ABC3: Experts Create New Consensus Guidelines for Advanced Breast Cancer Treatment


Key Points

  • Physical side effects (from dyspnea to nausea) are included in the guidelines, as are psychosocial and logistical side effects.
  • Experts called for objective methods for determining cost of care, especially in low-resource countries.
  • Also included in the guidelines is the importance of communication between patient and doctor, and new methods for helping patients living in remote areas to stay connected.

Although advanced breast cancer is incurable, there are some patients who have just a few small metastases who would respond well to systemic treatments such as chemotherapy and hormone therapy. In new guidelines agreed on by participants at the Advanced Breast Cancer Third International Consensus Conference in Lisbon, Portugal, on November 7, experts said these patients could achieve complete remission from their disease and long survival if given the most appropriate treatments.

Side Effects of Treatment

In the new consensus guidelines, the experts point out that as survival is improving in many patients with advanced breast cancer, consideration of a number of issues that arise for these people should be part of their routine care. These issues include: changing and adapting treatment strategies depending on the status of the disease; systematic monitoring for and alleviating treatment side effects to improve patients’ quality of life; adjusting treatments to suit patients’ priorities and plans for their lives; and incorporating measures into treatment planning that take account of the needs of the patients and their families, jobs, and social requirements.

Information on the management of cancer or treatment-related problems is important, and is addressed thoroughly in the guidelines. These problems include cancer-related fatigue, which can have a severe impact on quality of life; neutropenia; noninfectious pneumonitis; mucositis and stomatitis; dyspnea; and nausea and vomiting.

Remote Communication

In a world in which the means of communication are changing all the time, the new consensus guidelines highlight the importance of harnessing technology to improve cancer treatment, particularly for patients living in remote areas and in developing countries.

“Telemedicine oncology is an important option to consider when geographic distance is a problem, provided that connectivity problems can be overcome,” said Fatima Cardoso, MD, Director of the Breast Unit of the Champalimaud Cancer Centre in Lisbon, Portugal.

Cost of Care

As the cost of new, cutting-edge drugs and other treatments for advanced breast cancer continues to rise, the experts also highlighted the problem of their affordability, and stressed the need to use objective measures to evaluate the effectiveness of therapies.

“We strongly recommend the use of objective methods to evaluate the real magnitude of benefit provided by a new treatment in order to help prioritize funding, particularly in countries with limited resources,” said Eric Winer, MD, Director of Breast Oncology at Dana-Farber Cancer Institute and Co-Chair of the conference. “However, doctors should be guided at all times by patient well-being, length of life, and preferences, and should reach balanced decisions in all cases.”

Patient Input

The consensus guidelines make a number of new or modified recommendations on the treatment and management of all types of advanced breast cancer. The conference was attended by a large number of patients who were involved in the discussions and decision-making processes.

CJ” (Dian) Corneliussen-James, Cofounder and President of METAvivor, who has been living with advanced breast cancer for 9 years, said, “These guidelines are critical, especially for patients living in parts of the world where there are no specialist oncology centers. They allow the doctors in these regions to know what some of the world’s leading oncologists are recommending, thereby optimizing the care of their patients.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.