Recorded Presentation from the NCCN Oncology Case Manager and Medical Director Program: Updates in the Treatment of HER-2 Positive Breast Cancer

The American Society of Clinical Oncology/College of American Pathologists recently updated criteria for HER2-overexpression.  These criteria are also endorsed by the NCCN panel.  It is important for clinicians to be aware of the updated criteria to appropriately select patients who are sensitive to HER2-targeted agents.

Strategies for adjuvant therapy continue to evolve and available options continue to expand. Recent data shows that ado-trastuzumab emtansine (T-DM1) reduces the risk of recurrence of invasive breast cancer in those with residual HER2-positive disease after preoperative therapy. In the metastatic setting too, multiple choices exist for first- and second-line HER2-targeted therapy. 

It is important for clinicians to stay up-to-date with evolving treatment strategies; to understand how to choose optimal treatment based on patient preference, toxicities, and drug availability; and to effectively evaluate patients during therapies and manage any therapy-related adverse effects.

Target Audience

This activity is designed to meet the educational needs of case managers, medical directors, physicians, nurses, pharmacists, and other health care professionals who manage the care of patients with cancer.  These webinars may be of particular interest to those in care coordination roles and those who interact with, counsel, and refer patients with cancer to appropriate sources of care and/or make coverage decisions in both managed care organizations and clinical settings.

Learning Objectives

Following this activity, participants should be able to:

  • Describe the criteria for selection of appropriate neoadjuvant/adjuvant systemic treatment for patients with early stage HER2-positive breast cancer. 
  • List the currently available therapeutic approaches for treatment of metastatic HER2-positive breast cancer.
  • Outline strategies to evaluate patients during HER2-targeted therapy and describe strategies to manage potential therapy-related adverse effects. 
Additional information

This activity is supported by educational grants from:

  • Celgene Corporation
  • Loxo Oncology, Inc. a wholly owned subsidiary of Eli Lilly and Company
  • Novartis
  • Verastem

This activity is supported by an unrestricted educational grant from Gilead Sciences, Medical Affairs.

Course summary
Available credit: 
  • 1.00 AAPA Category 1 CME credit
  • 1.00 ACPE contact hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.04 ANCC contact hours
  • 1.00 CCM clock hours
  • 1.00 Participation
Course opens: 
Course expires: 

Ingrid A. Mayer, MD, MSCI
Vanderbilt-Ingram Cancer Center

Vandana Abramson, MD
Vanderbilt-Ingram Cancer Center


NCCN Medical Education Disclosure Policy
It is the policy of NCCN that every 12 months, all faculty, moderators, activity planners and all internal planning staff participating in NCCN continuing education activities are expected to disclose any financial relationships with a commercial interest as defined by the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support. In addition, all faculty presentations have been reviewed for adherence to the ACCME’s Standards for Commercial Support (the provider develops activities/educational interventions independent of commercial interests [SCS 1, 2 and 6] by experts on the topics). 

Per the ACCME Standards for Commercial Support, individuals who do not disclose relevant financial relationships will be disqualified from involvement in the CE activity as a content developer, planner, or presenter. A complete list of individuals’ relationships with external entities is available upon request.

NCCN continuing education considers financial relationships to create a “conflict of interest” when an individual has both a financial relationship with a commercial interest and the opportunity to affect CE content about the products or services of a commercial interest with which he/she and/or a spouse or partner has a financial relationship.

NCCN continuing education considers “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. NCCN does not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. 

Faculty Disclaimers  
All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation for the tasks and methods of delivery.

Faculty presentations may include discussion of off-label use. Faculty will disclose that the use in question is not currently approved by the FDA per the product labeling.

Faculty Disclosures
The faculty listed below discloses the following relevant financial relationships:
Ingrid A. Mayer, MD, MSCI
AstraZeneca Pharmaceuticals LP: Consulting Fee; Honoraria
Genentech, Inc.: Grant/Research Support; Consulting Fee; Honoraria
GlaxoSmithKline: Consulting Fee
Immunomedics, Inc.: Consulting Fee
Lilly: Consulting Fee
Novartis Pharmaceuticals Corporation: Grant/Research Support; Consulting Fee; Honoraria
Macrogenics: Consulting Fee
Pfizer Inc.: Grant/Research Support
Seattle Genetics, Inc.: Consulting Fee

Vandana G. Abramson, MD, MTR
Daiichi-Sankyo Co: Scientific Advisor
Genentech, Inc.: Grant/Research Support
Novartis Pharmaceuticals Corporation: Scientific Advisor
Pfizer Inc.: Grant/Research Support

NCCN Staff Disclosures
The NCCN Activity Planning staff listed below discloses no relevant financial relationships:
Melissa Esplen; Mark A. Geisler; Kristina M. Gregory, RN, MSN, OCN; Kristin Kline Hasson; Rose Joyce; Karen Kanefield; Heather Matt; Melanie Moletzsky; Lisa Perfidio, MS; Shannon Ryan, CMP; Sarah Sinclair; Kathy Ann Smith, CHCP

The NCCN Clinical staff listed below discloses no relevant financial relationships:
Rashmi Kumar, PhD

In support of improving patient care, National Comprehensive Cancer Network (NCCN) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

NCCN designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

NCCN designates this educational activity for a maximum of 1.04 contact hours.

NCCN designates this knowledge-based continuing education activity for 1.0 contact hour (0.10 CEUs) of continuing education credit. UAN: JA4008196-0000-19-084-H01-P

Physician Assistants 
NCCN has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credit. Approval is valid until 10/18/2020. PAs should only claim credit commensurate with the extent of their participation.

Case Managers
This program has been pre-approved by The Commission for Case Manager Certification to provide continuing education credit to CCM® board certified case managers. The course is approved for 1.0 CE contact hour. Activity Code: I00039174; Approval #: 190003700

Available Credit

  • 1.00 AAPA Category 1 CME credit
  • 1.00 ACPE contact hours
  • 1.00 AMA PRA Category 1 Credit™
  • 1.04 ANCC contact hours
  • 1.00 CCM clock hours
  • 1.00 Participation


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Required Hardware/software

To complete this activity, users will need:

  • A device with an Internet connection and sound playback capability
    • One of the two latest versions of Google Chrome, Mozilla Firefox, or Safari
    • Internet Explorer is no longer supported
  • Adobe Reader or other PDF reader software for certificate viewing/printing