Review of concepts in therapeutic decision-making in HER2-negative luminal metastatic breast cancer

Clin Transl Oncol. 2020 Aug;22(8):1364-1377. doi: 10.1007/s12094-019-02269-7. Epub 2020 Feb 12.

Abstract

Purpose: Hormone receptor (HR)-positive, Human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) requires a therapeutic approach that takes into account multiple factors, with treatment being based on anti-estrogen hormone therapy (HT). As consensus documents are valuable tools that assist in the decision-making process for establishing clinical strategies and optimize the delivery of health services, this consensus document has been created with the aim of developing recommendations on cretiera for hormone sensitivity and resistance in HER2-negative luminal MBC and facilitating clinical decision-making.

Methods: This consensus document was generated using a modification of the RAND/UCLA methodology, which included the definition of the project and identification of issues of interest, a non-exhaustive systematic review of the literature, an analysis and synthesis of the scientific evidence, preparation of recommendations, and external evaluation with a panel of 64 medical oncologists specializing in breast cancer.

Results: A Spanish panel of experts reached consensus on 32 of the 32 recommendations/conclusions presented in the first round and were accepted with an approval rate of 100% about definition of metastatic disease not susceptible to local curative treatment, definition of hormone sensitivity and hormone resistance in metastatic luminal disease and therapeutic decision-making.

Conclusion: We have developed a consensus document with recommendations on the treatment of patients with HER2-negative luminal MBC that will help to improve therapeutic benefits.

Keywords: Consensus; Hormonal receptor; Hormonal resistance; Hormonal therapy; Luminal; Metastatic breast cancer.

Publication types

  • Systematic Review

MeSH terms

  • Aged
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Biomarkers, Tumor / blood
  • Biopsy
  • Breast / pathology
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Clinical Decision-Making*
  • Consensus*
  • Drug Resistance, Neoplasm
  • Female
  • Gene Expression
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen / analysis
  • Menopause / metabolism
  • Middle Aged
  • Molecular Targeted Therapy
  • Neoplasm Recurrence, Local / metabolism
  • Neoplasms, Hormone-Dependent / diagnosis
  • Ovary / drug effects
  • Practice Guidelines as Topic
  • Receptor, ErbB-2*
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism

Substances

  • Antineoplastic Agents, Hormonal
  • Biomarkers, Tumor
  • Ki-67 Antigen
  • Receptors, Estrogen
  • Receptors, Progesterone
  • ERBB2 protein, human
  • Receptor, ErbB-2