourn

Saturday, 9 March, 2013

08:15

Welcome and introduction

Pieter E. Postmus, MD, PhD

Session V: Oncogenic addiction and lung cancer 1

Moderators: Tony S.K. Mok, MD and Pieter E. Postmus, MD, PhD

NSCLC tumors with certain mutations in EGFR have been termed 'oncogene addicted' to reflect their dependence on EGFR-mediated pro-survival signalling and their high susceptibility to apoptosis induced by EGFR TKIs. The most common mutations (L858R and exon 19 deletions) predict an improved clinical response to first-line oral EGFR TKIs compared with standard platinum-based chemotherapy in patients with advanced NSCLC. Moreover, these mutations are also prognostic of a relatively indolent course of disease, regardless of treatment, as compared with classical NSCLC. Treatment strategies for oncogene-addicted NSCLC are therefore distinct from those for non-oncogene addicted NSCLC, and will depend on the specific genetic mutation present.

08:30

EGFR mutant tumors: Where we are with reversible EGFR TKI

Fabrice Barlesi, MD, PhD

08:50

Advantages and disadvantages of irreversible EGFR-TKI

Martin Reck, MD, PhD

09:10

Mechanisms of resistance to EGFR TKI and treatment strategies

Tony S.K. Mok, MD

09:30

Case-based panel discussion

10:00

Break

Session VI: Oncogenic addiction and lung cancer 2

Moderators: Federico Cappuzzo, MD, PhD and Pieter E. Postmus, MD, PhD

There are now multiple examples of cancers that are addicted to specific tyrosine kinases. These cancers often respond to TKIs. In these oncogene-addicted cancers, treatment with the appropriate TKI invariably leads to decreased signaling along the downstream oncogenic pathways. Unfortunately, oncogene-addicted cancers invariably become resistant to TKI therapy, often within a year. Resistance is associated with re-activation of these downstream signaling pathways. As targeted therapies become a more prominent component of cancer therapy, there is a priority to devise strategies to overcome resistance.

10:20

K-ras and lung cancer

Egbert F. Smit, MD, PhD

10:40

HER-2 and lung cancer

Federico Cappuzzo, MD, PhD

11:00

Treatment of ALK- and ROS-1 translocated NSCLC and mechanisms of resistance

Alice T. Shaw, MD, PhD

11:20

Genomic alterations in squamous cell carcinoma

Peter S. Hammerman, MD, PhD

11:40

End morning sessions

12:15

Lunch and Satellite Symposium begins

Treatment approaches in NSCLC: from the test track to the clinic

Supported by F. Hoffmann-La Roche Ltd

13:45

Satellite Symposium ends

Session VII: Approaches to therapy of metastatic NSCLC

Moderators: Lucio Crinò, MD and Giorgio V. Scagliotti, MD, PhD

Several considerations have evolved in the therapeutic approach to advanced NSCLC. Certainly performance status (PS) remains a critical assessment in the first-line setting. As therapy is not curative, optimizing its benefits (survival, palliation) while minimizing the toxicity and costs associated with treatment remains a challenge. Another important consideration with regard to first-line therapy is the fact that there are approved second- and third-line agents that are known to improve survival and palliate symptoms. The optimal duration of first-line therapy and the timing and selection of subsequent therapies are also important issues in advanced NSCLC.

14:00

Maintenance paradigm in non-squamous NSCLC

Luis Paz-Ares, MD, PhD

14:20

Second-line and beyond

Lucio Crinò, MD

14:40

A new life for immunotherapy in lung cancer?

Giorgio V. Scagliotti, MD, PhD

15:00

Treatment of PS2 patients

Elisabeth Quoix, MD

15:20

Case-based panel discussion

15:45

Adjourn

ALK Testing