5:00–7:00 p.m.

Welcome Reception (provided)

7:00–8:30 p.m.

Group Dinner (provided)

      7:00 a.m.

Registration and Breakfast

      8:00 a.m.

Welcome and Opening Remarks

      8:15 a.m.

Keynote Address — Precision Medicine: The Customization of Health Care, Lincoln D. Nadauld, MD, PhD, Intermountain Healthcare

Precision medicine refers to an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person. The goal is to identify populations that are most likely to benefit from a prevention or treatment strategy for a specific disease. Currently, precision medicine is commonly used to predict which patients are most likely to respond to treatment based on the presence of genetic mutations, particularly in the field of cancer and rare diseases.

This presentation will discuss current and future roles of precision medicine in the prevention and management of disease, as well as barriers to the growth of precision medicine.

Learning objectives:

• Describe current and potential future applications of precision medicine in the prevention and management of disease.
• Formulate strategies to promote research in precision medicine and address barriers to its growth.
• Identify challenges and potential downsides of precision medicine.

      9:15 a.m.

Break

      9:30 a.m.

Chronic Obstructive Pulmonary Disease (COPD), Neil R. MacIntyre, MD, Duke University Medical Center

According to the Centers for Disease Control (CDC), more than 15 million people in the United States have a diagnosis of COPD, and an additional 12 million may remain undiagnosed. As the third leading cause of death in the United States, COPD accounts for 120,000 deaths annually. Over the last few years, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has undergone several important changes. In addition to revising the definition of COPD and modifying the ABCD severity grading system, the most recent GOLD guidelines provide recommendations for individualized pharmacotherapy treatment.

This session will introduce the most recent GOLD guideline revisions and recommendations, as well as discuss the latest evidence-based management strategies for COPD, including the importance of tailoring treatment to patient- and disease-specific factors.

Learning objectives:

• Discuss the most recent GOLD guideline revisions regarding the definition and severity grading of COPD.
• Summarize individualized approaches for pharmacologic treatment of COPD based on the updated ABCD severity grading.
• Outline GOLD guideline recommendations for the nonpharmacologic management of COPD.
• Discuss the role of advance care planning and the importance of identifying a medical care proxy for individuals with severe end-stage COPD.

    10:30 a.m.

Successes and Challenges with Chimeric Antigen Receptor (CAR) T-Cell Therapy, Stephen J. Forman, MD, City of Hope

CAR T-cell therapy has the potential to revolutionize cancer treatment. It is expected to expand quickly, with nearly 200 clinical trials ongoing, 50 of which were added in 2016 alone. While the majority of CAR T-cell therapy studies involve B-cell malignancies, this treatment is being investigated in solid tumors as well.

CAR T-cell therapy has been shown to be highly effective against relapsed/refractory (R/R) malignancies; however, serious toxicities present an important treatment challenge. These toxicities, along with the logistical requirements that are needed for CAR T-cell therapy to be adopted in clinical practice, will be reviewed during this session, as well as approved and emerging CAR T-cell therapies.

Learning objectives:

• State the currently available and emerging CAR T-cell therapies for R/R malignancies.
• Describe the serious and common toxicities associated with CAR T-cell therapy and strategies for their management.
• Outline the infrastructure requirements and team competencies required for implementing CAR T-cell therapy in clinical practice and potential barriers against doing so.
• Discuss potential future directions of CAR T-cell therapy.

    11:30 a.m.

Lunch Buffet (provided)

    11:45–12:45

Satellite Symposium (optional; not affiliated with the Medical Director/Physician Leadership Forum)

      1:00 p.m.

Management of the Aging Population in the U.S., Helen Chen, MD, Hebrew Rehabilitation Center/Hebrew SeniorLife, Harvard Medical School

The number of adults over 65 years old in the U.S. is expected to rapidly increase over the next few decades. Elderly individuals are often frail, have high rates of institutionalization, and are at increased risk of death and dependency after hospitalization.

