Journal article
Endocrine Treatment and Targeted Therapy for Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer: ASCO Guideline Update
Journal of clinical oncology, Vol.39(35), pp.3959-3977
12/10/2021
DOI: 10.1200/JCO.21.01392
PMCID: PMC8659999
PMID: 34324367
Abstract
PURPOSE To update recommendations of the ASCO systemic therapy for hormone receptor (HR)-positive metastatic breast cancer (MBC) guideline.
METHODS An Expert Panel conducted a systematic review to identify new, potentially practice-changing data.
RESULTS Fifty-one articles met eligibility criteria and form the evidentiary basis for the recommendations.
RECOMMENDATIONS Alpelisib in combination with endocrine therapy (ET) should be offered to postmenopausal patients, and to male patients, with HR-positive, human epidermal growth factor receptor 2 (HER2)-negative, PIK3CA-mutated, ABC, or MBC following prior endocrine therapy with or without a cyclin-dependent kinase (CDK) 4/6 inhibitor. Clinicians should use next-generation sequencing in tumor tissue or cell-free DNA in plasma to detect PIK3CA mutations. If no mutation is found in cell-free DNA, testing in tumor tissue, if available, should be used as this will detect a small number of additional patients with PIK3CA mutations. There are insufficient data at present to recommend routine testing for ESR1 mutations to guide therapy for HR-positive, HER2-negative MBC. For BRCA1 or BRCA2 mutation carriers with metastatic HER2-negative breast cancer, olaparib or talazoparib should be offered in the 1st-line through 3rd-line setting. A nonsteroidal aromatase inhibitor (AI) and a CDK4/6 inhibitor should be offered to postmenopausal women with treatment-naive HR-positive MBC. Fulvestrant and a CDK4/6 inhibitor should be offered to patients with progressive disease during treatment with AIs (or who develop a recurrence within 1 year of adjuvant AI therapy) with or without one line of prior chemotherapy for metastatic disease, or as first-line therapy. Treatment should be limited to those without prior exposure to CDK4/6 inhibitors in the metastatic setting.
Details
- Title: Subtitle
- Endocrine Treatment and Targeted Therapy for Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer: ASCO Guideline Update
- Creators
- Harold J. Burstein - Dana-Farber Cancer InstituteMark R. Somerfield - American Society of Clinical OncologyDebra L. Barton - University of Michigan–Ann ArborAli Dorris - Breast Cancer Research FoundationLesley J. Fallowfield - University of SussexDharamvir Jain - Houston MethodistStephen R. D. Johnston - Royal Marsden NHS Foundation TrustLarissa A. Korde - Clinical Investigations Branch, CTEP, DCTD, National Cancer Institute, Bethesda, MD.Jennifer K. Litton - The University of Texas MD Anderson Cancer CenterErin R. Macrae - Columbus Oncology and Hematology AssociatesLindsay L. Peterson - Washington University in St. LouisPraveen Vikas - HoldenRachel L. Yung - University of WashingtonHope S. Rugo - University of California, San Francisco
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.39(35), pp.3959-3977
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1200/JCO.21.01392
- PMID
- 34324367
- PMCID
- PMC8659999
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Number of pages
- 22
- Language
- English
- Date published
- 12/10/2021
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359849402771
Metrics
12 Record Views