Therapies for Breast and Prostate Cancer

Dr. Shannon Puhalla and Dr. Leonard Appleman each present at UPMC department of medicine grand rounds. Dr. Puhalla reviews endocrine therapy in breast cancer, and Dr. Appleman discusses randomized trials of chemotherapy for hormone-naïve metastatic prostate cancer.

Educational objectives:

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

  • Describe data supporting early chemotherapy in metastatic prostate cancer
  • Recognize selection of patients for early chemotherapy for metastatic prostate cancer
  • Recognize risk factors for chemotherapy toxicity
  • Describe the history of endocrine treatment
  • Follow the differences in pre vs post-menopausal breast cancer
  • Recognize recent updates in hormonal therapy

Reading Resources:

  1. Parent-Metabolite Pharmacokinetic Modeling and Pharmacodynamics of Veliparib (ABT-888), a PARP Inhibitor, in Patients With BRCA 1/2-Mutated Cancer or PARP-Sensitive Tumor Types. Niu J, Scheuerell C, Mehrotra S, Karan S, Puhalla S, Kiesel BF, Ji J, Chu E, Gopalakrishnan M, Ivaturi V, Gobburu J, Beumer JH. J Clin Pharmacol. 2017 Apr 7. doi: 10.1002/jcph.892. [Epub ahead of print]
  2. Clinical effects of prior trastuzumab on combination eribulin mesylate plus trastuzumab as first-line treatment for human epidermal growth factor receptor 2 positive locally recurrent or metastatic breast cancer: results from a Phase II, single-arm, multicenter study. Puhalla S, Wilks S, Brufsky AM, O'Shaughnessy J, Schwartzberg LS, Berrak E, Song J, Vahdat L. Breast Cancer (Dove Med Press). 2016 Dec 7;8:231-239. eCollection 2016.
  3. A randomized Phase II study of veliparib with temozolomide or carboplatin/paclitaxel versus placebo with carboplatin/paclitaxel in BRCA1/2 metastatic breast cancer: design and rationale. Isakoff SJ, Puhalla S, Domchek SM, Friedlander M, Kaufman B, Robson M, Telli ML, Diéras V, Han HS, Garber JE, Johnson EF, Maag D, Qin Q, Giranda VL, Shepherd SP. Future Oncol. 2017 Feb;13(4):307-320. doi: 10.2217/fon-2016-0412. Epub 2016 Oct 14.
  4. Molecular Subtypes Improve Prognostic Value of International Metastatic Renal Cell Carcinoma Database Consortium Prognostic Model. de Velasco G, Culhane AC, Fay AP, Hakimi AA, Voss MH, Tannir NM, Tamboli P, Appleman LJ, Bellmunt J, Kimryn Rathmell W, Albiges L, Hsieh JJ, Heng DY, Signoretti S, Choueiri TK. Oncologist. 2017 Mar;22(3):286-292. doi: 10.1634/theoncologist.2016-0078. Epub 2017 Feb 20.
  5. Simultaneous quantitation of abiraterone, enzalutamide, N-desmethyl enzalutamide, and bicalutamide in human plasma by LC-MS/MS. Kim KP, Parise RA, Holleran JL, Lewis LD, Appleman L, van Erp N, Morris MJ, Beumer JH. J Pharm Biomed Anal. 2017 May 10;138:197-205. doi: 10.1016/j.jpba.2017.02.018. Epub 2017 Feb 13.


Dr. Puhala has financial interests with the following entity or entities producing health care goods or services as indicated below:

  • Grant/Research Support: Abbvie, Pfizer, Lilly, Novartis, Incyte, Covance-Bayer, Eisai
  • Consultant: Abbvie, MedImmune, Alldex
  • Other: Board membership - Alldex (DSMB)

Dr. Appleman has financial interests with the following entity or entities producing health care goods or services as indicated below:

  • Grant/Research Support: Astellas BMS Bayer, Exelixis, Medivation, Cougar, Agensys, Pfizer, Roche

All presenters disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.1) continuing education units (CEU) which are equivalent to 1.0 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

ABIM MOC Part 2 Credit

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. 

To receive your ABIM MOC Part 2 credit, you will need to complete the post-test with a pass rate of 100% and provide your date of birth and ABIM number, along with the other required fields.  This information will be shared with the American Board of Internal Medicine using the Accreditation Council for Continuing Medical Education Program and Activity Reporting System.

Release Date: 10/18/2017 | Last Modified On: 10/18/2017 | Expires: 10/19/2020


October 18, 2017


October 19, 2020

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Shannon L. Puhalla, MD

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Assistant professor of medicine, University of Pittsburgh School of Medicine, Medical oncologist and hematologist, UPMC Hillman Cancer Center

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