ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer

Gennari, Alessandra; André, Fabrice; Barrios, Carlos H.; Cortés, Javier; Azambuja, Evandro de; DeMichele, A.; Dent, Rebecca; Fenlon, Deborah; Gligorov, Joseph; Hurvitz, Sara A.; Im, Seock‐Ah; Krug, David; Kunz, Wolfgang G.; Loi, Sherene; Penault-Llorca, F.; Ricke, Jens; Robson, Mark E.; Rugo, Hope S.; Saura, Cristina; Schmid, Peter; Singer, Christian F.; Španić, Tanja; Tolaney, Sara M.; Turner, Nicholas C.; Curigliano, Giuseppe; Loibl, Sibylle; Paluch‐Shimon, Shani; Harbeck, Nadia

doi:10.1016/j.annonc.2021.09.019

Cited by 556 publications

(598 citation statements)

References 92 publications

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“…In the case of PD-L1 CPS ≥ 10 measured by 22C3, the treatment consists of chemotherapy plus pembrolizumab. Other treatment options, such as olaparib, talazoparib or chemotherapy with carboplatin for BRCA mutated patients, as well as chemotherapy with or without bevacizumab, for PD-L1 negative patients are available in the metastatic TNBC field [ 88 ].…”

Section: Resultsmentioning

confidence: 99%

Programmed Death-Ligand 1 (PD-L1) as Immunotherapy Biomarker in Breast Cancer

Abad

Calabuig

Mena

et al. 2022

Cancers

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Breast cancer constitutes the most common malignant neoplasm in women around the world. Approximately 12% of patients are diagnosed with metastatic stage, and between 5 and 30% of early or locally advanced BC patients will relapse, making it an incurable disease. PD-L1 ligation is an immune inhibitory molecule of the activation of T cells, playing a relevant role in numerous types of malignant tumors, including BC. The objective of the present review is to analyze the role of PD-L1 as a biomarker in the different BC subtypes, adding clinical trials with immune checkpoint inhibitors and their applicable results. Diverse trials using immunotherapy with anti-PD-1/PD-L1 in BC, as well as prospective or retrospective cohort studies about PD-L1 in BC, were included. Despite divergent results in the reviewed studies, PD-L1 seems to be correlated with worse prognosis in the hormone receptor positive subtype. Immune checkpoints inhibitors targeting the PD-1/PD-L1 axis have achieved great response rates in TNBC patients, especially in combination with chemotherapy, making immunotherapy a new treatment option in this scenario. However, the utility of PD-L1 as a predictive biomarker in the rest of BC subtypes remains unclear. In addition, predictive differences have been found in response to immunotherapy depending on the stage of the tumor disease. Therefore, a better understanding of tumor microenvironment, as well as identifying new potential biomarkers or combined index scores, is necessary in order to make a better selection of the subgroups of BC patients who will derive benefit from immune checkpoint inhibitors.

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Section: Resultsmentioning

confidence: 99%

Programmed Death-Ligand 1 (PD-L1) as Immunotherapy Biomarker in Breast Cancer

Abad

Calabuig

Mena

et al. 2022

Cancers

View full text Add to dashboard Cite

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“…Furthermore, the establishment of a state of endocrine resistance and the exhaustion of endocrine-based strategies represent clinical scenarios where chemotherapy is still commonly used. 39 , 40 , 41 …”

Section: Hormone Receptor-positive/her2-negative Breast Cancermentioning

confidence: 99%

“…However, the strategy of switching to maintenance dual HER2-blockade (trastuzumab + pertuzumab) + ET in ER+ patients after completing at least six cycles of upfront concomitant taxane-based chemotherapy is currently enshrined in major international guidelines. 39 , 40 , 75 …”

Section: Her2+ Breast Cancermentioning

confidence: 99%

Major advancements in metastatic breast cancer treatment: when expanding options means prolonging survival

et al. 2022

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“…Current guidelines suggest that for those patients whose systemic disease is not progressive at the time of brain metastasis diagnosis, they should not switch systemic therapy and refer the patients for radiotherapy [ 26 ]. However, as patients with BM are often excluded from registration trials and little data is available regarding local treatments, limited knowledge is available on the interaction between brain radiotherapy and novel drugs.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Radiation and Dual Human Epidermal Growth Factor Receptor 2 Blockade with Trastuzumab and Pertuzumab in the Treatment of Breast Cancer Brain Metastases: A Single Institution Series

Ippolito

Silipigni

Matteucci

et al. 2022

Cancers

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(1) Background: This study aims to assess the safety and efficacy of fractionated SRT (fSRT) and pertuzumab–trastuzumab (PT) in patients with breast cancer brain metastases (BCBM). (2) Methods: Patients with HER2+ BCBM who received FSRT from 2015 to 2019 were identified. Patients were included if they were treated with fSRT within 21 days of receiving PT. All lesions were treated with LINAC-based fSRT to a total dose of 27 Gy delivered in three consecutive fractions. All patients received concurrent PT. Patients were evaluated 4–6 weeks after SRS and subsequently every 2–3 months with MRI re-imaging (3) Results: A total of 49 patients with HER2+ brain metastases were identified. Of these patients, a total of 10 patients with 32 HER2+ BCBM were treated with concurrent SRT and PT and included in the analysis. No local progression was observed. Overall response rate was 68.7%. Only one patient developed asymptomatic radionecrosis. Median time to BM occurrence was 15.6 (range: 1–40.5 months). Distant intracranial failure occurred in 4/10 patients (40.0%). Overall BCBM median survival was 33.9 months (95%CI 24.1–43.6). Mean duration of PT treatment was 27.9 months (range: 10.1–53.7 months). (4) Conclusions: In our single institution experience, fSRT and PT showed to be a safe treatment for patients with BCBM with an adequate overall response rate.

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ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer

Cited by 556 publications

References 92 publications

Programmed Death-Ligand 1 (PD-L1) as Immunotherapy Biomarker in Breast Cancer

Programmed Death-Ligand 1 (PD-L1) as Immunotherapy Biomarker in Breast Cancer

Major advancements in metastatic breast cancer treatment: when expanding options means prolonging survival

Stereotactic Radiation and Dual Human Epidermal Growth Factor Receptor 2 Blockade with Trastuzumab and Pertuzumab in the Treatment of Breast Cancer Brain Metastases: A Single Institution Series

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