6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)

Cardoso, Fatima; Paluch-Shimon, Shani; Schumacher-Wulf, Eva; Matos, Leonor; Gelmon, Karen; Aapro, Matti S.; Bajpai, Jyoti; Barrios, Carlos H.; Bergh, Jonas; Bergsten-Nordström, Elizabeth; Biganzoli, Laura; Cardoso, Maria João; Carey, Lisa A.; Chavez-MacGregor, Mariana; Chidebe, Runcie; Cortés, Javier; Curigliano, Giuseppe; Dent, Rebecca A.; El Saghir, Nagi S.; Eniu, Alexandru; Fallowfield, Lesley; Francis, Prudence A.; Franco Millan, Sandra X.; Gilchrist, Jenny; Gligorov, Joseph; Gradishar, William J.; Haidinger, Renate; Harbeck, Nadia; Hu, Xichun; Kaur, Ranjit; Kiely, Belinda; Kim, Sung-Bae; Koppikar, Smruti; Kuper-Hommel, Marion J.J.; Lecouvet, Frédéric E.; Mason, Ginny; Mertz, Shirley A.; Mueller, Volkmar; Myerson, Claire; Neciosup, Silvia; Offersen, Birgitte V.; Ohno, Shinji; Pagani, Olivia; Partridge, Ann H.; Penault-Llorca, Frédérique; Prat, Aleix; Rugo, Hope S.; Senkus, Elzbieta; Sledge, George W.; Swain, Sandra M.; Thomssen, Christoph; Vorobiof, Daniel A.; Vuylsteke, Peter; Wiseman, Theresa; Xu, Binghe; Costa, Alberto; Norton, Larry; Winer, Eric P.

doi:10.1016/j.breast.2024.103756

The Breast

2024

DOI: 10.1016/j.breast.2024.103756

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6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)

Fatima Cardoso,

Shani Paluch-Shimon,

Eva Schumacher-Wulf

et al.

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Cited by 18 publications

References 236 publications

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Neutrophil-to-lymphocyte ratio at the end of treatment with CDK4/6 inhibitors is an independent prognostic factor for ER-positive HER2-negative advanced breast cancer

Mitsuyoshi,

Nagahashi,

Kanaoka

et al. 2024

Int J Clin Oncol

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Neutrophil-to-lymphocyte ratio at the end of treatment with CDK4/6 inhibitors is an independent prognostic factor for ER-positive HER2-negative advanced breast cancer

Mitsuyoshi,

Nagahashi,

Kanaoka

et al. 2024

Int J Clin Oncol

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Evolving treatment paradigms after CDK4/6 inhibitors in advanced breast cancer

Gnant,

Balic,

Singer

et al. 2024

memo

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SummaryCyclin-dependent kinase 4/6 inhibitors (CDK4/6i) have transformed the treatment of hormone-receptor-positive, human epidermal growth factor receptor 2‑negative (HR+/HER2−) breast cancer, becoming the standard in first-line endocrine therapy (ET). However, evidence supporting the optimal sequencing post-CDK4/6i progression remains scarce. Liquid biopsy and comprehensive genomic profiling enable tracking of resistance and identifying actionable mutations like ESR1, PIK3CA, AKT or PTEN. So far, post-CDK4/6i therapies include PARP inhibitors, selective estrogen receptor degraders (SERDs), PI3K inhibitors, AKT inhibitors, mTOR inhibitors, chemotherapy, and antibody–drug conjugates (ADCs), while rechallenging CDK4/6 inhibitors also offers additional avenues for molecularly targeted care. This position paper emphasizes the importance of biomarker-driven, individualized treatment strategies, highlights the need for collaborative efforts to ensure broad access to innovative therapies, and provides guidance for clinical practice, paving the way for more precise and personalized care in HR+/HER2− advanced breast cancer.

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Capivasertib and fulvestrant for patients with HR-positive/HER2-negative advanced breast cancer: analysis of the subgroup of patients from Japan in the phase 3 CAPItello-291 trial

Tokunaga,

Iwata,

Itoh

et al. 2024

Breast Cancer

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Background In CAPItello-291, capivasertib–fulvestrant significantly improved progression-free survival (PFS) versus placebo–fulvestrant in the overall and PIK3CA/AKT1/PTEN-altered population with hormone receptor-positive (HR-positive)/human epidermal growth factor receptor 2-negative (HER2-negative) advanced breast cancer. Capivasertib–fulvestrant is approved in Japan for the treatment of patients with one or more tumor biomarker alterations (PIK3CA, AKT1 or PTEN). Here, we report outcomes in the CAPItello-291 subgroup of patients from Japan. Methods Adults with HR-positive/HER2-negative advanced breast cancer whose disease had relapsed or progressed during or after treatment with an aromatase inhibitor, with or without previous cyclin-dependent kinase 4/6 (CDK4/6) inhibitor therapy, were randomly assigned (1:1 ratio) to receive capivasertib or placebo, plus fulvestrant. The dual primary endpoint was investigator-assessed PFS in the overall and PIK3CA/AKT1/PTEN-altered population. Safety was a secondary endpoint. Results Of 708 patients randomized in CAPItello-291, 78 were from Japan (37 randomized to capivasertib–fulvestrant and 41 to placebo–fulvestrant). In the Japan subgroup, PFS numerically favored the capivasertib–fulvestrant arm (hazard ratio 0.73; 95% CI 0.40–1.28), consistent with the analysis of PFS in the global population. Similarly, in the Japan subgroup of patients with PIK3CA/AKT1/PTEN–altered tumors, PFS favored the capivasertib–fulvestrant arm (hazard ratio 0.65; 95% CI 0.29–1.39), consistent with the global population. The adverse event profile of capivasertib–fulvestrant in the Japan subgroup was broadly similar to that in the global population; no new safety concerns were identified. Conclusion Outcomes in the Japan subgroup were broadly similar to those of the global population, supporting the clinical benefit of capivasertib–fulvestrant in treating HR-positive/HER2-negative advanced breast cancer that has progressed on, or after, an endocrine-based regimen.

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6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)

Cited by 18 publications

References 236 publications

Neutrophil-to-lymphocyte ratio at the end of treatment with CDK4/6 inhibitors is an independent prognostic factor for ER-positive HER2-negative advanced breast cancer

Neutrophil-to-lymphocyte ratio at the end of treatment with CDK4/6 inhibitors is an independent prognostic factor for ER-positive HER2-negative advanced breast cancer

Evolving treatment paradigms after CDK4/6 inhibitors in advanced breast cancer

Capivasertib and fulvestrant for patients with HR-positive/HER2-negative advanced breast cancer: analysis of the subgroup of patients from Japan in the phase 3 CAPItello-291 trial

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