Personalizing the treatment of women with early breast cancer: Highlights of the st gallen international expert consensus on the primary therapy of early breast Cancer 2013 Journal Article
| Authors: | Goldhirsch, A.; Winer, E. P.; Coates, A. S.; Gelber, R. D.; Piccart-Gebhart, M.; Thürlimann, B.; Senn, H. J.; Albain, K. S.; André, F.; Bergh, J.; Bonnefoi, H.; Bretel-Morales, D.; Burstein, H.; Cardoso, F.; Castiglione-Gertsch, M.; Colleoni, M.; Costa, A.; Curigliano, G.; Davidson, N. E.; Leo, A. D.; Ejlertsen, B.; Forbes, J. F.; Gnant, M.; Goodwin, P.; Goss, P. E.; Harris, J. R.; Hayes, D. F.; Hudis, C. A.; Ingle, J. N.; Jassem, J.; Jiang, Z.; Karlsson, P.; Loibl, S.; Morrow, M.; Namer, M.; Osborne, C. K.; Partridge, A. H.; Penault-Llorca, F.; Perou, C. M.; Piccart-Gebhart, M. J.; Pritchard, K. I.; Rutgers, E. J. T.; Sedlmayer, F.; Semiglazov, V.; Shao, Z. M.; Smith, I.; Toi, M.; Tutt, A.; Untch, M.; Viale, G.; Watanabe, T.; Wilcken, N.; Wood, W. C. |
| Article Title: | Personalizing the treatment of women with early breast cancer: Highlights of the st gallen international expert consensus on the primary therapy of early breast Cancer 2013 |
| Abstract: | The 13th St Gallen International Breast Cancer Conference (2013) Expert Panel reviewed and endorsed substantial new evidence on aspects of the local and regional therapies for early breast cancer, supporting less extensive surgery to the axilla and shorter durations of radiation therapy. It refined its earlier approach to the classification and management of luminal disease in the absence of amplification or overexpression of the Human Epidermal growth factor Receptor 2 (HER2) oncogene, while retaining essentially unchanged recommendations for the systemic adjuvant therapy of HER2-positive and 'triple-negative' disease. The Panel again accepted that conventional clinico-pathological factors provided a surrogate subtype classification, while noting that in those areas of the world where multi-gene molecular assays are readily available many clinicians prefer to base chemotherapy decisions for patients with luminal disease on these genomic results rather than the surrogate subtype definitions. Several multi-gene molecular assays were recognized as providing accurate and reproducible prognostic information, and in some cases prediction of response to chemotherapy. Cost and availability preclude their application in many environments at the present time. Broad treatment recommendations are presented. Such recommendations do not imply that each Panel member agrees: indeed, among more than 100 questions, only one (trastuzumab duration) commanded 100% agreement. The various recommendations in fact carried differing degrees of support, as reflected in the nuanced wording of the text below and in the votes recorded in supplementary Appendix S1, available at Annals of Oncology online. Detailed decisions on treatment will as always involve clinical consideration of disease extent, host factors, patient preferences and social and economic constraints. © The Author 2013. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. |
| Keywords: | signal transduction; cancer surgery; unclassified drug; gene mutation; histopathology; cancer recurrence; fluorouracil; cancer risk; drug potentiation; treatment duration; unspecified side effect; bone metastasis; drug targeting; cancer adjuvant therapy; cancer radiotherapy; disease free survival; methotrexate; recurrence risk; follow up; lymph node metastasis; antineoplastic agent; cancer incidence; lymph node dissection; ki 67 antigen; biological marker; gene overexpression; heredity; tumor localization; ipilimumab; multiple cycle treatment; breast cancer; tumor volume; protein targeting; epidermal growth factor receptor 2; aromatase inhibitor; estrogen; obesity; bisphosphonic acid derivative; cyclophosphamide; antineoplastic activity; mutational analysis; cancer therapy; cancer mortality; risk assessment; cancer hormone therapy; cost effectiveness analysis; oncogene; tumor suppressor gene; patient care; cancer vaccine; early cancer; family history; mammalian target of rapamycin; cancer immunization; partial mastectomy; patient safety; comorbidity; micrometastasis; tamoxifen; surgery; consensus development; radiation therapy; clinical decision making; platinum derivative; mediterranean diet; physical activity; letrozole; age distribution; pluripotent stem cell; gonadorelin agonist; taxane derivative; cancer classification; premenopause; anthracycline derivative; estrogen receptor; progesterone receptor; adenoid cystic carcinoma; lymphocytic infiltration; social aspect; trastuzumab; risk reduction; breast metastasis; postmenopause; treatment contraindication; tumor vascularization; drug contraindication; fulvestrant; lifestyle; personalized medicine; drug indication; oncogene neu; patient preference; tumor microenvironment; breast calcification; subtypes; tenascin; early breast cancer; cancer prognosis; st gallen consensus; metronomic drug administration; systemic adjuvant therapies; byl 719; gdc 0032; luminal a disease; luminal b disease; oncogene tp53 |
| Journal Title: | Annals of Oncology |
| Volume: | 24 |
| Issue: | 9 |
| ISSN: | 0923-7534 |
| Publisher: | Oxford University Press |
| Date Published: | 2013-09-01 |
| Start Page: | 2206 |
| End Page: | 2223 |
| Language: | English |
| DOI: | 10.1093/annonc/mdt303 |
| PROVIDER: | scopus |
| PMCID: | PMC3755334 |
| PUBMED: | 23917950 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 October 2013" - "Art. No.: mdt303" - "CODEN: ANONE" - "Source: Scopus" |
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