The Comprehensive Geriatric Assessment (CGA) is a multidimensional, multidisciplinary diagnostic process designed to identify medical, psychosocial and functional limitations of frail older persons and develop a coordinated plan to maximize overall health with aging. This presentation will explore the role of the CGA, as well as address how the lack of coordinated care for older adults who often have chronic illness instigates underutilization of available palliative care.

Learning objectives:

• Describe the role of targeted geriatric assessment in formulating effective management plans for seniors in diverse health care settings.
• Review palliative and supportive services for seniors facing serious illness.
• List three social determinants that drive poor outcomes in seniors and identify potential solutions that can be applied to a broad population.

      1:45 p.m.

Advances and Recommendations for Optimal Diabetes Management, Marc-Andre Cornier, MD, University of Colorado School of Medicine

According to the CDC, approximately 30.3 million people in the U.S. have diabetes and 1.3 million new cases are diagnosed every year. The 2018 American Diabetes Association (ADA) guidelines include important updates, such as new recommendations for patients with cardiovascular disease and screening for type 2 diabetes in children and adolescents; however, only half of physicians who treat patients with diabetes routinely adhere to diabetes guidelines.

During this session, the most recent ADA guideline recommendations for diabetes care will be reviewed. The role of weight loss and surgical bariatric interventions in diabetes prevention and management, as well as the use of continuous glucose monitoring (CGM) technology to help automate and streamline diabetes self-management and potentially improve outcomes, will be discussed.

Learning objectives:

• Outline the latest ADA guideline recommendations for the diagnosis and management of diabetes, especially among specific patient populations.
• Explain the importance of weight loss and bariatric surgical interventions in the prevention and treatment of diabetes.
• Discuss the use of new and emerging technological advances and devices for CGM in managing diabetes.

      2:30 p.m.

Dessert Reception and Exhibit Grand Opening

      3:30 p.m.

Big Data: Integrated Cancer Information for Population-Based Research, Robin Yabroff, PhD, MBA, American Cancer Society, Inc.

“Big data” in the field of oncology refers to large, heterogeneous cohorts of patients with cancer whose data has been collected over the course of their disease. These data sets were often originally developed for delivery of care and administrative purposes, not research. In oncology research, clinical trial populations represent less than 3 percent of the cancer population; thus, clinical trial results cannot always be easily translated into real-world practice. Big data has the potential to play a key role in answering questions regarding the efficacy and long-term outcomes of treatments in the cancer population.
This session will promote understanding applications, challenges, and barriers using big data in cancer research and treatment.

Learning objectives:

• Discuss the importance and potential applications of big data in the research of cancer treatments and quality of care in oncology.
• Review the challenges and barriers to data collection and the development of interoperable data systems in oncology research and cancer care.
• Identify potential future applications for big data.

4:15–5:00 p.m.

At-Risk Populations and Evidence-Based Guidelines for Acute Stroke Management, David S. Liebeskind, MD, FAHA, FAAN, FANA,University of California, Los Angeles (UCLA)

Every year 795,000 individuals experience acute stroke, making it the fifth leading cause of death in the U.S. Stroke poses a significant economic burden that is expected to more than double by 2035.

The American Heart Association (AHA) guidelines for the management of acute ischemic stroke were updated in early 2018 to reflect important findings from recent thrombectomy trials. However, evidence-based recommendations for acute stroke care are often suboptimally adopted in health care systems. This session will review the patient populations at highest risk for acute stroke, as well as interventions to improve preventive and acute-stroke care. The most recent AHA guideline recommendations for managing acute stroke will also be presented.

Learning objectives:

• Identify patient groups who are at highest risk for acute stroke and may benefit from preventive management.
• Discuss the latest guideline recommendations and evidence for managing acute stroke.
• Describe strategies to implement interventions to optimize preventive and acute stroke care.

5:00–7:00 p.m.

Networking Reception and Exhibits (provided)