Chemotherapy and Targeted Therapy for Patients with Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer That is Either Endocrine-Pretreated or Hormone Receptor-Negative: ASCO Guideline Update

Beverly Moy, R. Bryan Rumble, Steven E. Come, Nancy E. Davidson, Angelo Di Leo, Julie R. Gralow, Gabriel N. Hortobagyi, Douglas Yee, Ian E. Smith, Mariana Chavez-MacGregor, Rita Nanda, Heather L. McArthur, Laura Spring, Katherine E. Reeder-Hayes, Kathryn J. Ruddy, Paul S. Unger, Shaveta Vinayak, William J. Irvin, Avan Armaghani, Michael A. DansoNatalie Dickson, Sophie S. Turner, Cheryl L. Perkins, Lisa A. Carey

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

PURPOSE This guideline updates recommendations of the ASCO guideline on chemotherapy and targeted therapy for patients with human epidermal growth factor receptor 2-negative metastatic breast cancer (MBC) that is either endocrine-pretreated or hormone receptor (HR)-negative. METHODS An Expert Panel conducted a targeted systematic literature review guided by a signals approach to identify new, potentially practice-changing data that might translate into revised guideline recommendations. RESULTS The Expert Panel reviewed abstracts from the literature review and retained 14 articles. RECOMMENDATIONS Patients with triple-negative, programmed cell death ligand-1-positive MBC may be offered the addition of immune checkpoint inhibitor to chemotherapy as first-line therapy. Patients with triple-negative, programmed cell death ligand-1-negative MBC should be offered single-agent chemotherapy rather than combination chemotherapy as first-line treatment, although combination regimens may be offered for lifethreatening disease. Patients with triple-negative MBC who have received at least two prior therapies for MBC should be offered treatment with sacituzumab govitecan. Patients with triple-negative MBC with germline BRCA mutations previously treated with chemotherapy may be offered a poly (ADP-ribose) polymerase inhibitor rather than chemotherapy. Patients with HR-positive human epidermal growth factor receptor 2-negative MBC for whom chemotherapy is being considered should be offered single-agent chemotherapy rather than combination chemotherapy, although combination regimens may be offered for highly symptomatic or life-threatening disease. Patients with HR-positive MBC with disease progression on an endocrine agent may be offered treatment with either endocrine therapy with or without targeted therapy or single-agent chemotherapy. Patients with HR-positive MBC with germline BRCA mutations no longer benefiting from endocrine therapy may be offered a poly (ADP-ribose) polymerase inhibitor rather than chemotherapy. No recommendation regarding when a patient's care should be transitioned to hospice or best supportive care alone is possible.

Original languageEnglish (US)
Pages (from-to)3938-3958
Number of pages21
JournalJournal of Clinical Oncology
Volume39
Issue number35
DOIs
StatePublished - Dec 10 2021
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Chemotherapy and Targeted Therapy for Patients with Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer That is Either Endocrine-Pretreated or Hormone Receptor-Negative: ASCO Guideline Update'. Together they form a unique fingerprint.

Cite this