International Conference Updates Guidelines for Advanced Breast Cancer

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Patients with two out of the three most common types of advanced breast cancer now have an average survival time of at least 5 years, according to a panel of experts at the Advanced Breast Cancer Sixth International Consensus Conference (ABC6), which was held virtually this year.

The Advanced Breast Cancer International Consensus Conferences have been held every 2 years for about 10 years. Experts gather to share and discuss the latest research on the disease and to update international guidelines for treatment. The new guidelines from this year’s meeting will be published in early 2022.

Panelists noted the progress that has been made in the past decade, culminating in a median survival time for hormone receptor–positive and HER2-positive advanced breast cancer—which together make up 85% of cases—that has risen from just 1 or 2 years to 5 years.

For triple-negative breast cancer, more work is needed, they acknowledged. Although outcomes for this subtype are still not as good, new drugs for cancer are making a difference. The new guidelines recommend that patients with triple-negative breast cancer have access to sacituzumab govitecan-hziy and anti–PD-L1 agents, especially pembrolizumab.

Goal to Double Survival

A key objective of the Advanced Breast Cancer Conferences and the ABC Global Alliance, delineated in the ABC Global Charter, is to double the survival among patients with advanced breast cancer by 2025. Chair of the ABC6 Conference and of the ABC Global Alliance, Fatima Cardoso, MD, Director of the Breast Unit of the Champalimaud Clinical Center in Lisbon, Portugal, commented, “We have made a major step toward our goal of doubling average survival times for patients because we have now achieved this in two out of three subtypes of advanced breast cancer.”

She added: “This disease is still incurable, but we have come a long way, and this progress makes me feel hopeful. It means that the majority of patients have 2 or 3 extra years of life, with good quality of life as well. Survival has also improved for patients with triple-negative disease, but we need to do more for these patients, especially as it tends to affect younger people who often have young children to care for.”

Evidence-Based Recommendations

Dr. Cardoso noted that research on treating advanced disease is now maturing and being put into clinical practice. This means that recommendations based on expert opinion are increasingly supported by strong evidence. “We’ve worked hard to galvanize the research community around this issue, and we’ve made major progress over the last 10 years. This year, as a result, most of our recommendations for treating ABC are now based on level 1 scientific evidence,” she said. 

The new guidelines also highlight local treatment of oligometastatic disease, which offers the potential for long-term survival; treatment-related cognitive impairment (ie, “onco-brain,” which the guidelines will define and make recommendations for managing); and support for caregivers, especially in terms of workplace protections and flexible hours to accommodate their responsibilities.

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®.