Shaheenah Dawood1, Maria Konstantionva2, Rebecca Dent3, Florencia Perazzo4, Sung-Bae Kim5, Cynthia Villarreal-Garza6,7, Sandra Franco8, Ming-Shen Dai9, Sergio Simon10. 1. Dubai Health Care City, Consultant Medical Oncologist, Mediclinic City Hospital - North Wing, Dubai, UAE. shaheenah@post.harvard.edu. 2. Head of the Department of antitumor drug therapy, F. VladimirskIy Moscow Regional Research Clinical Institute (MONIKI), Moscow, Russia. 3. Head, Breast Medical Oncology Team, National Cancer Center Singapore, Singapore, Singapore. 4. Department of Oncology, Centro de Educación Médicae Investigaciones Clínicas (CEMIC), Ciudad de Buenos Aires, Argentina. 5. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea. 6. Centro de Cancer de Mama, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza García, NL, Mexico. 7. Depto. de Investigacion, Instituto Nacional de Cancerologia, Mexico city, Mexico. 8. Head of Oncology, Clínica del Country, Bogotá, Colombia. 9. Department of Hematology/Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan. 10. Centro Paulista de Oncologia (CPO), Sao Paulo, Brazil.
Abstract
PURPOSE: The therapeutic landscape of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (mBC) has evolved considerably with the introduction of newer targeted agents and their combinations with endocrine therapies. In this scenario, optimizing treatment selection and sequencing is daunting for clinicians. The purpose of this review is to provide evidence-based answers to key clinical questions on treatment selection and sequencing for the management of HR + HER2 - mBC. DESIGN: A panel of nine key opinion leaders from Argentina, Brazil, Colombia, Mexico, Moscow, Singapore, South Korea, Taiwan, and UAE convened in October 2018. They reviewed the literature and formulated answers to clinical questions on optimizing the management of HR + HER2 - mBC. RESULTS: Evidence-based answers were formulated for: (1) optimal initial treatment choice; (2) ovarian function suppression, optimal endocrine partner, and role of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors (in premenopausal women); (3) better first-line standard of care than aromatase inhibitors; (4) preferred second-line treatment; (5) treatment of oligometastatic disease; (6) factors influencing first-line single-agent endocrine therapy choice; (7) influence of endocrine resistance on treatment selection; (8) optimal maintenance regimen in visceral crisis; and (9) need for a breast cancer registry for patients with HR + HER2 - mBC. The panel also proposed a treatment-sequencing algorithm for the management of HR + HER2 - mBC. CONCLUSION: The current article will serve as a comprehensive guide for optimizing the management of HR + HER2 - mBC. The proposed breast cancer registry will help identify unmet needs and develop strategic regional policies to help improve access to optimized care for HR + HER2 - mBC.
PURPOSE: The therapeutic landscape of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (mBC) has evolved considerably with the introduction of newer targeted agents and their combinations with endocrine therapies. In this scenario, optimizing treatment selection and sequencing is daunting for clinicians. The purpose of this review is to provide evidence-based answers to key clinical questions on treatment selection and sequencing for the management of HR + HER2 - mBC. DESIGN: A panel of nine key opinion leaders from Argentina, Brazil, Colombia, Mexico, Moscow, Singapore, South Korea, Taiwan, and UAE convened in October 2018. They reviewed the literature and formulated answers to clinical questions on optimizing the management of HR + HER2 - mBC. RESULTS: Evidence-based answers were formulated for: (1) optimal initial treatment choice; (2) ovarian function suppression, optimal endocrine partner, and role of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors (in premenopausal women); (3) better first-line standard of care than aromatase inhibitors; (4) preferred second-line treatment; (5) treatment of oligometastatic disease; (6) factors influencing first-line single-agent endocrine therapy choice; (7) influence of endocrine resistance on treatment selection; (8) optimal maintenance regimen in visceral crisis; and (9) need for a breast cancer registry for patients with HR + HER2 - mBC. The panel also proposed a treatment-sequencing algorithm for the management of HR + HER2 - mBC. CONCLUSION: The current article will serve as a comprehensive guide for optimizing the management of HR + HER2 - mBC. The proposed breast cancer registry will help identify unmet needs and develop strategic regional policies to help improve access to optimized care for HR + HER2 - mBC.
Authors: F Cardoso; S Kyriakides; S Ohno; F Penault-Llorca; P Poortmans; I T Rubio; S Zackrisson; E Senkus Journal: Ann Oncol Date: 2019-08-01 Impact factor: 32.976
Authors: F Cardoso; E Senkus; A Costa; E Papadopoulos; M Aapro; F André; N Harbeck; B Aguilar Lopez; C H Barrios; J Bergh; L Biganzoli; C B Boers-Doets; M J Cardoso; L A Carey; J Cortés; G Curigliano; V Diéras; N S El Saghir; A Eniu; L Fallowfield; P A Francis; K Gelmon; S R D Johnston; B Kaufman; S Koppikar; I E Krop; M Mayer; G Nakigudde; B V Offersen; S Ohno; O Pagani; S Paluch-Shimon; F Penault-Llorca; A Prat; H S Rugo; G W Sledge; D Spence; C Thomssen; D A Vorobiof; B Xu; L Norton; E P Winer Journal: Ann Oncol Date: 2018-08-01 Impact factor: 32.976
Authors: H B Muss; L D Case; J N Atkins; J D Bearden; M R Cooper; J M Cruz; D V Jackson; M A O'Rourke; M D Pavy; B L Powell Journal: J Clin Oncol Date: 1994-08 Impact factor: 44.544
Authors: Freddie Bray; Jacques Ferlay; Isabelle Soerjomataram; Rebecca L Siegel; Lindsey A Torre; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-09-12 Impact factor: 508.702